Cited by 383Schizophrenia research and treatmentNeurotransmitter Receptor Influence on BehaviorMental Health and Psychiatry

Neural development, cell-cell signaling, and the “two-hit” hypothesis of schizophrenia

Maynard, T. M., Sikich, L., Lieberman, J. A., LaMantia, A.-S.·2001·Schizophrenia Bulletin

Abstract

To account for the complex genetics, the developmental biology, and the late adolescent/early adulthood onset of schizophrenia, the "two-hit" hypothesis has gained increasing attention. In this model, genetic or environmental factors disrupt early central nervous system (CNS) development. These early disruptions produce long-term vulnerability to a "second hit" that then leads to the onset of schizophrenia symptoms. The cell-cell signaling pathways involved in nonaxial induction, morphogenesis, and differentiation in the brain, as well as in the limbs and face, could be targets for a "first hit" during early development. These same pathways, redeployed for neuronal maintenance rather than morphogenesis, may be targets for a "second hit" in the adolescent or adult brain. Furthermore, dysregulation of cell-cell signaling by a "first hit" may prime the CNS for a pathologic response to a "second hit" via the same signaling pathway. Thus, parallel disruption of cell-cell signaling in both the developing and the mature CNS provides a plausible way of integrating genetic, developmental, and environmental factors that contribute to vulnerability and pathogenesis in schizophrenia.

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Crossref · 10.1093/oxfordjournals.schbul.a006887

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  • These findings support a two-hit model in which early life stress confers vulnerability to psychiatric symptoms, but symptom onset occurs only after a subsequent stressor.

    “These studies support a “two hit” model in which ELS, such as maternal separation, confers vulnerability to symptoms of psychiatric illness, but with symptom onset only occurring after exposure to a subsequent stressor (Bayer et al., 1999; Maynard et al., 2001).”

    From The effects of early life stress on reward processing (2018) · cites this paper as Maynard et al., 2001

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Authors
Maynard, T. M., Sikich, L., Lieberman, J. A., & LaMantia, A.-S.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
LaMantia, A.-S.
Venue
Schizophrenia Bulletin
Published
2001-01-01
Volume
27
Issue
3
Pages
457-476
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
OpenAlex
W2056370816
Cited by
383
References
160
Citations by year
2026: 10 · 2025: 18 · 2024: 18 · 2023: 22 · 2022: 22 · 2021: 29 · 2020: 20 · 2019: 16 · 2018: 19 · 2017: 22 · 2016: 18 · 2015: 17 · 2014: 29 · 2013: 24 · 2012: 20
FWCI
2.80
Type
journal article
Language
en
Open access
closed
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Mental Health (MH 33127)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-29178)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, two-hit hypothesis
MeSH terms
Brain, Cell Communication, Chromosome Deletion, Chromosomes, Human, Pair 22, Environment, Humans, Neural Pathways, Psychological Theory, Schizophrenia, Tretinoin

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