TY - JOUR
T1 - Systemic hypotheses for generalized cognitive deficits in schizophrenia
T2 - A new take on an old problem
AU - Dickinson, Dwight
AU - Harvey, Philip D.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2009/5
Y1 - 2009/5
N2 - The schizophrenia research community, including government, industry, and academia, has made development of procognitive treatment strategies a priority. Much current research is directed at dividing broad impairments in cognition into more delineated components that might correspond to relatively specific neural systems and serve as targets for intervention. Sometimes overlooked in this ambitious agenda is the substantial neuropsychological literature that signals a more broadly generalized dysfunction in higher order cognitive functions in this illness. In this article, we argue that a generalized cognitive deficit is at the core of the disorder, is not a methodological artifact, and deserves more focused consideration from cognitive specialists in the field. Further, we weigh evidence that this broad deficit may have systemic biological underpinnings. At the level of the central nervous system, examples of findings that might help to account for broad cognitive impairment include gray and white matter irregularities, poor signal integration by neurons and neural networks, and abnormalities in glutamate and γ-aminobutyric acid neurotransmission. Other, more speculative hypotheses focus on even broader somatic systems, including energy metabolism and inflammatory processes. Treatment implications of systemic conceptualizations of schizophrenia are also considered.
AB - The schizophrenia research community, including government, industry, and academia, has made development of procognitive treatment strategies a priority. Much current research is directed at dividing broad impairments in cognition into more delineated components that might correspond to relatively specific neural systems and serve as targets for intervention. Sometimes overlooked in this ambitious agenda is the substantial neuropsychological literature that signals a more broadly generalized dysfunction in higher order cognitive functions in this illness. In this article, we argue that a generalized cognitive deficit is at the core of the disorder, is not a methodological artifact, and deserves more focused consideration from cognitive specialists in the field. Further, we weigh evidence that this broad deficit may have systemic biological underpinnings. At the level of the central nervous system, examples of findings that might help to account for broad cognitive impairment include gray and white matter irregularities, poor signal integration by neurons and neural networks, and abnormalities in glutamate and γ-aminobutyric acid neurotransmission. Other, more speculative hypotheses focus on even broader somatic systems, including energy metabolism and inflammatory processes. Treatment implications of systemic conceptualizations of schizophrenia are also considered.
KW - Cognition
KW - Energy metabolism
KW - General cognitive deficit
KW - Gray matter
KW - Inflammation
KW - Neuropsychology
KW - Schizophrenia
KW - White matter
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U2 - 10.1093/schbul/sbn097
DO - 10.1093/schbul/sbn097
M3 - Article
C2 - 18689868
AN - SCOPUS:65349113335
VL - 35
SP - 403
EP - 414
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
SN - 0586-7614
IS - 2
ER -