Cited by 544Neuroscience and Neuropharmacology ResearchSchizophrenia research and treatmentAutism Spectrum Disorder Research

The DOI matches its Crossref record; 341 of the 341 references it cites were found in a registry or an index; none of the 340 sources its claims cite is checked for support yet.

Common Mechanisms of Excitatory and Inhibitory Imbalance in Schizophrenia and Autism Spectrum Disorders

Open access
Gao, R., Penzes, P.·2015·Current Molecular Medicine

Abstract

Autism Spectrum Disorders (ASD) and Schizophrenia (SCZ) are cognitive disorders with complex genetic architectures but overlapping behavioral phenotypes, which suggests common pathway perturbations. Multiple lines of evidence implicate imbalances in excitatory and inhibitory activity (E/I imbalance) as a shared pathophysiological mechanism. Thus, understanding the molecular underpinnings of E/I imbalance may provide essential insight into the etiology of these disorders and may uncover novel targets for future drug discovery. Here, we review key genetic, physiological, neuropathological, functional, and pathway studies that suggest alterations to excitatory/inhibitory circuits are keys to ASD and SCZ pathogenesis.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that autism spectrum disorder (ASD) and schizophrenia (SCZ), despite distinct genetic architectures, converge on disrupted excitatory/inhibitory (E/I) balance in cortical circuits. It synthesizes genetic, postmortem, physiological, and animal-model evidence for shared glutamatergic and GABAergic mechanisms, including mTOR and NMDA receptor pathways.

Key findings

  • E/I ratios are developmentally and cell-type specific: cultured hippocampal pyramidal dendrites shift from 2:1 at 14 days to 4:1 at 19 days, while hippocampal parvalbumin and calretinin interneurons show 14:1 and 3:1 ratios, respectively.
  • In SCZ, postmortem work links gray matter loss and reduced spine density in dorsolateral prefrontal cortex, auditory cortex, and hippocampus to working memory, hallucination, and memory deficits; PV+ interneurons show lower parvalbumin and GAD67 mRNA without loss of cell number, and gamma oscillations (30–80 Hz) are abnormal.
  • In ASD, early brain overgrowth occurs in about 25–30% of children between years 1 and 2, epilepsy in about 30%, and postmortem tissue shows increased spine density in some cortical layers but also contradictory simplified dendrites; GABAergic markers (GAD65/GAD67, GABA receptors, PV+ interneurons) are altered.
  • Shared risk genes and pathways include NRG1/ErbB4, DISC1, 22q11 deletion, neurexins/neuroligins, SHANK, MeCP2, FMRP, CNTNAP2, mTOR, and NMDAR hypofunction; 22q11 deletion accounts for up to 1–2% of SCZ cases, and Rett syndrome has epilepsy in 80% of cases.

Methods

  • Narrative review with no primary experiments; synthesizes genetic linkage/GWAS, postmortem neuropathology, electrophysiology, imaging, and mouse/animal model studies.
  • Organizes evidence by disorder and circuit: SCZ and ASD separately across glutamatergic and GABAergic systems, then convergent mTOR and NMDAR signaling pathways.
  • No systematic search, inclusion criteria, or meta-analysis described.

Limitations

  • Authors caution that ASD postmortem evidence is limited by small samples (about 120 brains since 1980) and lack of closely matched controls; syndromic autism models (TSC, PTEN, FXS, Rett) are genetically and pathologically distinct from idiopathic autism, so their mechanisms may not fully generalize.
  • Authors note unresolved discrepancies, such as ErbB4 pre- versus postsynaptic localization and NL4 synaptic localization.
  • Evident from the text: conclusions rely heavily on animal models and narrative synthesis; many genetic associations are weak and heterogeneous, with individual genes explaining little risk.

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Integrity signals

Registry

Crossref · 10.2174/1566524015666150303003028

Cites

341 of 341 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

215 Not checked yet · 43 Own interpretation · 12 No basis given · 1 Own method

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Show all 147 claims

  • It may state two separate claims as one. 117
  • Probably not a substantial claim. 11
  • The quote only partly states this claim. 1
124 of 124
  • The paper relies on this without support.

    Behavioral phenotypes in rodent models described as schizophrenia-like or autism-like correspond to the human disorders.

    “mice lacking ErbB4 in the CNS show reduced spine density in both the hippocampus and cortex and exhibit schizophrenia-related behavioral phenotypes [84].”
  • The paper relies on this without support.

    Postmortem brain findings reflect antemortem pathophysiological processes relevant to the disease.

    “Postmortem studies have examined brain regions showing the highest indices of gray matter loss and have consistently found reductions in spine density in these parts.”
  • The paper relies on this without support.

    Spine density changes observed in animal models are relevant to human SCZ and ASD pathophysiology.

    “Primary hippocampal neurons from mice engineered to carry hemizygous deletion of the 1.3-Mb orthologous chromosomal region (Df(16)A+/−) showed reduced spine density and sizes [107].”
  • The paper relies on this without support.

    A significant symptom overlap exists between ASD and SCZ.

    “a significant overlap in symptoms exists”
  • The paper relies on this without support.

    FXS, like many developmental disorders, involves synaptic plasticity changes that may impair learning and memory.

    “Like many developmental disorders, FXS is associated with alterations in synaptic plasticity that may impair learning and memory processes in the brain.”
5 of 5

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Metadata

Authors
Gao, R., & Penzes, P.
Affiliations
Northwestern University (US)
Venue
Current Molecular Medicine
Published
2015-03-18
Volume
15
Issue
2
Pages
146-167
ISSN
1566-5240 (ISSN-L)
OpenAlex
W2334244908
Cited by
516
References
339
Citations by year
2026: 27 · 2025: 53 · 2024: 51 · 2023: 57 · 2022: 59 · 2021: 75 · 2020: 66 · 2019: 39 · 2018: 42 · 2017: 32 · 2016: 11 · 2015: 4
FWCI
13.84
Type
journal article
Language
en
Open access
Locations
  • Current Molecular Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (F30MH096457, R01MH071316)
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
excitatory-inhibitory imbalance, schizophrenia, autism spectrum disorder, shared pathophysiology, glutamatergic circuits, inhibitory interneurons, genetic architecture, neuropathology, therapeutic target
MeSH terms
Autism Spectrum Disorder, Gene Expression Regulation, Humans, Interneurons, Nerve Tissue Proteins, Synaptic Transmission, Schizophrenia, Synapses, Receptors, N-Methyl-D-Aspartate, Pyramidal Cells, Genetic Predisposition to Disease, Dendritic Spines, TOR Serine-Threonine Kinases, GABAergic Neurons

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