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Trends Neurosci. 2014 Feb;37(2):85-94. doi: 10.1016/j.tins.2013.11.003. Epub 2014 Jan 2.

Dopaminergic basis of salience dysregulation in psychosis.

Author information

1
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK. Electronic address: toby.winton-brown@kcl.ac.uk.
2
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK; OASIS Prodromal Service, South London and Maudsley (SLaM) National Health Service (NHS) Foundation Trust, London, UK.
3
Medical Research Council Clinical Sciences Centre, Imperial College London, London, UK.
4
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, SE58AF London, UK; Medical Research Council Clinical Sciences Centre, Imperial College London, London, UK.

Abstract

Disrupted salience processing is proposed as central in linking dysregulated dopamine function with psychotic symptoms. Several strands of evidence are now converging in support of this model. Animal studies show that midbrain dopamine neurons are activated by unexpected salient events. In psychotic patients, neurochemical studies have confirmed subcortical striatal dysregulation of dopaminergic neurotransmission, whereas functional magnetic resonance imaging (fMRI) studies of salience tasks have located alterations in prefrontal and striatal dopaminergic projection fields. At the clinical level, this may account for the altered sense of meaning and significance that predates the onset of psychosis. This review draws these different strands of evidence together in support of an emerging understanding of how dopamine dysregulation may lead to aberrant salience and psychotic symptoms.

KEYWORDS:

dopamine; psychosis; reward; salience; schizophrenia

PMID:
24388426
DOI:
10.1016/j.tins.2013.11.003
[Indexed for MEDLINE]

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