Galderisi Silvana, Merlotti Eleonora, Mucci Armida
Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy.
Eur Arch Psychiatry Clin Neurosci. 2015 Oct;265(7):543-58. doi: 10.1007/s00406-015-0590-4. Epub 2015 Mar 24.
Studies investigating neurobiological bases of negative symptoms of schizophrenia failed to provide consistent findings, possibly due to the heterogeneity of this psychopathological construct. We tried to review the findings published to date investigating neurobiological abnormalities after reducing the heterogeneity of the negative symptoms construct. The literature in electronic databases as well as citations and major articles are reviewed with respect to the phenomenology, pathology, genetics and neurobiology of schizophrenia. We searched PubMed with the keywords "negative symptoms," "deficit schizophrenia," "persistent negative symptoms," "neurotransmissions," "neuroimaging" and "genetic." Additional articles were identified by manually checking the reference lists of the relevant publications. Publications in English were considered, and unpublished studies, conference abstracts and poster presentations were not included. Structural and functional imaging studies addressed the issue of neurobiological background of negative symptoms from several perspectives (considering them as a unitary construct, focusing on primary and/or persistent negative symptoms and, more recently, clustering them into factors), but produced discrepant findings. The examined studies provided evidence suggesting that even primary and persistent negative symptoms include different psychopathological constructs, probably reflecting the dysfunction of different neurobiological substrates. Furthermore, they suggest that complex alterations in multiple neurotransmitter systems and genetic variants might influence the expression of negative symptoms in schizophrenia. On the whole, the reviewed findings, representing the distillation of a large body of disparate data, suggest that further deconstruction of negative symptomatology into more elementary components is needed to gain insight into underlying neurobiological mechanisms.
研究精神分裂症阴性症状的神经生物学基础,但未能得出一致的结果,这可能是由于这种精神病理学结构的异质性所致。我们试图在减少阴性症状结构的异质性之后,回顾迄今为止发表的关于神经生物学异常的研究结果。针对精神分裂症的现象学、病理学、遗传学和神经生物学,对电子数据库中的文献以及参考文献和主要文章进行了综述。我们在PubMed上搜索了关键词“阴性症状”“缺陷型精神分裂症”“持续性阴性症状”“神经传递”“神经影像学”和“遗传学”。通过手动查阅相关出版物的参考文献列表,又识别出了其他文章。我们纳入了英文出版物,未纳入未发表的研究、会议摘要和海报展示。结构和功能影像学研究从多个角度探讨了阴性症状的神经生物学背景问题(将其视为一个统一的结构、关注原发性和/或持续性阴性症状,以及最近将它们聚类为不同因素),但得出了不一致的结果。所审查的研究提供的证据表明,即使是原发性和持续性阴性症状也包括不同的精神病理学结构,这可能反映了不同神经生物学底物的功能障碍。此外,这些研究表明,多种神经递质系统和基因变异的复杂改变可能会影响精神分裂症阴性症状的表达。总体而言,所审查的研究结果是大量不同数据的提炼,表明需要进一步将阴性症状学解构为更基本的成分,以便深入了解潜在的神经生物学机制。
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