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The British Journal of Psychiatry 174: 196-204 (1999)
© 1999 The Royal College of Psychiatrists
I Feinberg and M Guazzelli
Department of Psychiatry, University of California, Davis, CA, USA.
BACKGROUND: In spite of intensive research, no causal anatomical lesion has been found in schizophrenia. It may instead be caused by malfunctioning circuits in the corollary discharge, feed forward (CD- FF) systems of thought. AIMS: To integrate with the CD-FF hypothesis recent data showing that subcortical motor systems participate in thinking. METHODS: We review CD-FF concepts in relation to recent evidence that 'motor' brain structures participate in cognitive processing. RESULTS: Malfunctioning of CD-FF systems that integrate thinking and consciousness could produce auditory hallucinations, delusions and disorganised thought. CONCLUSIONS: We hypothesise that the pathophysiology of schizophrenia lies in integrative circuits of basal ganglia, thalamus and frontal cortex. Fruitful research directions would include elucidation of CD-FF circuits at even higher brain levels, the behaviour of these circuits during dreaming, and their responses to late maturational events including synaptic elimination.
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