Granger B
Service de Psychiatrie d'Adultes, Hôpital Necker, Paris.
Presse Med. 1996 Nov 2;25(33):1595-8.
An understanding of the pathogenesis of schizophrenia as described by the neurodevelopmental theory requires knowledge of the links between potential etiological factors occurring early in the developmental phase and symptom onset which occurs late in adolescence or early adulthood. Synapse pruning, a phenomenon in which a large proportion of the huge quantity of synapses produced during the developmental stage disappear, occurs during this same period and might play a causal role in triggering schizophrenia. On the basis of other cerebral anomalies reported in the literature as well as clinical and epidemiological data currently available on schizophrenia, the most probable hypotheses integrate synapse pruning as part of a wider disturbance of cerebral development in the prefrontal, temporal and limbic regions. These perturbations may occur early in the pre- or perinatal period, or late during adolescence. It cannot be excluded that abnormal synapse pruning alone may be the underlying cause in a subgroup of schizophrenia patients.
要理解神经发育理论所描述的精神分裂症发病机制，需要了解发育早期潜在病因与青春期后期或成年早期出现的症状发作之间的联系。突触修剪是指发育阶段产生的大量突触中有很大一部分消失的现象，它发生在同一时期，可能在引发精神分裂症中起因果作用。根据文献中报道的其他脑异常情况以及目前关于精神分裂症的临床和流行病学数据，最有可能的假说是将突触修剪整合为前额叶、颞叶和边缘系统更广泛的脑发育障碍的一部分。这些扰动可能发生在产前或围产期早期，也可能发生在青春期后期。不能排除仅异常的突触修剪可能是一部分精神分裂症患者的潜在病因。
