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Reviews in the Neurosciences

Editor-in-Chief: Huston, Joseph P.

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Volume 24, Issue 4

Issues

Does the dopamine hypothesis explain schizophrenia?

Chi-Ieong Lau
  • Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
  • Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
  • Other articles by this author:
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/ Han-Cheng Wang
  • Corresponding author
  • Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
  • College of Medicine, National Taiwan University, Taipei, Taiwan
  • College of Medicine, Taipei Medical University, Taipei, Taiwan
  • Email
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/ Jung-Lung Hsu
  • Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
  • Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
  • Graduate Institute of Medical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
  • Other articles by this author:
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/ Mu-En Liu
Published Online: 2013-07-11 | DOI: https://doi.org/10.1515/revneuro-2013-0011

Abstract

The dopamine hypothesis has been the cornerstone in the research and clinical practice of schizophrenia. With the initial emphasis on the role of excessive dopamine, the hypothesis has evolved to a concept of combining prefrontal hypodopaminergia and striatal hyperdopaminergia, and subsequently to the present aberrant salience hypothesis. This article provides a brief overview of the development and evidence of the dopamine hypothesis. It will argue that the current model of aberrant salience explains psychosis in schizophrenia and provides a plausible linkage between the pharmacological and cognitive aspects of the disease. Despite the privileged role of dopamine hypothesis in psychosis, its pathophysiological rather than etiological basis, its limitations in defining symptoms other than psychosis, as well as the evidence of other neurotransmitters such as glutamate and adenosine, prompt us to a wider perspective of the disease. Finally, dopamine does explain the pathophysiology of schizophrenia, but not necessarily the cause per se. Rather, dopamine acts as the common final pathway of a wide variety of predisposing factors, either environmental, genetic, or both, that lead to the disease. Other neurotransmitters, such as glutamate and adenosine, may also collaborate with dopamine to give rise to the entire picture of schizophrenia.

Keywords: aberrant salience; dopamine; dopamine hypothesis; psychosis; schizophrenia

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About the article

Chi-Ieong Lau

Chi-Ieong David Lau is a Consultant Neurologist whose research interests focus on the cognitive neuroscience underpinning neurological diseases. His recent work includes the investigation of the visual system in migraine, as well as the modulation of slow-wave-sleep-related memory consolidation using a variety of methods, including EEG, neuroimaging, brain stimulation, and genetics. He completed his medical degree and neurology training in Taiwan and postgraduate studies at the University College London and the University of Oxford, supported by the British Chevening Scholarship.

Han-Cheng Wang

Han-Cheng Wang is a Consultant Neurologist at Shin Kong Wu Ho-Su Memorial Hospital, with specialist clinics for Parkinson’s disease and movement disorders. He is Assistant Professor of Neurology at the College of Medicine, National Taiwan University. He is the former President and present Standing Member of the Executive Board of Taiwan Movement Disorder Society. His research interests include understanding basic neurophysiology underlying human movements and movement disorders. He is interested in linking clinical features with functional connectivity of the brain, reflected in his recent works correlating regional cerebral blood flow (CBF) changes and tract-specific abnormalities with severity of Parkinsonism.

Jung-Lung Hsu

Jung-Lung Hsu is a Clinical Neurologist. He is interested in behavioral/cognitive neuroscience. His main study is focused on brain structural change and human behavior. He is also participating in the event-related potential (ERP) study (P50 and MMN) of schizophrenia patients.

Mu-En Liu

Mu-En Liu’s research interests include biological psychiatry and geriatric psychiatry. Some of the study topics are novel in the genetic study of cognitive ageing. Recently, he examined genetic effects on age-related morphologic changes in the brain. His researches may clarify the underlying molecular mechanisms of brain aging.


Corresponding author: Han-Cheng Wang, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen-Chang Road, Shih-Lin District, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan; and College of Medicine, Taipei Medical University, Taipei, Taiwan


Received: 2013-04-17

Accepted: 2013-06-05

Published Online: 2013-07-11

Published in Print: 2013-08-01


Citation Information: Reviews in the Neurosciences, Volume 24, Issue 4, Pages 389–400, ISSN (Online) 2191-0200, ISSN (Print) 0334-1763, DOI: https://doi.org/10.1515/revneuro-2013-0011.

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