Cited by 184Schizophrenia research and treatmentNeuroscience and Neuropharmacology ResearchNeurotransmitter Receptor Influence on Behavior

Glutamatergic Synaptic Dysregulation in Schizophrenia: Therapeutic Implications

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Coyle, Joseph T., Basu, Alo, Benneyworth, Michael, Balu, Darrick, Konopaske, Glenn·2012·Handbook of Experimental Pharmacology

Abstract

Schizophrenia affects approximately 1% of the population and continues to be associated with poor outcome because of the limited efficacy of and noncompliance with existing antipsychotic medications. An alternative hypothesis invoking the excitatory neurotransmitter, glutamate, arose out of clinical observations that NMDA receptor antagonists, the dissociative anesthetics like ketamine, can replicate in normal individuals the full range of symptoms of schizophrenia including psychosis, negative symptoms, and cognitive impairments. Low dose ketamine can also re-create a number of physiologic abnormalities characteristic of schizophrenia. Postmortem studies have revealed abnormalities in endogenous modulators of NMDA receptors in schizophrenia as well as components of a postsynaptic density where NMDA receptors are localized. Gene association studies have revealed several genes that affect NMDA receptor function whose allelic variants are associated with increased risk for schizophrenia including genes encoding D-amino acid oxidase, its modulator G72, dysbindin, and neuregulin. The parvalbumin-positive, fast-firing GABAergic interneurons that provide recurrent inhibition to cortical-limbic pyramidal neurons seem to be most sensitive to NMDA receptor hypofunction. As a consequence, disinhibition of glutamatergic efferents disrupts cortical processing, causing cognitive impairments and negative symptoms, and drives subcortical dopamine release, resulting in psychosis. Drugs designed to correct the cortical-limbic dysregulated glutamatergic neurotransmission show promise for reducing negative and cognitive symptoms of schizophrenia as well as its positive symptoms.

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  • Post-mortem studies of schizophrenia brains revealed lower GRIN1 expression, increases in kynurenate, and reductions in D-serine and D-serine racemase.

    “Post-mortem studies of the brain of patients with schizophrenia have revealed lower levels of expression of the obligate NMDAR subunit GRIN1 (glutamate receptor ionotropic, NMDA 1), increases in the expression of the endogenous NMDAR antagonist kynurenate, and a reduction in levels of the NMDAR co-agonist D-serine and the enzyme that catalyses its production, D-serine racemase 10,[16][17][18] .”
  • Treatment of adult rodents with NMDAR antagonists triggers acute schizophrenia-related behaviours, including deficits in attention/vigilance, learning and memory, and sensory gating.

    “As in humans, treatment of adult rodents with NMDAR antagonists triggers acute schizophrenia-related behaviours, including deficits in attention and/ or vigilance, learning and memory and sensory gating, broadly mimicking the symptoms of patients with schizophrenia 10,15,23,24 .”
  • NMDAR antagonism during the first 2 postnatal weeks in rodents induces long-lasting behavioural and cognitive disturbances relevant to the schizophrenia phenotype that extend into adolescence and adulthood.

    “In supporting of this notion, NMDAR antagonism during an equivalent period in rodents (first 2 post-natal weeks) induces long-lasting behavioural and cognitive disturbances that are relevant to the schizophrenia phenotype and which extend into adolescence and adulthood 10,27 .”

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Authors
Coyle, J. T., Basu, A., Benneyworth, M., Balu, D., & Konopaske, G.
Affiliations
Harvard University (US)
Corresponding author
Coyle, Joseph T.
Venue
Handbook of Experimental Pharmacology
Published
2012
Issue
213
Pages
267-295
ISSN
  • 0171-2004 (ISSN-L)
  • 1865-0325
OpenAlex
W1872072116
Cited by
180
References
216
Citations by year
2026: 7 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 13 · 2021: 19 · 2020: 10 · 2019: 9 · 2018: 10 · 2017: 11 · 2016: 11 · 2015: 21 · 2014: 25 · 2013: 22 · 2012: 4
FWCI
81.63
Type
book chapter
Language
en
Open access
Locations
  • Handbook of experimental pharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Public Health Service
  • National Institute of Mental Health (P50MH060450, R01 MH51290, R01MH051290, F32MH090697, P50MH06045)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
schizophrenia, NMDA receptor hypofunction, ketamine, dissociative anesthetics, postsynaptic density, D-amino acid oxidase, G72, dysbindin, neuregulin, parvalbumin interneurons, cognitive impairment, negative symptoms, psychosis, dopamine release, glutamatergic neurotransmission
MeSH terms
Animals, Cognition, gamma-Aminobutyric Acid, Humans, Ketamine, Synaptic Transmission, Schizophrenia, Synapses, Receptors, N-Methyl-D-Aspartate, Glutamic Acid

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