Brain Scans Link Two Key Pieces Of Schizophrenia Puzzle: this is big big news in the effort to elucidate the pathophysiology of schizophrenia, which affects around 1-2% of the world’s population. It has long been known that schizophrenic symptoms come from dysfunctions in two brain areas — underactivity in parts of the frontal cortex (which probably underlies the cognitive and ‘negative’ symptoms of the disease) and dopamine overactivity in a deep region called the striatum (probably related to the florid ‘positive’ symptoms — delusions and hallucinations — of the disease). Classical antipsychotic medications block dopamine in the latter areas, thus treating some of the dramatic symptomatic episodes but not more fundamental impoverishment suffered by the schizophrenic patient. The newer ‘atypical’ antipsychotic medications help to modulate, either instead or in addition, the frontal underactivity and thus allow more global restitution of function. But, although I and others have long suspected, it had never been demonstrated until this study by some of the luminaries of NIH (National Institutes of Health) schizophrenia research, that the dysfunction of the prefrontal cortex is primary and that dopamine activity in the striatum is under prefrontal control. The principal investigator comments, “These results provide a long-sought insight into the roots of dopamine dysregulation in schizophrenia. They suggest a possible treatment strategy that targets prefrontal cortex dysfunction, not just excess dopamine.” They may allow the rational, rather than trial-and-error, design of treatment strategies that would get at root causes, rather than slapping bandaids on end manifestations, of the illness. ScienceDaily