The neurodevelopmental hypothesis of schizophrenia, revisited

Schizophr Bull. 2009 May;35(3):528-48. doi: 10.1093/schbul/sbn187. Epub 2009 Feb 17.

Abstract

While multiple theories have been put forth regarding the origin of schizophrenia, by far the vast majority of evidence points to the neurodevelopmental model in which developmental insults as early as late first or early second trimester lead to the activation of pathologic neural circuits during adolescence or young adulthood leading to the emergence of positive or negative symptoms. In this report, we examine the evidence from brain pathology (enlargement of the cerebroventricular system, changes in gray and white matters, and abnormal laminar organization), genetics (changes in the normal expression of proteins that are involved in early migration of neurons and glia, cell proliferation, axonal outgrowth, synaptogenesis, and apoptosis), environmental factors (increased frequency of obstetric complications and increased rates of schizophrenic births due to prenatal viral or bacterial infections), and gene-environmental interactions (a disproportionate number of schizophrenia candidate genes are regulated by hypoxia, microdeletions and microduplications, the overrepresentation of pathogen-related genes among schizophrenia candidate genes) in support of the neurodevelopmental model. We relate the neurodevelopmental model to a number of findings about schizophrenia. Finally, we also examine alternate explanations of the origin of schizophrenia including the neurodegenerative model.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Brain / pathology
  • Brain / physiopathology
  • Disease Models, Animal
  • Female
  • Gene Expression / genetics
  • Humans
  • Infant, Newborn
  • Mutation / genetics
  • Nerve Net / pathology
  • Nerve Net / physiopathology
  • Neurodegenerative Diseases / genetics
  • Neurodegenerative Diseases / pathology
  • Neurodegenerative Diseases / physiopathology*
  • Oligonucleotide Array Sequence Analysis
  • Pregnancy
  • Prenatal Exposure Delayed Effects / genetics
  • Prenatal Exposure Delayed Effects / pathology
  • Prenatal Exposure Delayed Effects / physiopathology*
  • Risk Factors
  • Schizophrenia / genetics
  • Schizophrenia / pathology
  • Schizophrenia / physiopathology*
  • Schizophrenic Psychology*
  • Virus Diseases / genetics
  • Virus Diseases / pathology
  • Virus Diseases / physiopathology
  • Young Adult