Maj 2011

Temanummer af Nature om skizofreni

Det højst ansete tidsskrift NATURE bragte i november 2010 både en leder og flere statusartikler med oversigter over centrale patofysiologiske emner, særligt arv-miljø
samspillet og implikationer heraf for vor forståelse af skizofreni. Forfatterne er førende forskere og gode at lære af.

Meyer-Lindenberg fokuserer på studier med brug af billeddannende metoder og inddrager også molekylær genetiske studier, Van Os drøfter nøje miljøfaktorers betydning, mens Insel peger på implikationer af forskningen. Han ser opfattelse af skizofreni som en neuroudviklingsmæssig forstyrrelse som en model, der lover godt for fremtidens muligheder for forebyggelse og behandling. Som det fremhæves i lederen har udforskning af skizofreni vist sig umådelig kompleks, men der er heldigvis håb!

Artiklerne er grundige, men velskrevne, men naturligvis også lidt præget af forfatternes egne opfattelser – og der er med mange referencer. Der er således en glimrende mulighed for at få sin viden om skizofreni ajourført på væsentlige områder.

Nature. 2010 Nov 11;468(7321):194-202.

From maps to mechanisms through neuroimaging of schizophrenia.

Meyer-Lindenberg A.

Source
Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
a.meyer-lindenberg@zi-mannheim.de

Abstract
Functional and structural brain imaging has identified neural and neurotransmitter systems involved in schizophrenia and their link to cognitive and behavioural disturbances such as psychosis. Mapping such abnormalities in patients, however,
cannot fully capture the strong neurodevelopmental component of schizophrenia that pre-dates manifest illness. A recent strategy to address this issue has been to focus on mechanisms of disease risk. Imaging genetics techniques have made it possible to define neural systems that mediate heritable risk linked to candidate and genome-wide-supported common variants, and mechanisms for environmental risk and gene-environment interactions are emerging.
Characterizing the neural risk architecture of schizophrenia provides a translational research strategy for future treatments

http://www.ncbi.nlm.nih.gov/pubmed/21068827

Nature. 2010 Nov 11;468(7321):203-12.
The environment and schizophrenia.
van Os J, Kenis G, Rutten BP.

Source
European Graduate School for Neuroscience, SEARCH, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands. j.vanos@sp.unimaas.nl

Abstract
Psychotic syndromes can be understood as disorders of adaptation to social context. Although heritability is often emphasized, onset is associated with environmental factors such as early life adversity, growing up in an urban environment, minority group position and cannabis use, suggesting that exposure may have an impact on the developing ‘social’ brain during sensitive periods. Therefore heritability, as an index of genetic influence, may be of limited explanatory power unless viewed in the context of interaction with social effects. Longitudinal research is needed to uncover gene-environment interplay that determines how expression of vulnerability in the general population may give rise to more severe psychopathology

http://www.ncbi.nlm.nih.gov/pubmed/21068828

Nature. 2010 Nov 11;468(7321):187-93.
Rethinking schizophrenia.

Insel TR.

Source
National Institute of Mental Health, Bethesda, Maryland 20892, USA. tinsel@mail.nih.gov

Abstract
How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world’s population. After a century of studying schizophrenia, the cause of the disorder
remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This ‘rethinking’ of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.

http://www.ncbi.nlm.nih.gov/pubmed/21068826

Af:
Professor Raben Rosenberg, led. overlæge, dr.med.
Center for Psykiatrisk Forskning (Center for Psychiatric Research )
Århus Universitetshospital Risskov (Aarhus University Hospital Risskov)