Zeynep Yağmur KARAGÜLLEOĞLU, Ahmet ÇARHAN

Tarihteki İlk İzleri ile Şizofreni

Belirli tanıma ulaşma süreci oldukça uzun olan şizofreni, hastalığa sahip insanların parçalanmış düşüncelerini oldukça iyi tanımlamaktadır. Şizofreni kelimesi, Yunanca bölünmüş anlamına gelen schizo ve zihin anlamındaki phrene köklerinden oluşmaktadır. Günümüzdeı ise; sanrılar, halüsinasyon gibi semptomlar ile düşünce ve davranışları etkileyen duygulanım bozukluğu ile ilişkili durumdur. Çalışmamızda şizofreni terimini, tanı ve tedavi yaklaşımlarını yazılı kaynakları baz alarak inceledik. Eski Mısır'da ortaya çıkan Ebers Papirüsü, ruhsal duygulanım bozukluklarına ışık tutmakla beraber farklı alanlarda gözlemlenen tıbbi endikasyonlara karşı tedavi yöntemlerini reçete olarak barındıran bir koleksiyon niteliğindedir. İki Homo türü olan Homo sapiens sapiens ile Avrupa ve Batı Asya’da var olan Homo neanderthalensis arasındaki genomik farklılıklar, belirli insan özelliklerini ve insan evrimi ile şizofreni arasındaki ilişkiyi açıklamaya yardımcı olabilmektedir. Şizofreninin, insan beyninin karmaşık evriminde bir yan ürün olarak çıktığı ve doğal seçilim sağladığı teorisi bu durumu destekler niteliktedir. Neandertallere ait genom dizisi erken modern insanlar ve yakın akrabaları ile birbirinden ayrıldıklarından beri pozitif seleksiyondan etkilenen genomik bölgeleri belirlemeye yardımcı olmaktadır. Genetik biliminin ilerlemesi ile şizofreninin oluşumunda, genetik delesyonun da etkili olduğu düşünülmüştür. Kromozom 22’nin q11.2 bölgesinde yer alan ve transkripsiyon faktörlerini kodlayan, filogenetik olarak korunmuş T-box transkripsiyon faktörü 1’in (TBX1) delesyona uğraması, beynin üst kortikal bölgelerindeki fizyolojik hasar ile ilişkilendirilmektedir. Çalışmamız, modern insanlara taşınan Neandertal kaynaklı polimorfizm sayısının, kafatası ve beyin morfolojisi ile ilişkisini gösteren literatür çalışmalarına dayandırılmaktadır. Günümüzde gri madde miktarının tayini ile şizofreni tanısı yapılabilmektedir. Eski Mısır'a ait tıbbi kaynakların ve modern genetik ve nöro-bilimsel araştırmaların sentezini içeren bu çalışma; şizofrenin tanımını, etkilerini ve tedavisini yüzyıllar öncesinden günümüze nasıl değiştiğini ve geliştiğini göstermektedir.

Anahtar Kelimeler:

şizofreni, eber papirüsü, neandertaller, genetik, gri madde

Schizophrenia with its First Marks in History

Schizophrenia, whose process of reaching a specific definition is quite long, describes the fragmented thoughts of people with the disease quite well. The word schizophrenia comes from the Greek schizo meaning divided and phrene meaning mind. Today, however; It is a condition associated with a mood disorder that affects thoughts and behaviors, with symptoms such as delusions, hallucinations. In our study, we examined the term schizophrenia, diagnosis and treatment approaches based on written sources. The Ebers Papyrus, which emerged in Ancient Egypt, is a collection that sheds light on mental affective disorders and includes prescription treatment methods against medical indications observed in different fields. Genomic differences between the two Homo species, Homo sapiens sapiens, and Homo neanderthalensis, which exist in Europe and Western Asia, may help explain certain human traits and the relationship between human evolution and schizophrenia. The theory that schizophrenia emerged as a by-product of the complex evolution of the human brain and led to natural selection supports this situation. The genome sequence of Neanderthals helps identify genomic regions that have been affected by positive selection since their divergence from early modern humans and their close relatives. With the advancement of genetics, it was thought that genetic deletion was also effective in the formation of schizophrenia. Deletion of the phylogenetically conserved T-box transcription factor 1 (TBX1) located in the q11.2 region of chromosome 22 and encoding transcription factors is associated with physiological damage in the upper cortical regions of the brain. Our study is based on literature studies showing the relationship between the number of Neanderthal polymorphisms carried to modern humans and skull and brain morphology. Today, the diagnosis of schizophrenia can be made by determining the amount of gray matter. This study, which includes the synthesis of ancient Egyptian medical sources and modern genetic and neuro-scientific research; It shows how the definition, effects and treatment of schizophrenia have changed and developed from centuries ago to the present.

Keywords:

Schizophrenia, Ebers Papyrus, Neanderthals, Genetics, Gray matter,

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