Mapping The Pathophysiology Of Schizophrenia

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 12/28/2020

Schizophrenia is a long-term mental illness that affects a person’s ability to determine what is real. Less than one percent of the population in the United States are diagnosed with the disease. The symptoms can vary and may come and go during a lifetime.

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The Pathology of Schizophrenia

The pathology of schizophrenia is investigating neurobiological deficits in social cognition to find biomarkers of the disease. By identifying these biomarkers, mental health professionals can use the information to develop treatments. There have been various biomarkers in the brain that have been found to cause social cognition deficits.

Neuroimaging and Pathways In The Brain

Neuroimaging tools like MRIs and CT scans have been used to identify the differences in brain structure and activation linked to social cognitive deficits. In addition, schizophrenia pathophysiology is important in learning about the dysregulation of brain pathways that may be caused by imbalances of cholinergic neurotransmitter systems, GABAergic, glutamatergic, and dopaminergic systems.

The cognitive deficits noticed in schizophrenia have been linked to abnormal gamma oscillations and cholinergic system characteristics and links to serotonin, GABA, dopamine, and glutamate. These neurotransmitters are known to be connected in some way with the immune and inflammatory systems.

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Schizophrenia Pathology OnPolysialic Acid

By using biomarkers for major neurotransmitter systems, researchers could uncover evidence in microRNS dysregulation of the brain and blood in those with schizophrenia. Schizophrenia pathology on polysialic acid was a major influence in learning more about the dopamine, ion channels, and cell adhesion of certain enzymes.

The Physiology of Schizophrenia

The physiology of schizophrenia includes translational psychopathology, like matching psychotic symptoms with brain systems. The language system in the brain is the control system of thoughts and speech. This part of the brain is what may be connected to abnormal thoughts, logic, and speech.

The limbic system is an area that cannot be mapped well because they are the result of complex cognitive processes in more than one area of the brain. For example, in the symptoms of delusions, one may link this to the language system because they are related to thought. However, they are also connected to the limbic system of nerves linked to mood and emotions.

Connecting the Genes and Environmental Interactions

The schizophrenia physiology also includes many environmental and genetic interactions. Although the current treatments most often focus on positive symptoms, those with schizophrenia also have symptoms that affect their occupational and social functioning. Most of the research has been looking into dopamine dysfunctions like nicotinic, serotonin, and glutamate systems. Clinicians are also using these abnormalities as they are linked to issues like inflammation and diabetes.

Mapping the Symptoms in Brain Systems

Psychopathology in schizophrenia involves mapping the areas of the brain that are involved in the symptoms of schizophrenia. Because language and communication skills are adversely affected in schizophrenia, mapping the areas of the brain's areas is an important tool. Using electrophysiological studies, the researchers have found a glitch in the left hemispheric area, linked to verbal tasks.

Using fMRI imaging, the abnormalities in the left temporal regions were related to formal thought disorders, which include speech perception and production and the language system. These scans also showed a correlation with a decrease of gray matter in the inferior frontal lobe with hyperperfusion in the same area. Behavioral alterations have also been linked to linear brain behavior in white matter microstructure.

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Language Mapping and Hallucinations

Language tests such as the Bern Psychopathology Scale (BPS) language score was used to map cerebral blood flow changes in the cerebral language system. Patients with behavioral inhibition of language were found to have a higher fractional value, which suggests a structural specialization of language tracts and increased white matter direction.

Auditory hallucinations are frequent complaints in those with schizophrenia, but they are still being mapped in the brain regions. Several studies have been published that found alterations in the brain's acoustic and language areas in those with schizophrenia. Using an fMRI, the primary auditory cortex and the frontal lobe were found to be a major language building site and understanding.

In one case, in a patient who was hearing a threatening voice, there was an increase of activation in the amygdala. This was later found to be a problem with the connections in the left arcuate fascicle. This is a fiber tract that connects the temporal components of the language system.

Low Brain Chemical Levels May Be Linked to Schizophrenic Language Symptoms

In other brain mapping studies, abnormal activities at the dopamine receptor sites were thought to be associated with many of the symptoms of schizophrenia. The four dopaminergic paths that are the cause are in the nigrostriatal pathways, causing low dopamine levels that lead to the motor symptoms. The results show that imbalanced dopamine levels may cause the negative cognitive issues in schizophrenia.

Another chemical in the brain thought to be connected to schizophrenia is serotonin. According to studies, the development of schizophrenia began as a result of imbalanced serotonin and dopamine. The addition of glutamate activity also enhanced the theory of chemical imbalances being a cause of worsening schizophrenic symptoms.

Risk Factors of Schizophrenia

Although the experts are still unsure of the disease's reasons, there are some risk factors to be aware of. Some of these include:

  • Family history of schizophrenia or other mental illness
  • Genetics
  • Parents under 25 or over 30
  • Chemical imbalance in the brain
  • Brain injury or disease
  • Virus or malnutrition during pregnancy
  • Drug use during teen years
  • Extreme stress during the first five years of life

The Symptoms of Schizophrenia

Knowing the symptoms of schizophrenia is important if you or a loved one may have the disease. If you do not know whether you or your loved one has schizophrenia, there are free online schizophrenia tests you can use. These tests aren’t as accurate as a full evaluation by a psychiatrist, but can be helpful in supporting you in choosing to take the next step of having an evaluation. You can also be alert for these symptoms:

  • Hallucinations such as seeing, hearing, smelling, or feeling things that are not there.
  • Delusions like having unusual beliefs such as being watched through the television or contacted by aliens.
  • Speech dysregulation or inability to speak clearly. This may also include speaking in a made-up language and not understanding others when they speak.
  • Not having any interest in life, friends, or socializing.
  • Speaking in a toneless and flat voice that has no emotion.
  • Inability to dress or bathe due to loss of interest or trouble making decisions.
  • Memory loss, such as forgetting what was just taught or talked about or losing things.
  • Inattention, such as inability to focus or concentrate.

Treating Schizophrenia

Even though schizophrenia is a serious and chronic disorder, treatments can help. Besides antipsychotic drugs, some types of therapy like psychotherapy are very helpful in keeping life on track. Cognitive-behavioral therapy, dialectical behavioral therapy, and interpersonal therapy are three of the most common treatments.

  • Cognitive-Behavioral Therapy (CBT) is a common type of talk therapy in which you are taught how to connect your behaviors, emotions, and thoughts. By learning about your cognitive distortions causing you to think and behave negatively, the therapist can teach you skills to help. This type of therapy typically includes keeping a journal, role-playing, and group therapy.
  • Dialectical Behavioral Therapy (DBT) is similar to CBT, except it encourages you to allow your negative thoughts and feelings to be felt rather than trying to block them. By accepting them, you are more able to face what they are and why they are there. Your therapist will also encourage you to keep a journal.
  • Interpersonal Therapy teaches you relationship skills such as socializing with others, occupational therapy, social cognition, and how to face social deficits. You will also learn how to deal with any hardships or stressors that come up in the future. Support groups and role-playing are two important parts of this therapy.

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Talk to A Professional

It is important to contact a mental health expert if you or a loved one has any signs of schizophrenia. You can also talk to a therapist online using a phone, laptop, or another electronic device without an appointment. You do not even have to leave your house.