title: Schizophrenia is a disorder of higher order hierarchical processing.
abstract: Schizophrenia is a mental disorder in which the patient manifests with auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. It is associated with significant social dysfunction. There are many hypotheses regarding schizophrenia. Most of these focus on schizophrenia as a manifestation of abnormalities from genetic [Mulle JG. Genomic structural variation and schizophrenia. Curr Psychiatry Rep 2008;10(2):171-7], viral [Fruntes V, Limosin F. Schizophrenia and viral infection during neurodevelopment: a pathogenesis model? Med Sci Monit 2008;14(6):RA71-7], neurochemical [e.g. dopamine (Lewis DA, Akil M. Cortical dopamine in schizophrenia: strategies for postmortem studies. J Psychiatr Res 1997;31(2):175-95) or interactions between neurotransmitters (Duncan GE, Sheitman BB, Lieberman JA. An integrated view of pathophysiological models of schizophrenia. Brain Res Brain Res Rev 1999;29(2):250-64)] or brain structural [Kotrla KJ, Weinberger DR. Brain imaging in schizophrenia. Annu Rev Med 1995;46:113-22] origins. Most of these hypotheses do not account for how or why these presumed causes lead to the manifestations of schizophrenia. We argue that brain structure and function is compatible with a hierarchical processing structure that forms the basis for perception and thought in healthy humans. We propose that perturbations of the types listed above lead to disruption of higher levels of perception and hierarchical temporal processing by the brain and that this constitutes the core deficit in schizophrenia. We present evidence that this model explains many of the features of schizophrenia and we make a series of predictions about schizophrenia.
authors.affiliation: Department of Psychiatry & Behavioural Sciences, Duke University Medical Center, Box 3950, 4584 South Hospital, White Zone #45, Durham, NC 27710, USA. krish001@mc.duke.edu
authors.forename: Ranga R
authors.initials: RR
authors.lastname: Krishnan
authors.forename: Richard
authors.initials: R
authors.lastname: Keefe
authors.forename: Michael
authors.initials: M
authors.lastname: Kraus
mesh_terms: D001921:Brain / Q000503:physiopathology*; D006801:Humans; D008959:Models, Neurological; D008960:Models, Psychological; D010465:Perception; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology