Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, 19129, USA.
Mol Psychiatry. 2022 Jan;27(1):731-743. doi: 10.1038/s41380-021-01196-w. Epub 2021 Jun 23.
The neurobiology of schizophrenia involves multiple facets of pathophysiology, ranging from its genetic basis over changes in neurochemistry and neurophysiology, to the systemic level of neural circuits. Although the precise mechanisms associated with the neuropathophysiology remain elusive, one essential aspect is the aberrant maturation and connectivity of the prefrontal cortex that leads to complex symptoms in various stages of the disease. Here, we focus on how early developmental dysfunction, especially N-methyl-D-aspartate receptor (NMDAR) development and hypofunction, may lead to the dysfunction of both local circuitry within the prefrontal cortex and its long-range connectivity. More specifically, we will focus on an "all roads lead to Rome" hypothesis, i.e., how NMDAR hypofunction during development acts as a convergence point and leads to local gamma-aminobutyric acid (GABA) deficits and input-output dysconnectivity in the prefrontal cortex, which eventually induce cognitive and social deficits. Many outstanding questions and hypothetical mechanisms are listed for future investigations of this intriguing hypothesis that may lead to a better understanding of the aberrant maturation and connectivity associated with the prefrontal cortex.
精神分裂症的神经生物学涉及多种病理生理学方面,包括从遗传学基础到神经化学和神经生理学的变化,再到神经回路的系统水平。尽管与神经病理生理学相关的确切机制仍难以捉摸,但一个重要方面是前额叶皮层的异常成熟和连接,这导致了疾病各个阶段的复杂症状。在这里,我们重点关注早期发育功能障碍,特别是 N-甲基-D-天冬氨酸受体 (NMDAR) 的发育和功能低下,如何导致前额叶皮层内局部回路及其长程连接的功能障碍。更具体地说,我们将重点关注一个“条条大路通罗马”的假说,即发育过程中 NMDAR 功能低下如何作为一个汇聚点,导致前额叶皮层中局部γ-氨基丁酸 (GABA) 不足和输入-输出连接障碍,最终导致认知和社交缺陷。列出了许多悬而未决的问题和假设机制,以供未来对这一引人入胜的假说进行研究,这可能有助于更好地理解与前额叶皮层相关的异常成熟和连接。