Overactivity in the Thalamus Among Those With Schizophrenia Is Related to Hallucinations and Cognitive Impairment

Schizophrenia is a complex and severe mental disorder that affects millions of people worldwide. It is characterized by a range of symptoms, such as delusions, hallucinations, social withdrawal, and cognitive impairment. The causes and mechanisms of schizophrenia are still poorly understood, but recent research has suggested that the thalamus, a brain region that relays sensory and cognitive information to the cortex, may play a key role in the development and manifestation of the disorder.

The Thalamus and Its Functions

The thalamus is a large, egg-shaped structure located in the center of the brain. It consists of several nuclei that receive inputs from different sensory modalities, such as vision, hearing, touch, and pain. The thalamus also receives inputs from higher-order brain regions, such as the prefrontal cortex, the hippocampus, and the amygdala. The thalamus acts as a gatekeeper and filter for these inputs, selectively transmitting or inhibiting them to the appropriate cortical areas. The thalamus also modulates the activity of cortical neurons by generating rhythmic patterns of electrical impulses, known as oscillations, that synchronize neural firing and facilitate communication between brain regions.

The thalamus is involved in many cognitive functions, such as attention, memory, language, and emotion. It is also essential for consciousness and awareness, as damage to the thalamus can result in coma or vegetative state. The thalamus is not a homogeneous structure, but rather a collection of functionally distinct subregions that interact with specific cortical areas. For example, the medial dorsal nucleus (MDN) of the thalamus projects to the prefrontal cortex and is involved in executive functions and working memory. The pulvinar nucleus of the thalamus projects to the parietal and temporal cortices and is involved in visual attention and spatial processing. The anterior nucleus of the thalamus projects to the cingulate cortex and is involved in emotion regulation and motivation.

Thalamic Abnormalities in Schizophrenia

Several studies have reported structural and functional abnormalities in the thalamus of people with schizophrenia. These include reduced volume, altered shape, decreased blood flow, impaired connectivity, and disrupted oscillations. These abnormalities may affect the ability of the thalamus to process sensory and cognitive information accurately and efficiently, leading to distorted perceptions and impaired cognition.

One of the most common symptoms of schizophrenia is auditory hallucinations (AH), which are false perceptions of sounds or voices that are not present in reality. AH can be distressing and interfere with daily functioning and social interactions. AH are thought to result from abnormal activity in the auditory cortex and its associated regions, such as the temporal lobe and the parahippocampal gyrus. However, recent evidence suggests that the thalamus may also contribute to AH by overactivating or hyperconnecting with these regions.

According to Medical Xpress , a study by researchers from CNRS (French National Centre for Scientific Research) and Aix-Marseille University found that people with schizophrenia who experienced AH had increased volume and connectivity of the medial geniculate nucleus (MGN) of the thalamus, which relays auditory information from the ear to the cortex. The researchers also found that these thalamic abnormalities correlated with increased activity in the auditory cortex and reduced activity in the prefrontal cortex during AH episodes. These findings suggest that overactivity in the MGN may amplify or distort auditory signals before they reach the cortex, resulting in false perceptions of sounds or voices.

Another symptom of schizophrenia is cognitive impairment, which affects various domains such as attention, memory, reasoning, problem-solving, and social cognition. Cognitive impairment can limit the functional recovery and quality of life of people with schizophrenia. Cognitive impairment is also associated with abnormalities in several brain regions, including the prefrontal cortex, which is responsible for executive functions and working memory. However, recent evidence suggests that the thalamus may also play a role in cognitive impairment by underactivating or hypoconnecting with the prefrontal cortex.

According to Frontiers , a review article by researchers from St. Jude Children’s Research Hospital proposed that synaptic dysfunction and oscillatory abnormalities in neural circuits involving projections from and within the thalamus may underlie cognitive impairment in schizophrenia. The researchers focused on modeling 22q11.2 deletion syndrome (22q11DS), a rare genetic disorder that confers a high risk of developing schizophrenia. They found that 22q11DS mice had reduced volume and connectivity of the MDN of the thalamus, which projects to the prefrontal cortex. They also found that these mice had impaired working memory and reduced gamma oscillations (a type of fast brain rhythm) in both the MDN

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