schizophrenia new pathological insights and therapies

schizophrenia new pathological insights and therapies -...

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Unformatted text preview: Schizophrenia: New Pathological Insights and Therapies L. Fredrik Jarskog, 1 Seiya Miyamoto, 2 and Jeffrey A. Lieberman 3 1 Department of Psychiatry, Schizophrenia Research Center, University of North CarolinaChapel Hill, Chapel Hill, North Carolina 27599; email: jarskog@med.unc.edu 2 Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan; email: s2miya@marianna-u.ac.jp 3 Department of Psychiatry, Columbia University, New York, New York 10032; email: JLieberman@pi.cpmc.columbia.edu Annu. Rev. Med. 2007. 58:4961 First published online as a Review in Advance on August 11, 2006 The Annual Review of Medicine is online at http://med.annualreviews.org This articles doi: 10.1146/annurev.med.58.060904.084114 Copyright c 2007 by Annual Reviews. All rights reserved 0066-4219/07/0218-0049$20.00 Key Words neurodevelopment, synapse, progression, dopamine, GABA Abstract The neurodevelopmental hypothesis of schizophrenia posits an in- teraction between multiple susceptibility genes and one or more environmental insults in early life, resulting in altered brain devel- opment and the emergence of psychosis in early adulthood. Based on this framework, it has been argued that most neuropathologi- cal deficits observed in post mortem and neuroimaging studies of schizophrenia represent one or more lesions that originated in early life and remained static thereafter. However, recent longitudinal neuroimaging studies demonstrate a progressive component to the neuropathology of new-onset schizophrenia. This opens the pos- sibility that the functional decline seen in many patients following the onset of illness may be halted or slowed. This review provides an update on developments in research on the neuropathology of schizophrenia and discusses recent advances in antipsychotic treat- ment and the potential impact on long-term outcomes. 49 A n n u . R e v . M e d . 2 7 . 5 8 : 4 9- 6 1 . D o w n l o a d e d f r o m a r j o u r n a l s . a n n u a l r e v i e w s . o r g b y O h i o S t a t e U n i v e r s i t y L i b r a r y o n 5 / 4 / 7 . F o r p e r s o n a l u s e o n l y . DLPFC: dorsolateral prefrontal cortex ACC: anterior cingulate cortex INTRODUCTION Schizophrenia is widely considered a neu- rodevelopmental disorder that stems from in- teractions among genetic and environmen- tal factors. Although the contribution of any single gene appears to be quite small, the combined inuence of multiple susceptibility genes contributes substantially to the risk of developing schizophrenia (1). Epidemiologi- cal studies have also identified a number of environmental factors that confer additional risk, including early life exposure to infection, trauma, and hypoxia (2). Despite the inuence of multiple genetic and environmental factors on brain development, however, the clinical symptoms of psychosis typically remain dor- mant until adolescence or early adulthood....
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This note was uploaded on 07/17/2008 for the course PSYCH 501 taught by Professor Bruno during the Winter '08 term at Ohio State.

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schizophrenia new pathological insights and therapies -...

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