Owen Michael J, Sawa Akira, Mortensen Preben B
MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lancet. 2016 Jul 2;388(10039):86-97. doi: 10.1016/S0140-6736(15)01121-6. Epub 2016 Jan 15.
Schizophrenia is a complex, heterogeneous behavioural and cognitive syndrome that seems to originate from disruption of brain development caused by genetic or environmental factors, or both. Dysfunction of dopaminergic neurotransmission contributes to the genesis of psychotic symptoms, but evidence also points to a widespread and variable involvement of other brain areas and circuits. Disturbances of synaptic function might underlie abnormalities of neuronal connectivity that possibly involves interneurons, but the precise nature, location, and timing of these events are uncertain. At present, treatment mainly consists of antipsychotic drugs combined with psychological therapies, social support, and rehabilitation, but a pressing need for more effective treatments and delivery of services exists. Advances in genomics, epidemiology, and neuroscience have led to great progress in understanding the disorder, and the opportunities for further scientific breakthrough are numerous--but so are the challenges.
精神分裂症是一种复杂的、异质性的行为和认知综合征,似乎源于遗传或环境因素或两者共同导致的大脑发育紊乱。多巴胺能神经传递功能障碍促成了精神病性症状的发生,但有证据也表明其他脑区和神经回路广泛且多样地参与其中。突触功能障碍可能是神经元连接异常的基础,这可能涉及中间神经元,但这些事件的确切性质、位置和时间尚不确定。目前,治疗主要包括抗精神病药物联合心理治疗、社会支持和康复,但迫切需要更有效的治疗方法和服务提供。基因组学、流行病学和神经科学的进展在理解该疾病方面取得了巨大进展,进一步科学突破的机会众多——但挑战也同样如此。