Zusammenfassung
Schizophrene und affektive Psychosen weisen pathomorphologische Veränderungen mit
frontotemporalem Schwerpunkt auf. Die im präfrontalen Kortex beobachtete Volumenreduktion
bei schizophrenen Patienten ist bei relativ erhöhter Zelldichte auf eine Neuropilreduktion
zurückzuführen. Zusammen mit einer verminderten Expression synaptischer Proteine ist
dies ein Hinweis auf eine gestörte neuronale Konnektivität. Für eine intakte Konnektivität
sind aber auch Interneurone von großer Bedeutung. Bei schizophrenen und affektiven
Psychosen sind GABA-erge Interneurone vermindert. Eine gestörte Verschaltung des glutamatergen,
GABA-ergen und dopaminergen Systems könnten in Kombination mit der reduzierten Zahl
von Interneuronen das Korrelat für ein defizientes neuronales Netzwerk sein, welches
unter exogenen Faktoren psychotische Symptome generiert. Reelin bzw. sein Pathway
stellen Kandidatenmoleküle dar, deren Fehlregulation wesentliche Merkmale des dysfunktionellen
Netzwerkes bei der Schizophrenie erklären.
Abstract
In brains of patients with schizophrenic and affective disorders pathomorphological
changes have been shown focussing in frontal and temporal cortex. The volume reduction
in prefrontal cortex of schizophrenic patients is hypothesized to be based on a reduction
of neuropil. A decrease of synaptic proteins and a decrease of dendritic spines of
pyramidal cells can additionally be the origin of disconnections of neurons. Affection
of the glutamatergic, GABA-ergic and dopaminergic system and reduction of interneurons
could be the correlate of a deficient neuronal network which might be combined with
exogen factors generate psychotic symptoms. Reelin and associated proteins are candidate
molecules. Their dysregulation might explain essential features of the dysfunctional
network of schizophrenia.
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Dr. med. Harald Scherk
Universitätskliniken des Saarlandes, Nervenklinik und Poliklinik - Psychiatrie und
Psychotherapie
66421 Homburg
Email: harald.scherk@uniklinik-saarland.de
