Dergi Ara >>
Yıl:2010; Cilt: 3; Sayı: 2>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2010;3(2):12-23
Şizofreni: Nöron Içi Ve Nöronlar Arası entegrasyon / Senkronizasyon / Rezonans Bozukluğu Mu?
ME Ceylan
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi
Şizofreniyi frontal kortekste nöronal bir entegrasyon / senkronizasyon bozukluğu olarak tanımlamak gerekecektir. Zayıf entegrasyon / senkronizasyon bilgi işleme süreçlerinde nöral devrelerin yeterli ve düzenli veri kullanmasına engel olarak klinikte ambivalans ve muhakeme bozukluğuna neden olur. Entegrasyon/senkronizasyon bozukluğu iki alt grupta incelenmelidir. İlk bozukluğu nöron düzeyinden başlatıp devreler düzeyine kadar izlemek gerekir. Nöronda veriler dendrit düzeyinden başlayarak somaya kadar entegre olarak ilerler, her dendritten gelen uyarılar dendrit kolları boyunca akarken somaya kadar entegre olarak ilerler ve sonunda somada basit düzeyde de olsa bütünsel bir entegrasyona uğrar. Daha sonra her nöronun bütünsel bilgisi üst düzey bir bütünleşmeye uğramak üzere nöronal devrelere verilir. Nöronal devreler içinde ve arasında en yüksek düzeyde entegrasyonun sağlanabilmesi için bütün nöronların eşzamanlı olarak aktif olarak içlerindeki bilgiyi devreye aktarmaları gerekir. Yüksek senkronizasyon ve rezonans D1 reseptörlerinin yoğunluğuna bağlı olarak değişir. Fazla sayıdaki D1 reseptörü aktive olduğunda çok sayıda nöronu aktif halde tutarak birbirleriyle senkronize olmalarını sağlar. Şizofren hastalarda karar verme süreçlerinde yeterli sayıda D1 aktivasyonu olamadığını biliyoruz. Williamson 2007 de, şizofren hastalarda bazal ganglion, talamus ve kortekste normal devrelere antikorele çalışan devreler tespit etti. Bu durum hastaların korteksinde nöral devrelerin birbirine senkronize çalışmasını ve birbirinin şiddetini arttırarak(rezonans) daha geniş bir sahayı aktive etmelerini, böylelikle çok daha geniş bir bilgi kütlesini kullanıma hazır hale getirmelerini engelleyici bir faktördür. Özellikle frontal kortekste nöral devreler arasında senkronizasyonun yanı sıra rezonansın korunmuş olması yürütücü işlevler açısından son derece önemlidir. Her düşüncenin/davranışın başladıktan sonra kendi gücünü arttırarak sürmesi nöral devrelerde pozitif geri beslemenin yanı sıra rezonansın gerçekleşmesiyle mümkün olur. Anti-korele devreler korele devrelerle ters çalışarak muhtemelen rezonansı söndürmektedirler. Şizofren hastalardaki yüksek başlayıp sonu düşük tonla ve içeriği anlaşılmaz tarzda biten konuşmalar, yüksek bir güdüyle başlayıp ambivalan bir tutumla sonlanan davranışlar rezonansın sönmesiyle de açıklanabilir. İkinci olarak talamus ve frontal korteks arasındaki entegrasyon bozukluğu da, frontal korteks içinde zaten varolan bozukluğun kompanse halde kalmasına engel olup süreci bir üst aşamaya taşır ve hasta dekompanse bir halde şizofreni kliniği ile karşımıza çıkar. Talamus embriyolojik olarak diensefalondan, frontal korteks de telensefalondan meydana gelir. Köken olarak bu farklı iki yapının embriyolojik dönemde sağlıklı bir entegrasyon gösterebilmesi gerekir. Halbuki şizofrenlerde muhtemelen bu entegrasyon gerektiği gibi kurulamamaktadır. Buna destek veren çalışmalar, frontal kortekste nöropil azalmasıyla korele giden sinaps proteinlerinde(synaptofizin ve SNAP-25) azalma tespit etmiş olan çalışmalardır.
Schizophrenia: Is It A Disorder Of Intraneuronal And Interneuronal Integration / Synchronization / Resonance
Schizophrenia may be hypothesized as a disorder of integration / synchronization of the neural circuits especially in frontal cortex. Weak integration / synchronization causes ambivalance and judgment disorder that has been seen at schizophrenia symptomathology by way of blocking information process at neural circuits. The disorder of integration/synchronization in schizophrenia neuropathology shows itself at two group pthology. Firstly, it seems as intraneuronal and intracircuit disintegration Inputs are integrated firstly at dendrits and then soma of the neurons. The input integration of soma is relatively complex while dendritic one is absolutely primitive. After dendritic and somatic integration, inputs goes to high level integration at neural circuits; in this way, the integration of integration is getting at neural circuits. D1 receptors are necessary for both of the intra and inter circuits integration, together with synchronization. Stimulating of much more D1 receptors causes synchronization of neural circuits by way of long term activation of these receptors. Schizophrenic patients does not activate the sufficient number of D1 receptors and does not get the synchronization and resonance of the neurons and circuits. At 2007, Williams implicated the anticorrelated networks in the brain of schizophrenic patients. These networks may block the synchronization and the resonance that occur between neural networks during executive function. In this way, the neural networks do not corrolate with each other and they do not compose resonance. To prevent resonance is very important for executive functions. Every thought/behavior enhance its power with going on by way of pozitif feed back and resonance. Anticorrolated networks extinguish resonance with working opposite of corrolated networks in frontal cortex. The high tone beginning with low tone ending conversation of schizophrenic patients is based on extinguishing of resonance in frontal cortex. Secondly, the disintegration between thalamus and frontal cortex enhance disintegration of neuronal circuits of frontal cortex. Thalamus occurs from diencephalon while frontal cortex emanetes from telencephalon. As origin, the different parts of the brain, the thalamus and the frontal cortex of schizophrenic patients probably can not integrate eachother properly at embriyologic period. There are some other results for supporting this thought, such as there is a correlation between the reduced neuropil density and the level of synaptic proteins(synaptofizin and SNAP-25).

http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-red.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-white-grey.html http://www.simplehandbaga.com/hermes-kelly-32cm-ostrich-vein-6108-black-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-dark-red.html http://www.simplehandbaga.com/hermes-herbag-31cm-green-canvas-bag.html http://www.simplehandbaga.com/hermes-epsom-leather-wallet-camel-silver.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-green-silver.html http://www.simplehandbaga.com/hermes-kelly-32cm-togo-leather-6108-electric-blue-silver.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-blue-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-pink-bag.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-croco-leather-black.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-pink-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-elephant-grey.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-dark-blue-golden.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-brown.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-electric-blue.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-pink.html http://www.simplehandbaga.com/hermes-h-wallet-royal-blue-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-electric-blue.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-blue-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-burgundy.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-grey.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-grey-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-elephant-grey.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-red.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-camel-gold.html http://www.simplehandbaga.com/hermes-kelly-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-pink.html http://www.simplehandbaga.com/hermes-herbag-31cm-burgundy-canvas-bag.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-blue-silver.html http://www.simplehandbaga.com/hermes-30cm-birkin-bag-togo-leather-with-strap-light-pink-gold.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-rose-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-brown.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-green.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-black.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-red-silver.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-pink-silver.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-pink.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-in-orange.html http://www.simplehandbaga.com/hermes-picotin-lock-togo-leather-red.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-green-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbag-yellow-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-camel-gold.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-gold-light-coffee.html http://www.simplehandbaga.com/hermes-kelly-28cm-bag-togo-leather-blue-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-pink.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-red.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-burgundy-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-dark-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-light-coffee-silver.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-hot-pink-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-white.html http://www.simplehandbaga.com/hermes-garden-party-36cm-leather-handbag-black-hot-pink.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-brown-gold.html http://www.simplehandbaga.com/hermes-constance-wallet-togo-leather-rose.html http://www.simplehandbaga.com/hermes-bi-fold-wallet-h006-black.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-black-silver.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-blue.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-orange-bag.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-h-red.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-birkin-35cm-crocodile-leather-handbag-grey-white-gold.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-dark-khaki-silver.html http://www.simplehandbaga.com/hermes-garden-party-36cm-canvas-handbag-yellow.html http://www.simplehandbaga.com/hermes-calf-leather-8616-handbag-cherry-pink.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-orange-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-camel.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-green.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-green.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-togo-leather-orange-silver.html