Dysconnectivity, large-scale networks and neuronal dynamics in schizophrenia

Schizophrenia remains a daunting challenge for efforts aimed at identifying fundamental pathophysiological processes and to develop evidence-based effective treatments and interventions. One reason for the lack of progress lies in the fact that the pathophysiology of schizophrenia has been predominantly conceived in terms of circumscribed alterations in cellular and anatomical variables. In the current review, it is proposed that this approach needs to be complemented by a focus on the neuronal dynamics in large-scale networks which is compatible with the notion of dysconnectivity, highlighting the involvement of both reduced and increased interactions in extended cortical circuits in schizophrenia. Neural synchrony is one candidate mechanisms for achieving functional connectivity in large-scale networks and has been found to be impaired in schizophrenia. Importantly, alterations in the synchronization of neural oscillations can be related to dysfunctions in the excitation-inhibition (E/I)-balance and developmental modifications with important implications for translational research.

► The causes of schizophrenia remain unclear despite 100 years of research. ► It is proposed that future research needs a stronger focus on neuronal dynamics in large-scale networks. ► Neural synchrony is one of the candidate mechanisms for achieving functional integration in large-scale networks and is impaired in patients with schizophrenia. ► Further research into neural synchrony in schizophrenia may be fundamental for translational research aimed at developing novel treatments.