IMAGING THE BRAIN AS SCHIZOPHRENIA DEVELOPS: DYNAMIC & GENETIC BRAIN MAPS.

Primary psychiatry Pub Date : 2002-01-01
Paul Thompson, Judith L Rapoport, Tyrone D Cannon, Arthur W Toga
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Abstract

Schizophrenia is a chronic, debilitating psychiatric disorder that affects 0.2-2% of the population worldwide. Often striking without warning in the late teens or early twenties, its symptoms include auditory and visual hallucinations, psychotic outbreaks, bizarre or disordered thinking, depression and social withdrawal. To combat the disease, new antipsychotic drugs are emerging; these atypical neuroleptics target dopamine and serotonin pathways in the brain, offering increased therapeutic efficacy with fewer side effects. Despite their moderate success in controlling some patients' symptoms, little is known about the causes of schizophrenia, and what triggers the disease. Its peculiar age of onset raises key questions: What physical changes occur in the brain as a patient develops schizophrenia? Do these deficits spread in the brain, and can they be opposed? How do they relate to psychotic symptoms? As risk for the disease is genetically transmitted, do a patient's relatives exhibit similar brain changes? Recent advances in brain imaging and genetics provide exciting insight on these questions. Neuroimaging can now chart the emergence and progression of deficits in the brain, providing an exceptionally sharp scalpel to dissect the effects of genetic risk, environmental triggers, and susceptibility genes. Visualizing the dynamics of the disease, these techniques also offer new strategies to evaluate drugs that combat the unrelenting symptoms of schizophrenia.

精神分裂症发展过程中的大脑成像:动态和遗传脑图
精神分裂症是一种慢性、使人衰弱的精神疾病,全世界有 0.2-2% 的人患有这种疾病。患者通常在十几岁或二十出头时毫无征兆地发病,症状包括听觉和视觉幻觉、精神病发作、思维怪异或紊乱、抑郁和社交退缩。为了防治这种疾病,新的抗精神病药物不断涌现;这些非典型神经安定药以大脑中的多巴胺和血清素通路为靶点,提高了疗效,减少了副作用。尽管这些药物在控制部分患者症状方面取得了一定的成功,但人们对精神分裂症的病因和诱发因素却知之甚少。其特殊的发病年龄也提出了一些关键问题:精神分裂症患者的大脑发生了哪些生理变化?这些缺陷会在大脑中扩散吗?它们与精神症状有何关系?由于患病风险是通过遗传传递的,患者的亲属是否会表现出类似的脑部变化?脑成像和遗传学的最新进展为这些问题提供了令人兴奋的见解。神经成像技术现在可以描绘大脑缺陷的出现和发展过程,为剖析遗传风险、环境诱因和易感基因的影响提供了一把异常锋利的手术刀。通过对疾病动态的可视化,这些技术还为评估抗击精神分裂症顽固症状的药物提供了新的策略。
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