How clinical neurophysiology may contribute to the understanding of a psychiatric disease such as schizophrenia.

ABSTRACT

INTRODUCTION: The increasing knowledge about anatomical structures and cellular processes underlying psychiatric disorders may help bridge the gap between clinical manifestations and basic physiological processes. Accordingly, important insights have been brought these last years into a main psychiatric affection, i.e. schizophrenia. MATERIAL AND METHODS: Here we reviewed and described, by comparison to healthy people, different physiological parameters - oculomotor measures, startle response, and cognitive event related potentials, which are altered in schizophrenia, in order to link these physiological parameters to dysfunctional cognitive processes and specific clinical symptoms. RESULTS: Schizophrenic patients displayed (1) abnormalities in smooth pursuit eye movements and saccadic inhibition during antisaccade tasks that may stem from the same prefrontal "inhibitory" cortical dysfunction; (2) deficits in prepulse inhibition and facilitation suggesting disturbed attentional modulations, which seem also correlated to abnormal patterns of prefrontal activation; and (3) decreased amplitude for cognitive ERP situated all along the continuum of the information processing, suggesting that schizophrenia shows neurophysiological deficits since the level of the sensory cortex and not only disturbances involving associative cortices and limbic structures. DISCUSSION: The heterogeneity of schizophrenic disorders regarding symptomatology, course, and outcome is underlain by various pathophysiological processes that physiological parameters may help define. These alterations may be related to precise cognitive processes that are easily neurophysiologically monitored in order to create more homogeneous subgroups of schizophrenic patients.