[Neuropathology of scizophrenia--from a new perspective]

Over 100 years ago, Kreapelin had supposed that the etiology of schizophrenia (dementia praecox) was owing to the brain pathology. Afterwards, the pioneers including Dr. Alois Alzheimer had been pursued the peculiarity of neuropathological findings of this disease. But the neuropathology of schizophrenia remains obscure. While remarkable progress has been made in the neuropathological study of neurodegenerative diseases including Alzheimer's disease, progress in studying the neuropathological entity of schizophrenia has not keep pace; the phrase "schizophrenia is the graveyard of neuropathologists" has been stated in the field. By means of CT or MRI and with advanced functional brain image technology such as PET or SPECT since the 1980's, many studies of the morphological or functional abnormalities in the brains of schizophrenia patients have been reported. These neuroimaging researches have stimulated the neuropathological investigation of the schizophrenic brain again. Not only the classical microscopic observation of neuropathology, but also the measurement and the statistical analysis using computer imaging software or using histological techniques including immunocytochemistry or in situ hybridization etc, has been performed. Based on the neuropathological studies of schizophrenia over the last 20 years, it is clear that schizophrenia is not a pure functional disease without organic factors. Reports of neuropathological abnormalities in the post mortem schizophrenic brain indicated they were found in stated almost all areas of the brain, and especially more reports concerning the temporal lobe and frontal lobe. These observed neuropathological abnormalities are explained rationally by the hypothesis of a neurodevelopmental disorder. In recent genetic studies, several putative candidate genes in this disease were reported, and some of these genes might have the role of neurodevelopment or making neuronal networks. It is important to consider together these findings with morphometric studies in neuropathological observation, neuroimaging studies and genome studies to pursue the etiology of schizophrenia from various perspectives.