Tarihteki İlk İzleri ile Şizofreni

Yıl 2021, , 400 - 410, 22.09.2021

Zeynep Yağmur Karagülleoğlu , Ahmet Çarhan

https://doi.org/10.31020/mutftd.872400

Öz

Belirli tanıma ulaşma süreci oldukça uzun olan şizofreni, hastalığa sahip insanların parçalanmış düşüncelerini oldukça iyi tanımlamaktadır. Şizofreni kelimesi, Yunanca bölünmüş anlamına gelen schizo ve zihin anlamındaki phrene köklerinden oluşmaktadır. Günümüzdeı ise; sanrılar, halüsinasyon gibi semptomlar ile düşünce ve davranışları etkileyen duygulanım bozukluğu ile ilişkili durumdur. Çalışmamızda şizofreni terimini, tanı ve tedavi yaklaşımlarını yazılı kaynakları baz alarak inceledik. Eski Mısır'da ortaya çıkan Ebers Papirüsü, ruhsal duygulanım bozukluklarına ışık tutmakla beraber farklı alanlarda gözlemlenen tıbbi endikasyonlara karşı tedavi yöntemlerini reçete olarak barındıran bir koleksiyon niteliğindedir. İki Homo türü olan Homo sapiens sapiens ile Avrupa ve Batı Asya’da var olan Homo neanderthalensis arasındaki genomik farklılıklar, belirli insan özelliklerini ve insan evrimi ile şizofreni arasındaki ilişkiyi açıklamaya yardımcı olabilmektedir. Şizofreninin, insan beyninin karmaşık evriminde bir yan ürün olarak çıktığı ve doğal seçilim sağladığı teorisi bu durumu destekler niteliktedir. Neandertallere ait genom dizisi erken modern insanlar ve yakın akrabaları ile birbirinden ayrıldıklarından beri pozitif seleksiyondan etkilenen genomik bölgeleri belirlemeye yardımcı olmaktadır. Genetik biliminin ilerlemesi ile şizofreninin oluşumunda, genetik delesyonun da etkili olduğu düşünülmüştür. Kromozom 22’nin q11.2 bölgesinde yer alan ve transkripsiyon faktörlerini kodlayan, filogenetik olarak korunmuş T-box transkripsiyon faktörü 1’in (TBX1) delesyona uğraması, beynin üst kortikal bölgelerindeki fizyolojik hasar ile ilişkilendirilmektedir. Çalışmamız, modern insanlara taşınan Neandertal kaynaklı polimorfizm sayısının, kafatası ve beyin morfolojisi ile ilişkisini gösteren literatür çalışmalarına dayandırılmaktadır. Günümüzde gri madde miktarının tayini ile şizofreni tanısı yapılabilmektedir. Eski Mısır'a ait tıbbi kaynakların ve modern genetik ve nöro-bilimsel araştırmaların sentezini içeren bu çalışma; şizofrenin tanımını, etkilerini ve tedavisini yüzyıllar öncesinden günümüze nasıl değiştiğini ve geliştiğini göstermektedir.

Anahtar Kelimeler

şizofreni, eber papirüsü, neandertaller, genetik, gri madde

Teşekkür

Yayını hazırlama sürecinde tüm katkılarından dolayı Öğr. Gör. Pelin Kılıç ve Doç. Dr. Haldun Soygür'e; son okumalarından dolayı Sinan Ünal, Beyza Dönmüş ve Hicran Şahin Gökçe'ye teşekkür ederim.

Schizophrenia with its First Marks in History

Öz

Schizophrenia, whose process of reaching a specific definition is quite long, describes the fragmented thoughts of people with the disease quite well. The word schizophrenia comes from the Greek schizo meaning divided and phrene meaning mind. Today, however; It is a condition associated with a mood disorder that affects thoughts and behaviors, with symptoms such as delusions, hallucinations. In our study, we examined the term schizophrenia, diagnosis and treatment approaches based on written sources. The Ebers Papyrus, which emerged in Ancient Egypt, is a collection that sheds light on mental affective disorders and includes prescription treatment methods against medical indications observed in different fields. Genomic differences between the two Homo species, Homo sapiens sapiens, and Homo neanderthalensis, which exist in Europe and Western Asia, may help explain certain human traits and the relationship between human evolution and schizophrenia. The theory that schizophrenia emerged as a by-product of the complex evolution of the human brain and led to natural selection supports this situation. The genome sequence of Neanderthals helps identify genomic regions that have been affected by positive selection since their divergence from early modern humans and their close relatives. With the advancement of genetics, it was thought that genetic deletion was also effective in the formation of schizophrenia. Deletion of the phylogenetically conserved T-box transcription factor 1 (TBX1) located in the q11.2 region of chromosome 22 and encoding transcription factors is associated with physiological damage in the upper cortical regions of the brain. Our study is based on literature studies showing the relationship between the number of Neanderthal polymorphisms carried to modern humans and skull and brain morphology. Today, the diagnosis of schizophrenia can be made by determining the amount of gray matter. This study, which includes the synthesis of ancient Egyptian medical sources and modern genetic and neuro-scientific research; It shows how the definition, effects and treatment of schizophrenia have changed and developed from centuries ago to the present.

Anahtar Kelimeler

Schizophrenia, Ebers Papyrus, Neanderthals, Genetics, Gray matter

Kaynakça

• 1. Lichtenstein P, et al.Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. The Lancet 2009; 373(9659):234–239.
• 2. Srinivasan S, et al. Genetic Markers of Human Evolution Are Enriched in Schizophrenia. Biol Psychiatry 2016;80(4):284–292.
• 3. Crespi B, Summers K, Dorus S. Adaptive evolution of genes underlying schizophrenia. Proc Biol Sci 2007;274(1627):2801–2810.
• 4. Jablensky, A. El concepto diagnóstico de la esquizofrenia: su historia, evolución y perspectivas futuras. Dialogues Clin Neurosci 2010;12(3):271–287.
• 5. Engstrom EJ, Weber MM, Burgmair W. Emil Wilhelm Magnus Georg Kraepelin (1856-1926). Am J Psychiatry 2006;163(10):1710.
• 6. Okasha A. Psychiatry in Egypt Through Pharaonic to Arabic and Present Era. Pichot P, Berner P, Wolf R, Thau K ed. Psychiatry The State of the Art. Boston, Springer;1985. pp:201–206.
• 7. Heinrichs R. Historical origins of schizophrenia: two early madmen and their illness. J Hist Behav Sci 2003;39(4):349–363.
• 8. Berrios GE. Historical aspects of psychoses: 19th century issues. Br Med Bull 1987;43(3):484–498.
• 9. Cutting J, Shepherd M. The Clinical Roots Of The Schizophrenia Concept: Translations Of Seminal European Contributions On Schizophrenia. 13th ed. Cambridge University Press; 1986.
• 10. Berrios G, Hauser R. The early development of Kraepelin’s ideas on classification: A conceptual history. Psychol Med 1988;18(4):813–821.
• 11. Bou Khalil R, Richa S. When affective disorders were considered to emanate from the heart: the ebers papyrus. Am J of Psychiatry 2014;171(3):275.
• 12. Smith G. The Papyrus Ebers. 1st ed. Bryan C, editor. Garden city press, London Letchworth, Herts; 1930.
• 13. Lambert E. In Psychiatry The State of the Art. 4th ed. Pichot P, editor. US: Springer US; 1985.
• 14. Quaritch B. Hieratic Papyri From Kahun and Gurob. 2nd ed. Griffith F, editor. London: Gilbert&Rivington;1898.
• 15. Maddison D, Mackey KH. Suicide: the clinical problem. Br J Psychiatry 1966;112(488):693–703.
• 16. Syme K, Hagen E. Mental health is biological health: Why tackling “diseases of the mind” is an imperative for biological anthropology in the 21st century. Am J Phys Anthropol 2020;87–117.
• 17. Salomon R. A newly discovered manuscript of Opicinus de Canistris. 16th ed. London: Journal of the Warburs and Courtauld Institutes, 1953. pp:46-57.
• 18. Whittington K. Body-Worlds: Opicinus de Canistris and the Medieval Cartographic Imagination. 2nd ed. Belçika: Brepols; 2016.
• 19. Kris E. Psychoanalytic Explorations in Art. In New York: International Universities Press, College Art Journal; 1952. pp: 358.
• 20. Hare E. Schizophrenia as a recent disease. Br J Psychiatry 1988;153:521–531.
• 21. Pötzl-Malíková M. Messerschmidt, Franz Xaver. 1st ed. İngiltere: Oxford University Press; 2003.
• 22. Schizophrenia Working Group of the Psychiatric Genomics Consortium. Biological insights from 108 schizophrenia-associated genetic loci. Nature 2014;511(7510):421–427.
• 23. Green R, et al. A draft sequence of the neandertal genome. Science 2010;328(5979):710–722.
• 24. Prüfer K, et al.The complete genome sequence of a Neanderthal from the Altai Mountains. Nature 2014;505(7481):43–49.
• 25. Li M, et al. Recent Positive Selection Drives the Expansion of a Schizophrenia Risk Nonsynonymous Variant at SLC39A8 in Europeans. Schizophr Bull 2016;42(1):178–190.
• 26. Gregory M, et al. Neanderthal-Derived Genetic Variation Shapes Modern Human Cranium and Brain. Sci Rep 2017;7(1):6308.
• 27. Williams N, O’Donovan M, Owen M. Chromosome 22 Deletion Syndrome And Schizophrenia. Int Rev Neurobiol. 2006;73:1-27.
• 28. Bassett AS, Chow EW. Schizophrenia and 22q11.2 deletion syndrome, Curr Psychiatry Rep 2008;10(2):148–157
• 29. Basset AS, et al. Clinical features of 78 adults with 22q11 deletion syndrome. Am J Med Genet 2005:138(4):307-313.
• 30. Pulver A, et al. Sequential strategy to identify a susceptibility gene for schizophrenia: Report of potential linkage on chromosome 22q12‐q13.1. Am J Med Genet 1994;54(1):36-43.
• 31. Sellier C, et all. Decreased DGCR8 Expression and miRNA Dysregulation in Individuals with 22q11.2 Deletion Syndrome. Plos One 2014;9(8), e103884.
• 32. Bassett A, et all. Rare genome-wide copy number variation and expression of Schizophrenia in 22q11.2 Deletion Syndrome. Am J Psychiatry 2017;174(11),1054-1063.
• 33. Williams H, et al. Association analysis of TBX1 and schizophrenia. Am J Med Genet 2001;105(1).
• 34. Lee P, et al. Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders. Cell 2019;179(7), 1469-1482.e11.
• 35. Goghari V, Regionally specific cortical thinning and gray matter abnormalities in the healthy relatives of schizophrenia patients. Cereb Cortex 2007;17(2), 415–424.
• 36. Lee C, Fusiform gyrus volume reduction in first-episode schizophrenia: A magnetic resonance imaging study. Arch Gen Psychiatry 2002;59(9), 775–781.
• 37. Onitsuka T, et al. Middle and inferior temporal gyrus gray matter volume abnormalities in chronic schizophrenia: An MRI study. Am J Psychiatry, 2004;161(9), 1603–1611.
• 38. Picard H, et al. The role of the cerebellum in schizophrenia: An update of clinical, cognitive, and functional evidences. Schizophr Bull 2008;34(1), 155-172.
• 39. Shenton M, et al. A review of MRI findings in schizophrenia. Schizophr Res 2001; 49(1-2), 1-52.
• 40. Yildiz M, Borgwardt S, Berger G. Parietal Lobes in Schizophrenia: Do They Matter? Schizophr Res Treatment 2011;2011:581686.
• 41. Hulshoff Pol H, Kahn R. What happens after the first episode? A review of progressive brain changes in chronically ill patients with schizophrenia. Schizophr Bull 2008;34(2), 354-366.
• 42. Vita A, et al. Progressive loss of cortical gray matter in schizophrenia: A meta-analysis and meta-regression of longitudinal MRI studies. Transl Psychiatry 2012;2(11), e19.
• 43. Yüksel C, et al. Gray matter volume in schizophrenia and bipolar disorder with psychotic features. Schizophr Res 2012;138(2–3), 177–182.
• 44. Liu N, et al. Characteristics of gray matter alterations in never-treated and treated chronic schizophrenia patients. Transl Psychiatry 2020;10(1), 136.
• 45. Rezaki M. Şizofreni Nörobiyolojisine Kısa Bir Bakış. Klin Ps 1998;1, 31-34.
• 46. Yue Y, et al. Regional abnormality of grey matter in schizophrenia: Effect from the illness or treatment? PLoS ONE, 2016;11(1),e0147204.
• 47. Honea R, et al. Regional deficits in brain volume in schizophrenia: A meta-analysis of voxel-based morphometry studies. In American Journal of Psychiatry, Vol. 162, Issue 12. Am J Psychiatry; 2005;162(12), 2233-2245.
• 48. Guo X, et al. Hippocampal and orbital inferior frontal gray matter volume abnormalities and cognitive deficit in treatment-naive, first-episode patients with schizophrenia. Schizophr Res 2014;152(2–3), 339–343.
• 49. Kong L, et al. Neurological soft signs and gray matter changes: A longitudinal analysis in first-episode schizophrenia. Schizophr Res 2012;134(1), 27–32.
• 50. Chan R, et al. Brain anatomical abnormalities in high-risk individuals, first-episode, and chronic schizophrenia: An activation likelihood estimation meta-analysis of illness progression. Schizophr Bull 2011;37(1), 177–188.
• 51. Kong L, et al. Comparison of grey matter volume and thickness for analysing cortical changes in chronic schizophrenia: A matter of surface area, grey/white matter intensity contrast, and curvature. Psychiatry Res 2015;231(2), 176–183.
• 52. Van den Heuvel M, Sporns O. A cross-disorder connectome landscape of brain dysconnectivity. Nat Rev Neurosci 2019;20, 435–446.
• 53. Andreasen NC, et al. Ventricular enlargement in schizophrenia: relationship to positive and negative symptoms. Am J Psychiatry 1982;139(3):297-302.
• 54. McGrath JJ. Myths and plain truths about schizophrenia epidemiology. Acta Psychiatr Scand 2005;111(1):4-11.
• 55. Brüne M. Schizophrenia-an evolutionary enigma? Neurosci Biobehav Rev. 2004;28(1):41-53.
• 56. Crow TJ, Done DJ, Sacker A. Childhood precursors of psychosis as clues to its evolutionary origins. Eur Arch Psychiatry Clin Neurosci 1995;245(2):61-69.
• 57. Crow TJ. Is schizophrenia the price that Homo sapiens pays for language? Schizophr Res. 1997;28(2-3):127-141.
• 58. Van den Heuvel M. Evolutionary modifications in human brain connectivity associated with schizophrenia. Brain 2019;3991–4002.