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The role of genes, stress, and dopamine in the development of schizophrenia

Howes, Oliver D., McCutcheon, Robert, Owen, Michael and Murray, Robin M. 2017. The role of genes, stress, and dopamine in the development of schizophrenia. Biological psychiatry 81 (1) , pp. 9-20. 10.1016/j.biopsych.2016.07.014

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Abstract

The dopamine hypothesis is the longest standing pathoetiologic theory of schizophrenia. Because it was initially based on indirect evidence and findings in patients with established schizophrenia, it was unclear what role dopamine played in the onset of the disorder. However, recent studies in people at risk of schizophrenia have found elevated striatal dopamine synthesis capacity and increased dopamine release to stress. Furthermore, striatal dopamine changes have been linked to altered cortical function during cognitive tasks, in line with preclinical evidence that a circuit involving cortical projections to the striatum and midbrain may underlie the striatal dopamine changes. Other studies have shown that a number of environmental risk factors for schizophrenia, such as social isolation and childhood trauma, also affect presynaptic dopaminergic function. Advances in preclinical work and genetics have begun to unravel the molecular architecture linking dopamine, psychosis, and psychosocial stress. Included among the many genes associated with risk of schizophrenia are the gene encoding the dopamine D2 receptor and those involved in the upstream regulation of dopaminergic synthesis, through glutamatergic and gamma-aminobutyric acidergic pathways. A number of these pathways are also linked to the stress response. We review these new lines of evidence and present a model of how genes and environmental factors may sensitize the dopamine system so that it is vulnerable to acute stress, leading to progressive dysregulation and the onset of psychosis. Finally, we consider the implications for rational drug development, in particular regionally selective dopaminergic modulation, and the potential of genetic factors to stratify patients.

Item Type: Article
Date Type: Publication
Status: Published
Schools: MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Dopamine, etiology, genetics, neuroimaging, PET, prodrome, psychosis, schizophrenia, stress
Publisher: Elsevier
ISSN: 0006-3223
Date of First Compliant Deposit: 7 December 2017
Date of Acceptance: 10 July 2016
Last Modified: 03 Jun 2018 08:02
URI: http://orca-mwe.cf.ac.uk/id/eprint/103694

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