HVO1 − Von Carl Wernicke zu Computational Psychiaty: Syndrombasierte
Pathogeneseforschung am Beispiel Formaler Denkstörungen
Categorical classifications are used for more than a
century in clinical psychiatry. This has hindered aetiological research.
Syndrom based approaches are more apt for pathogenetic research. Novel
approaches are on the horizon, using big data and machine learning methods to
delineate new biotypes. These ideas will be exempified at hand of Formal
Thought Disorders (FTD). They arepresent in most psychiatric disorders and in
some healthy subjects. We present a comprehensive and integrative, multilevel
account on what we currently know about FTD, covering environmental influences,
genetics, cellular and transmitter levels, experimental and neuropsychology,
brain imaging and phenomenology. FTD is a dimensional, phenomenologically
defined construct, which can clinically be subdivided into positive (pFTD)
versus negative (nFTD) as well as objective versus subjective symptom clusters.
Since FTDs have been traditionally linked to schizophrenia, studies in other
diagnoses are scarce. Aetiologically, FTD is the only symptom under genetic
influence in schizophrenia (linkage studies), while familial communication
patterns (“allusive thinking”) have also been associated with it. pFTDs are
related to synaptic rarefication in the glutamate system of the superior and
middle lateral temporal cortices. Left superior temporal gyrus (STG) cortical
volume is decreased in schizophrenia patients (SZ) with pFTD in structural
magnetic resonance imaging (sMRI) studies and shows reversed activation in
functional MRI (fMRI) experiments during speech production. An outlook will be
given on machine learning appoaches using multi-omics, multi-level data for
classification and prediction.
Literature: Tilo Kircher, Henrike Bröhl, Felicitas
Meier, Jennifer Engelen. Formal Thought Disorders (FTD): From
Phenomenology to Neurobiology. Lancet Psychiatry, 2018
Prof. Dr. Tilo Kircher
Philipps-University
Marburg, Department for Psychiatry and Psychotherapy, Marburg, Germany
Erlenring 15
35037 Marburg
+49(0)6421-58-65200
kircher2@staff.uni-marburg.de