Schizofrenia, Plasticità Neuronale e Farmaci Antipsicotici
Year: 2006
Type: article
Abstract: Results Although many theories exist, the pathogenesis and pathophysiology of schizophrenia are not clearly understood. Recent experimental and clinical neurobiological studies have demonstrated that this illness not only involves an altered function of the dopamine systems, but is also associated with modifications of other neurotransmitters such as serotonin, glutamate and GABA. More recently, it has been suggested that alterations in neuronal trophism and changes in brain volume of those areas implicated in the control of emotions, affectivity and cognitive functions play a key role in the pathogenesis of schizophrenia. The possibility that the loss of trophism and the inability of neurons to adapt may contribute towards the psychopathological basis of schizophrenia has recently been widely confirmed by findings of both experimental and clinical studies. These studies largely focused on those brain areas (limbic area, cortex, etc) implicated in the control of positive and negative symptoms. Recent experimental data have demonstrated the presence of altered brain levels of neurotrophic factors in animal models of schizophrenia. The possible association between an altered synthesis of BDNF and vulnerability to schizophrenia has been strongly hypothesized by findings of recent studies carried out by several authors. Moreover, the latter studies have demonstrated a decreased volume of the hippocampus and cortex and altered neuronal function in various brain areas. The neurotrophic hypothesis is supported by the mechanism of action of atypical antipsychotics, drugs capable of improving positive and negative symptoms without inducing serious extrapyramidal effects. These drugs today largely replaced classical neuroleptics, that in the past were the treatment of choice for this severely disabling disease. In clinical practice, the advent of new generation of “atypical” antipsychotic drugs represented a considerable step forward in the treatment of schizophrenia with respect to traditional neuroleptics, providing several new molecules capable of revealing undiscovered neurochemical and molecular mechanisms involved in the physiopathological development of this disease. The ability of these drugs to selectively block specific subpopulations of D2 dopamine and 5HT2 serotoninergic receptors with a considerably higher affinity for the latter, underlines the atypical nature of these molecules and explains the increased efficacy of these drugs on negative and cognitive symptoms and the decreased incidence of extrapyramidal effects.
Author: Giovanni Biggio
Language: Italian
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2108830692