Patofisiologi Skizofrenia
Patofisiologi Skizofrenia
Pada skizofrenia terdapat penurunan aliran darah dan ambilan glukosa, terutama
di korteks prefrontalis, dan pada pasien tipe II (negativisme) terdapat penurunan
sejumlah neuron (penurunan jumlah substansia grisea). Selain itu, migrasi neuron
abnormal selama perkembangan otak secara patofisologis sangat bermakna.
Atrofi penonjolan dendrit dari sel piramidal telah ditemukan pda korteks
prefrontalis
dan
girus
singulata.
Penonjolan
dedrit
mengandung
sinaps
pada
reseptor
dopamin-D2
telak
sukses
digunakan
dalam
Pathophysiology
Both anatomic and neurotransmitter system abnormalities have been implicated in the
pathophysiology of schizophrenia.
Anatomic abnormalities
Neuroimaging studies in patients with schizophrenia show abnormalities such as enlargement of the
ventricles, decreased brain volume in medial temporal areas, and changes in the hippocampus. [6, 7,
8]
These findings are of interest more for research purposes than for clinical application.
Interest has also focused on the various connections within the brain rather than on localization in a
single part of the brain. Magnetic resonance imaging (MRI) studies show anatomic abnormalities in a
network of neocortical and limbic regions and interconnecting white matter tracts. [9] A meta-analysis of
studies using diffusion tensor imaging (DTI) to examine white matter found that 2 networks of whitematter tracts are reduced in schizophrenia.[10]
In the Edinburgh High-Risk Study, brain imaging showed reductions in whole-brain volume and in left
and right prefrontal and temporal lobe volumes in 17 of 146 people who were at high genetic risk for
schizophrenia. The changes in prefrontal lobes were associated with increasing severity of psychotic
symptoms.[11]
In a meta-analysis of 27 longitudinal MRI studies comparing schizophrenic patients with control
subjects, Olabi et al found that schizophrenia was associated with structural brain abnormalities that
progressed over time. The abnormalities identified included loss of whole-brain volume in both gray
and white matter and increases in lateral ventricular volume. [12]
Schizophrenia
. 2013. http://emedicine.medscape.com/article/288259overview#aw2aab6b2b3aa
sangat tinggi terutama pada kembar monozigot (40-80%), sedangkan kembar dizigot lebih
rendah, yakni 10-20%. 3
Faktor
psikososial
yang berperan
adalah
peristiwa
kehidupan
dan stress