Department of Neurosciences, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
Mol Psychiatry. 2022 May;27(5):2393-2404. doi: 10.1038/s41380-022-01494-x. Epub 2022 Mar 9.
A substantial and diverse body of literature suggests that the pathophysiology of schizophrenia is related to deficits of bioenergetic function. While antipsychotics are an effective therapy for the management of positive psychotic symptoms, they are not efficacious for the complete schizophrenia symptom profile, such as the negative and cognitive symptoms. In this review, we discuss the relationship between dysfunction of various metabolic pathways across different brain regions in relation to schizophrenia. We contend that several bioenergetic subprocesses are affected across the brain and such deficits are a core feature of the illness. We provide an overview of central perturbations of insulin signaling, glycolysis, pentose-phosphate pathway, tricarboxylic acid cycle, and oxidative phosphorylation in schizophrenia. Importantly, we discuss pharmacologic and nonpharmacologic interventions that target these pathways and how such interventions may be exploited to improve the symptoms of schizophrenia.
大量多样的文献表明，精神分裂症的病理生理学与生物能量功能缺陷有关。虽然抗精神病药物是治疗阳性精神病症状的有效方法，但它们对于完整的精神分裂症症状谱，如阴性和认知症状，并不有效。在这篇综述中，我们讨论了不同脑区各种代谢途径功能障碍与精神分裂症的关系。我们认为，大脑中存在多个生物能量子过程受到影响，而这些缺陷是该疾病的核心特征。我们概述了精神分裂症中胰岛素信号、糖酵解、磷酸戊糖途径、三羧酸循环和氧化磷酸化的中枢扰动。重要的是，我们讨论了针对这些途径的药物和非药物干预措施，以及如何利用这些干预措施来改善精神分裂症的症状。
