On localizing schizophrenic neuropathology

Many brain regions and circuits have been implicated in the neuropathology of schizophrenia. Drs. Bogerts and Jones have reviewed the evidence that links the disorder to temporal limbic structures and to frontal-thalamic circuits, respectively. Each article is an important update on what we know about the relevance of these brain regions to schizophrenia. In addition, each article, in summarizing the accumulation of relevant research data, is a testament to the likelihood that these structures play a role in the disease. In light of their compelling arguments, this commentary emphasizes incompleteness in the data and inconsistencies in published findings. The principal weaknesses of the temporal limbic findings are that most have been reported in chronically ill patients and that the only qualitative finding of cytoarchitectural disorganization has not been replicated convincingly. Problems of replication also compromise the interpretation of neuropathological findings in prefrontal cortex and thalamus. Despite the loose ends, I agree with the conclusions of Drs. Bogerts and Jones that brain circuits involving thalamus, prefrontal, and temporolimbic cortices are involved in the basic biology of schizophrenia.