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NTIS 바로가기생물정신의학 = Korean journal of biological psychiatry, v.20 no.4, 2013년, pp.136 - 143
김기원 (용인정신병원 정신건강의학과) , 박경민 (용인정신병원 정신건강의학과) , 장혜련 (용인정신병원 정신건강의학과) , 이유상 (용인정신병원 정신건강의학과) , 박선철 (용인정신병원 정신건강의학과)
Objectives We reviewed cellular and synaptic dysconnectivity, disturbances in micro- and macro- circuitries, and neurodevelopmentally-derived disruptions of neural connectivity in the pathogenesis of schizophrenia. Method We reviewed the selected articles about disturbances in neural circuits which ...
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핵심어 | 질문 | 논문에서 추출한 답변 |
---|---|---|
조현병의 병태생리를 '뇌 영역 사이 연결성의 변화'로 설명하는 개념은 어떤 가정으로부터 유래되는가? | 1-3) 뇌 국소적인 영역의 비정상성보다는 ‘뇌 영역 사이 연결성의 변화’가 조현병의 병태생리로서 더 타당할 것으로 여겨진다. 이러한 개념은 1906년에 Wer-nicke4)가 정신병은 연합섬유(association fibers)의 해부학적 파열(anatomical disruption)으로부터 발생한다고 한 가정으로부터 유래한다. 그리고 1911년에 Bleuler5)가 다양한 정신기능들 사이의 ‘분리’를 조현병의 핵심적인 정신 병리로 규정하여 mind-split-disease를 의미하는 “group of schizophrenias”로 명명한 것은 이러한 개념을 재구성한 것으로 볼 수 있다. | |
조현병은 어떤 장애로 설명되는가? | 조현병은 신경퇴행성 장애보다는 ‘신경발달성 장애’로 설명된다. 신경발달은 자궁 내 성장과 같이 협의의 개념으로도 이해 가능하지만, 일반적으로는 뉴런의 분화(neuronal differentia-tion), 뉴런의 이주(neuronal migration), 축색돌기의 형성과 수상돌기의 증식(axon formation and dendritic proliferation), 시냅스 형성(synaptogenesis), 마이엘린화(myelinization), 시냅스 가지치기(synaptic pruning), 세포자살(apoptosis) 등과 같이 자궁에서부터 시작되어 20대 초반까지 지속되는 일련의뇌 발달과 성숙(brain development and maturation)의 과정으로 이해하는 것이 더 포괄적일 것이다. | |
신경발달을 일반적이고 포괄적으로 이해하자면 어떤 개념으로 봐야 하는가? | 조현병은 신경퇴행성 장애보다는 ‘신경발달성 장애’로 설명된다. 신경발달은 자궁 내 성장과 같이 협의의 개념으로도 이해 가능하지만, 일반적으로는 뉴런의 분화(neuronal differentia-tion), 뉴런의 이주(neuronal migration), 축색돌기의 형성과 수상돌기의 증식(axon formation and dendritic proliferation), 시냅스 형성(synaptogenesis), 마이엘린화(myelinization), 시냅스 가지치기(synaptic pruning), 세포자살(apoptosis) 등과 같이 자궁에서부터 시작되어 20대 초반까지 지속되는 일련의뇌 발달과 성숙(brain development and maturation)의 과정으로 이해하는 것이 더 포괄적일 것이다. 조현병을 신경발달성 장애로 이해하는 것은 기능저하를 평가하는 지표에서도 뒷받침된다. |
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