PsychRounds: The Psychiatry Podcast Schizophrenia: Pathophysiology and Receptors of Interest
Aug 7, 2024
Dive into the fascinating world of schizophrenia as the hosts unravel its pathophysiology and the pivotal role of dopamine. Discover how genetics intertwine with environmental factors, including childhood adversities. The conversation highlights distinct neurobiological theories, like those around glutamate and serotonin. Key receptors such as muscarinic and GABA are explored for their impact on symptoms and treatment. Lastly, get a glimpse of future possibilities, like gene therapy, that may revolutionize care.
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Dopamine Imbalance in Schizophrenia
- The dopamine hypothesis states schizophrenia involves excess dopamine in mesolimbic and deficient dopamine in mesocortical pathways.
- PET imaging shows striatal dopamine is twice as high in schizophrenia patients compared to controls, supporting this theory.
Structural Brain Changes in Schizophrenia
- Schizophrenia brains show reduced gray matter in key areas and enlarged lateral ventricles indicating brain atrophy.
- There are fewer neurons and abnormal synaptic function, explaining impairments in memory, learning, and cognition.
Genetics of Schizophrenia
- Schizophrenia is 70-80% heritable but is polygenic, involving multiple genes like COMT and DISC-1 affecting dopamine metabolism and neurodevelopment.
- Genetic understanding remains limited, except for rare subtypes like 22q11.2 deletion syndrome.