神经病理学幻灯片.pptVIP

Schizophrenia What causes schizophrenia? Neuropathology Structural and functional changes Neurochemical alterations Treatments Schizophrenia Emil Kraepelin “Dementia Praecox’ 1896 Blueler “Schizophrenia” Onset: adolescence or young adulthood DSM-IV review: Positive symptoms delusions, hallucinations, disorganized speech or behavior Negative symptoms catatonia, affective flattening, withdrawal, or avolition Social-occupational disturbance 6+ months Associated Features Cognitive Disturbances Memory Sensory filtering Attention Emotion recognition Eye-tracking Interpersonal Dysfunction Subtypes Catatonic Paranoid Disorganized Unlikely to be a related to a single physiopathology Neuropathology Neurodevelopmental hypothesis Neurodegenerative hypothesis Dopamine hypothessis Glutamatergic hypothesis **These are not exclusive What causes schizophrenia? Heritable Shastry, 2002 Environmental factors Epidemiological studies Birth complications Maternal stress Seasonality effect Viral epidemics Latitude effect Rh incompatibility NeuropathologyStructural alterations Behavioral symptoms indicative of brain damage unusual rates of blinking, poor control of eye movements, unusual facial expressions Enlarged ventricles Weinberger Wyatt, 1982; Andreason Ventricular enlargement in monozygotic twin with schizophrenia Hippocampal volume loss and enlarged ventricles NeuropathologyStructural alterations cont Alterations in numerous areas, including frontal lobes, medial temporal lobes, lateral temporal lobes, parietal lobe, basal ganglia, corpus callosum, thalamus and even the cerebellum White matter deficits Evidence of disorganized neurons and failures of migration Altered density and disorganization of neurons found in the white matter below layer VI in the cortex Disorganized pyramidal cells in the hippocampus Altered development of hippocampal pyramidal neurons Neurodevelopmental Hypothesis Home movies from families with schizophrenic child displayed abnorma