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Nervenheilkunde 2003; 22(05): 245-252
DOI: 10.1055/s-0038-1624403
Original- und Übersichtsarbeiten/Original and Review Articles
Schattauer GmbH

Sprache, Gehirn und Schizophrenie

Language, brain and schizophrenia
T. Kircher
1   Universitätsklinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. G. Buchkremer), Tübingen
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Publikationsverlauf

Publikationsdatum:
22. Januar 2018 (online)

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Zusammenfassung

Störungen der Sprache und des Denkens gehören zu den Kernsymptomen der Schizophrenie. Untersuchungen mit strukturellen und funktionellen bildgebenden Methoden (fMRT) sowie Magnetenzephalographie (MEG) zu Sprachprozessen bei Patienten mit Schizophrenie können Hinweise für deren Pathogenese geben. In einem Erklärungsmodell für sprachvermittelte kognitive Defizite und psychopathologische Symptome werden verschiedene Beschreibungs-und Befundebenen integriert. Das Modell geht von einem diffusen Trauma (genetisch, Virusinfektion) auf das sich entwickelnde, embryonale Gehirn aus. Dieses Trauma hat eine pathologische Zellmigration, vermittelt durch Reelin, in der Embryonalphase innerhalb des Gyrus temp. sup. zur Folge. Die pathohistologischen und Rezeptorveränderungen (vor allem im Glutamat-System) in Spracharealen führen nach der Geburt zu einer verminderten zerebralen Sprachlateralisation. Das Zusammenspiel von strukturellen und Rezeptorveränderungen sowie daraus resultierender unvollständiger Sprachlateralisierung in der Kindheit führen in ihrer Summe zu einer gestörten Lateralisation des mentalen Lexikons (normalerweise ist die Sprachproduktion im linken G. temp. sup. verankert). Eine Verwendung des rechten mentalen Lexikons, mit seinen diffusen semantischen Feldern, zusammen mit einer Minderaktivierung des Wernicke-Areals ist eine Teilursache für positive formale Denkstörungen bei Patienten mit Schizophrenie.

Summary

Alterations in thought and language are core symptoms of schizophrenia. Studies with structural and functional imaging (fMRI) as well as magneto/electroencephalography (EEG, MEG) on language in schizophrenia will be selectively described. A model will be presented, where brain structure, function, receptorchemistry, cognitive deficits and psychopathology of language related phenomena are integrated. A diffuse brain trauma (genetic, viral) during fetal neurodevelopment results in pathological cell migration, mediated through Reelin, within the superior temporal gyrus. Consequently, alterations of the glutamate receptor system and decreased mismatch negativity have been described in schizophrenia. These structural and biochemical changes result in a disruption of the normal cerebral language lateralisation during childhood. As a result, the mental lexicon, normally in the left superior temporal gyrus, is reversed in adult schizophrenic patients. The production of thought disordered speech is in part due to a decreased activation of the Wernicke Area and the recruitment of the right mental lexicon with its diffuse semantic fields.

Schlüsselwörter

Schizophrenie - formale Denkstörungen - Sprache - funktionelle Bildgebung

Keywords

Schizophrenia - formal thought disorder - language - functional imaging
 

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