Von der Psychopathophysiologie zur Biomarker-basierten Klassifikation und stratifizierten Therapie schizophrener Störungen

Zusammenfassung

Dieser Artikel gibt eine Übersicht über die Rolle der funktionellen Bildgebung des Gehirns für 1. das Verständnis der Symptome der Schizophrenie und der ihnen zugrundeliegenden Pathophysiologie, 2. die Erforschung der pathogenetisch relevanten genetischen und Umweltfaktoren und 3. aktuelle und zukünftige Entwicklungen einer Biomarker-basierten Klassifikation und individualisierten Therapie schizophrener Störungen. Die Bildgebung endophänotypischer Hirnfunktionsstörungen und das Genomic Imaging sind vielversprechende wissenschaftliche Ansätze, die die Entwicklung funktioneller Hirnbildgebungsmarker für klinisch relevante pathophysiologische Prozesse vorantreiben. Solche Bildgebungsbiomarker werden eine präzisere Differenzialdiagnose zwischen pathophysiologisch und pathogenetisch distinkten Subtypen schizophrener Störungen ermöglichen und eine wichtige Rolle für die Vorhersage des individuellen Ansprechens auf spezifische Therapien und somit für eine individualisierte Therapieauswahl spielen.

Abstract

This article gives an overview of the role of functional neuroimaging for 1. a better understanding of the phenotypic symptoms and their underlying pathophysiology, 2. research into the genetic and environmental factors involved in the pathogenesis, and 3. current and future developments towards a biomarker-based classification and tailored therapy of schizophrenic disorders. In particular, neuroimaging of endophenotypic brain dysfunctions and imaging genetics are promising research approaches as endophenotypes may guide the development of functional neuroimaging biomarkers for clinically relevant pathophysiological processes. These biomarkers may permit a more precise differential diagnosis of pathophysiological and pathogenetic subtypes of the heterogeneous diagnostic category of schizophrenic disorders. Furthermore, they may allow us to predict individual treatment responses to specific therapies and to personalise treatment selection.

Schlüsselwörter

Schizophrenie - Biomarker - Neurofunktionelle Konnektivitäts-MRT - Diagnoseübergreifende Hirnbildgebung - Individualisierte Medizin

Key words

schizophrenia - neuroimaging biomarkers - neurofunctional connectivity MRI - cross-disorder neuroimaging - inividualised medicine

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