Regional neuropathology in schizophrenia: where are we? Where are we going?
This paper presents a neurologic formulation for the clinical features of the schizophrenic syndrome, and tests it against a systematic, region by region review of available postmortem neuroanatomical and neuropharmacological data. Based on this review a model is proposed that postulates a developmental lesion affecting the midline neurotransmitter-specific ascending projection systems. Due to the facilitatory role these systems play in the development of the brain regions to which they project, such a lesion is one parsimonious, and testable, explanation for virtually all the clinical, laboratory, and pathological findings reported to date in schizophrenia research. A case is made for establishing a global antemortem-postmortem collaboration using a Latin square design; the alternative may be that, as has happened in the past, the best efforts of dilligent researchers around the world may lead to little improvement in our understanding of schizophrenia.
Shapiro
R M
RM
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104.
D001921:Brain / Q000473:pathology; D006801:Humans; D009434:Neural Pathways / Q000473:pathology; D019965:Neurocognitive Disorders / Q000473:pathology* / Q000523:psychology; D018377:Neurotransmitter Agents / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000473:pathology*; D012565:Schizophrenic Psychology
D018377:Neurotransmitter Agents