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精神分裂症与自闭症谱系障碍之间明显的重叠是反映了表面上的相似性还是病因上的共性?

Do Apparent Overlaps between Schizophrenia and Autistic Spectrum Disorders Reflect Superficial Similarities or Etiological Commonalities?

作者信息

Stone William S, Iguchi Lisa

机构信息

Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

出版信息

N Am J Med Sci (Boston). 2011 Jul 25;4(3):124-133. doi: 10.7156/v4i3p124.

Abstract

STUDY BACKGROUND

Schizophrenia and autism are both neurodevelopmental disorders that were once considered to be the same disorder expressed in different developmental periods. Although they were separated diagnostically about 40 years ago, they share several clinical and possibly, etiological features. This paper reviews overlaps in four domains of function to consider the issue of whether these similarities are sporadic and likely to represent superficial similarities, or whether the disorders are more likely to share some features in common. METHODS: Representative areas of function were reviewed and compared for aspects of cognition (nonverbal reasoning, memory and language), social function (orienting/joint attention, eye contact and theory of mind), brain function (structural differences) and genetics. To facilitate comparisons with schizophrenia, a focus on high functioning autism/Asperger's disorder was utilized, particularly in the sections on cognition and social function. RESULTS: Significant similarities (and differences) characterized comparisons in each domain. CONCLUSIONS: Disturbed function in similar clinical (in cognition and social function), neurobiological (brain volumes) and genetic (e.g., involvement of the same genes or chromosomal locations) domains in autism and schizophrenia supports the hypothesis that while they are distinct disorders, they are not entirely unique. Additional studies of similarities and differences between them may thus shed light on common etiological mechanisms and hopefully, facilitate the development of novel treatment targets.

摘要

研究背景

精神分裂症和自闭症均为神经发育障碍,它们曾被认为是在不同发育阶段表现出的同一种障碍。尽管约40年前它们在诊断上被区分开来,但它们具有一些共同的临床特征,甚至可能在病因方面也有相似之处。本文回顾了四个功能领域的重叠情况,以探讨这些相似性是偶然出现且可能仅为表面相似,还是这两种障碍更有可能存在一些共同特征。方法:对认知(非言语推理、记忆和语言)、社会功能(定向/共同注意、眼神交流和心理理论)、脑功能(结构差异)和遗传学等方面的代表性功能区域进行了回顾和比较。为便于与精神分裂症进行比较,重点关注高功能自闭症/阿斯伯格综合征,尤其是在认知和社会功能部分。结果:每个领域的比较都呈现出显著的相似性(和差异)。结论:自闭症和精神分裂症在相似的临床(认知和社会功能)、神经生物学(脑容量)和遗传学(例如,相同基因或染色体位置的参与)领域存在功能紊乱,这支持了以下假设:尽管它们是不同的障碍,但并非完全毫无关联。因此,对它们之间异同的进一步研究可能会揭示共同的病因机制,并有望推动新型治疗靶点的开发。

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