Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/27420
Type
ArticleCopyright
Restricted access
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
Metadata
Show full item record
SCHIZOPHRENIA, BRAIN DISEASE AND META-ANALYSES: INTEGRATING THE PIECES AND TESTING FUSAR-POLI'S HYPOTHESIS
Sistema nervoso central
Humanos
Predisposição Genética para Doença
Imagem de ressonância magnética
Central nervous system
Humans
Genetic Predisposition to Disease
Magnetic Resonance Imaging
Affilliation
University of São Paulo. Institute of Psychology. Department of Neuroscience and Behavior. São Paulo, SP, Brazil.
University of São Paulo. Butatan Institute. Department of Bioscience. São Paulo, SP, Brazil.
University of São Paulo. Institute of Chemistry. Department of Biochemistry. São Paulo, SP, Brazil.
University of São Paulo. Butatan Institute. Department of Bioscience. São Paulo, SP, Brazil.
University of São Paulo. Institute of Chemistry. Department of Biochemistry. São Paulo, SP, Brazil.
Abstract
This paper aims to discuss and test the hypothesis raised by Fusar-Poli [Fusar-Poli P. Can neuroimaging prove that schizophrenia is a brain disease? A radical hypothesis. Medical Hypotheses in press, corrected proof] that "on the basis of the available imaging literature there is no consistent evidence to reject the radical and provocative hypothesis that schizophrenia is not a brain disease". To achieve this goal, all meta-analyses on 'fMRI and schizophrenia' published during the current decade and indexed in Pubmed were summarized, as much as some other useful information, e.g., meta-analyses on genetic risk factors. Our main conclusion is that the literature fully supports the hypothesis that schizophrenia is a syndrome (not a disease) associated with brain abnormalities, despite the fact that there is no singular and reductionist pathway from the nosographic entity (schizophrenia) to its causes. This irreducibility is due to the fact that the syndrome has more than one dimension (e.g., cognitive, psychotic and negative) and each of them is related to abnormalities in specific neuronal networks. A psychiatric diagnosis is a statistical procedure; these dimensions are not identically represented in each diagnosticated case and this explains the existence of more than one pattern of brain abnormalities related to schizophrenia. For example, chronification is associated with negativism while the first psychotic episode is not; in that sense, the same person living with schizophrenia may reveal different symptoms and fMRI patterns along the course of his life, and this is precisely what defines schizophrenia since the time when it was called Dementia Praecox (first by pick then by Kraepelin). It is notable that 100% of the collected meta-analyses on 'fMRI and schizophrenia' reveal positive findings. Moreover, all meta-analyses that found positive associations between schizophrenia and genetic risk factors have to do with genes (SNPs) especially activated in neuronal tissue of the central nervous system (CNS), suggesting that, to the extent these polymorphisms are related to schizophrenia's etiology, they are also related to abnormal brain activity.
Keywords in Portuguese
EsquizofreniaSistema nervoso central
Humanos
Predisposição Genética para Doença
Imagem de ressonância magnética
Keywords
SchizophreniaCentral nervous system
Humans
Genetic Predisposition to Disease
Magnetic Resonance Imaging
Share