Abstract
All research on schizophrenia depends on selecting the correct phenotype to define
the sample to be studied. Definition of the phenotype is complicated by the fact that
there are no objective markers for the disorder. Further, the symptoms are diverse,
leading some to propose that the disorder is heterogeneous and not a single disorder
or syndrome. This article explores an alternative possibility. It proposes that schizophrenia
may be a single disorder linked by a common pathophysiology (a neurodevelopmental
mechanism), which leads to a misconnection syndrome of neural circuitry. Evidence
for disruption in a specific circuit is explored: the cortical–thalamic–cerebellar–cortical
circuit (CCTCC). It is suggested that a disruption in this circuit leads to an impairment
in synchrony, or the smooth coordination of mental processes. When synchrony is impaired,
the patient suffers from a cognitive dysmetria, and the impairment in this basic cognitive
process defines the phenotype of schizophrenia and produces its diversity of symptoms.
Keywords
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Article info
Publication history
Accepted:
June 12,
1999
Received in revised form:
June 2,
1999
Received:
October 6,
1998
Identification
Copyright
© 1999 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
