Current Psychiatry Reports

, Volume 12, Issue 3, pp 202–207 | Cite as

The Role of the Entorhinal Cortex in Paraphrenia

Article

Abstract

Evidence derived from postmortem brain studies has implicated the uncal cortex in paraphrenia. In the present review, we expand on the anatomic and physiologic nuances endogenous to this region that make entorhinal cortex pathology an important clinicopathological correlate to paraphrenia. First, we summarize the anatomic landmarks and histologic features that will allow the reader to define the entorhinal region in future research studies. As cortical regions usually project to neighboring cortices, inferences will be drawn as to the function of the entorhinal region based on the surrounding cortical regions. The results will help explain why patients with paraphrenia may exhibit amnestic deficits that stand in contrast to a well-preserved thought process and personality. We also review the results of surgical ablation studies in animals. These studies suggest that some risk factors currently associated with paraphrenia (eg, social isolation) may in reality be an early manifestation of entorhinal pathology. Finally, the author provides a parallelism between the hallucinations observed in some paraphrenic patients and the results of electrical stimulation of the uncal cortex. The results will help explain why hallucinations in paraphrenia are usually limited to the patient’s surroundings.

Keywords

Paraphrenia Schizophrenia Entorhinal cortex Transentorhinal cortex 

References

Papers of particular interest, published recently, have been highlighted as: •Of importance

  1. 1.
    Braitenberg V, Schüz A: Some anatomical comments on the hippocampus. In Neurobiology of the Hippocampus. Edited by Seifert W. London: Academic Press; 1983:21–37.Google Scholar
  2. 2.
    Amaral DG, Insausti R, Cowan WM: The entorhinal cortex of the monkey: I. Cytoarchitectural organization. J Comp Neurol 1987, 264:326–355.CrossRefPubMedGoogle Scholar
  3. 3.
    Insausti R, Amaral DG, Cowan WM: The entorhinal cortex of the monkey: II. Cortical afferents. J Comp Neurol 1987, 264:356–395.CrossRefPubMedGoogle Scholar
  4. 4.
    Braak H: Architectonics of the Human Telencephalic Cortex. New York: Springer-Verlag; 1980.Google Scholar
  5. 5.
    Stephan H: Allocortex. New York: Springer; 1975.Google Scholar
  6. 6.
    Stephan H, Andy OJ: The allocortex in primates. In The Primate Brain. Edited by Noback CR, Montagna W. New York: Appleton-Century-Croft; 1970:109–135.Google Scholar
  7. 7.
    Van Hoesen GW: The parahippocampal gyrus: new observations regarding its cortical connections in the monkey. TINS 1982, 5:345–350.Google Scholar
  8. 8.
    Amaral DG, Insausti R: Hippocampal formation. In The Human Nervous System. Edited by Paxinos G. New York: Academic Press; 1990:711–749.Google Scholar
  9. 9.
    Hammarberg C: Studien über Klinik und Pathologie der Idiotie nebst Untersuchungen über die normale Anatomie der Hirnrinde [in German]. Upsala, Sweden: Berling; 1895.Google Scholar
  10. 10.
    Ramón y Cajal S: Studies on the Cerebral Cortex (Limbic Structures). Translated by Kraft LM. Chicago, IL: Year Book; 1955.Google Scholar
  11. 11.
    Lorente de Nó R: Studies on the structure of the cerebral cortex. I. The area entorhinalis. J Psychol Neurol 1933, 45:381–431.Google Scholar
  12. 12.
    Braak H: Zur pigmentarchitektonik der grosshirnrinde des menschen. I. Regio entorhinalis [in German]. Z Zellforsch 1972, 127:407–438.CrossRefPubMedGoogle Scholar
  13. 13.
    Sgonina K: Zur vergleichenden Anatomie der Entorhinal-und Präsubikularregion [in German]. J Psychol Neurol 1938, 48:56–163.Google Scholar
  14. 14.
    Fallon JH, Riley JN, Moore RY: Substantia nigra dopamine neurons: separate populations project to neostriatum and allocortex. Neurosci Lett 1978, 7:157–162.CrossRefPubMedGoogle Scholar
  15. 15.
    Lindvall O, Björklund A: The organization of the ascending catecholamine neuron systems in the rat brain revealed by the glyoxylic acid fluorescence method. Acta Physiol Scand Suppl 1974, 412:1–48.PubMedGoogle Scholar
  16. 16.
    Van Hoesen GW, Pandya DN: Some connections of the entorhinal (area 28) and perirhinal (area 35) cortices of the rhesus monkey. I. Temporal lobe afferents. Brain Res 1975, 95:1–24.CrossRefPubMedGoogle Scholar
  17. 17.
    Rose M: Der Allocortex beim Tier und Menschen, I. Teil [in German]. J Psychol Neurol 1926, 34:1–111.Google Scholar
  18. 18.
    Saunders RC, Rosene DL: A comparison of the efferents of the amygdala and the hippocampal formation in the rhesus monkey: I. Convergence in the entorhinal, prorhinal, and perirhinal cortices. J Comp Neurol 1988, 271:153–184.CrossRefPubMedGoogle Scholar
  19. 19.
    Saunders RC, Rosene DL, Van Hoesen GW: Comparison of the efferents of the amygdala and the hippocampal formation in the rhesus monkey: II. Reciprocal and non-reciprocal connections. J Comp Neurol 1988, 271:185–207.CrossRefPubMedGoogle Scholar
  20. 20.
    Blackstad TW: Commisural connections of the hippocampal region of the rat, with special reference to their mode of termination. J Comp Neurol 1956, 105:417–538.CrossRefPubMedGoogle Scholar
  21. 21.
    Rose M: Cytoarchitektonischer Atlas der Grosshirnrinde des Kaninchens [in German]. J Psychol Neurol 1931, 43:353–340.Google Scholar
  22. 22.
    Filimonov IN: Comparative Anatomy of the Cerebral Cortex of Mammalians: Paleocortex, Archicortex, and Interstitial Cortex. Translated by Dukoff V. Washington, DC: Joint Publications Research Service; 1965.Google Scholar
  23. 23.
    Macchi G: The ontogenetic development of the olfactory telencephalon in man. J Comp Neurol 1951, 95:245–305.CrossRefPubMedGoogle Scholar
  24. 24.
    Steward O, Scoville SA: Cells of origin of entorhinal cortical afferents to the hippocampus and fascia dentata of the rat. J Comp Neurol 1976, 169:347–370.CrossRefPubMedGoogle Scholar
  25. 25.
    Mesulam MM: Patterns in behavioral neuroanatomy: association areas, the limbic system, and hemispheric specialization. In Principles of Behavioral Neurology. Edited by Mesulam MM. Philadelphia, PA: F. A. Davis; 1985:1–70.Google Scholar
  26. 26.
    Squire LR, Zola-Morgan S: Memory: brain system and behavior. TINS 1988, 11:170–175.PubMedGoogle Scholar
  27. 27.
    Zola-Morgan S, Squire LR, Amaral DG: Lesions of the hippocampal formation but not lesions of the fornix or the mammillary nuclei produce long-lasting memory impairment in monkeys. J Neurosci 1989, 9:898–913.PubMedGoogle Scholar
  28. 28.
    • Stouffer EM: The entorhinal cortex, but not the dorsal hippocampus, is necessary for single-cue latent learning. Hippocampus 2009 Oct 5 (Epub ahead of print). The experiment used neurotoxin lesions to examine the role of the entorhinal cortex and dorsal/ventral hippocampus in a modified latent cue preference task. Results showed that lesions of the entorhinal cortex and ventral hippocampus disrupted the irrelevant-incentive latent learning, whereas lesions of the dorsal hippocampus did not.Google Scholar
  29. 29.
    Jones EG, Powell TP: An anatomical study of converging sensory pathways within the cerebral cortex of the monkey. Brain 1970, 93:793–820.CrossRefPubMedGoogle Scholar
  30. 30.
    Mesulam MM, Van Hoesen GW, Pandya DN, Geschwind N: Limbic and sensory connections of the inferior parietal lobule (area PG) in the rhesus monkey: a study with a new method for horseradish peroxidase histochemistry. Brain Res 1977, 136:393–414.CrossRefPubMedGoogle Scholar
  31. 31.
    Swanson LW: The hippocampus and the concept of the limbic system. In Neurobiology of the Hippocampus. Edited by Seifert W. London: Academic Press; 1983:4–19.Google Scholar
  32. 32.
    Nauta WJH: Some efferent connections of the prefrontal cortex in the monkey. In The Frontal Granular Cortex and Behavior. Edited by Warren JM, Akert K. New York: McGraw-Hill; 1964:397–409.Google Scholar
  33. 33.
    Van Hoesen GW, Pandya DN, Butters N: Some connections of the entorhinal (area 28) and perirhinal (area 35) cortices of the rhesus monkey. II. Frontal lobe efferents. Brain Res 1975, 95:25–38.CrossRefPubMedGoogle Scholar
  34. 34.
    Goldman-Rakic PS: Dual pathways connecting the dorsolateral prefrontal cortex with the hippocampal formation and parahippocampal cortex in the rhesus monkey. Neuroscience 1984, 12:719–743.CrossRefPubMedGoogle Scholar
  35. 35.
    Swanson LW: Anatomical evidence for direct projections from the entorhinal area to the entire cortical mantle of the rat. J Neurosci 1986, 6:3010–3023.PubMedGoogle Scholar
  36. 36.
    Giannakopoulos P, Hof PR, Michel JP, et al.: Cerebral cortex pathology in aging and Alzheimer’s disease: a quantitative survey of large hospital-based geriatric ad psychiatric cohorts. Brain Res Rev 1997, 25:217–245.CrossRefPubMedGoogle Scholar
  37. 37.
    Winson J, Abzug C: Neuronal transmission through hippocampal pathways dependent on behavior. J Neurophysiol 1978, 41:716–732.PubMedGoogle Scholar
  38. 38.
    Dahl D, Bailey WH, Winson J: Effect of norepinephrine depletion of hippocampus on neuronal transmission from perforant pathway through dentate gyrus. J Neurophysiol 1983, 49:123–133.PubMedGoogle Scholar
  39. 39.
    Winson J: Influence of the raphe nuclei on neuronal transmission from perforant pathway through dentate gyrus. J Neurophysiol 1980, 44:937–950.PubMedGoogle Scholar
  40. 40.
    Srebro B, Azmitia EC, Winson J: Effect of 5HT depletion of the hippocampus on neuronal transmission from perforant path through dentate gyrus. Brain Res 1982, 235:142–147.CrossRefPubMedGoogle Scholar
  41. 41.
    Penfield W, Perot P: The brain’s record of auditory and visual experience. Brain 1963, 86:595–696.CrossRefPubMedGoogle Scholar
  42. 42.
    Penfield WP: Functional localization in the temporal and deep Sylvian areas. Res Publ Assoc Res Nerv Ment Dis 1958, 36:210–226.PubMedGoogle Scholar
  43. 43.
    Penfield WP, Jasper H: Epilepsy and the Functional Anatomy of the Human Brain. Boston, MA: Little Brown; 1954.Google Scholar
  44. 44.
    Squire L: Memory and Brain. New York: Oxford University Press; 1987.Google Scholar
  45. 45.
    Stevens JR: Clinical and electroencephalographic correlates in patients hospitalized with psychiatric disorders. Electroencephalogr Clin Neurophysiol 1970, 28:90.CrossRefPubMedGoogle Scholar
  46. 46.
    Ferguson SM, Rayport M, Gardner E: Similarities in the mental content of psychotic states, spontaneous seizures, dreams, and responses to electrical brain stimulation in patients with temporal lobe epilepsy. Psychosom Med 1969, 31:479–498.PubMedGoogle Scholar
  47. 47.
    Horowitz MJ, Adams JE, Rutkin BB: Visual imagery on brain stimulation. Arch Gen Psychiatry 1968, 19:469–486.PubMedGoogle Scholar
  48. 48.
    Mahl GF, Rothenberg A, Delgado JM, Hamlin H: Psychological responses in the human to intracerebral electrical stimulation. Psychosom Med 1964, 26:337–368.PubMedGoogle Scholar
  49. 49.
    Halgren E, Walter RD, Cherlow DG, Crandall PH: Mental phenomena evoked by electrical stimulation of the human hippocampal formation and amygdala. Brain 1978, 101:83–115.CrossRefPubMedGoogle Scholar
  50. 50.
    Baldwin M: Electrical stimulation of the mesial temporal region. In Electrical Studies on the Unanesthetized Brain. Edited by Ramey ER, O’Doherty DS. New York: Hoeber; 1960:159–176.Google Scholar
  51. 51.
    Kling A: Effects of amygdalectomy on social-affective behavior in non-human primates. In The Neurobiology of the Amygdala. Edited by Eleftheriou BE. New York: Plenum; 1972:511–536.Google Scholar
  52. 52.
    Kling A: Brain lesions and aggressive behavior of monkeys in free living groups. In Neural Bases of Violence and Aggression. Edited by Fields WS, Sweet WH. St. Louis, MO: Warren H. Green; 1975:146–160.Google Scholar
  53. 53.
    Davison K, Bagely CR: Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. In Current Problems in Neuropsychiatry: Schizophrenia, Epilepsy, the Temporal Lobe. Edited by Herrington RN. Ashford, United Kingdom: Headley; 1969:113–184.Google Scholar
  54. 54.
    Trimble MR: Biological Psychiatry. New York: Wiley; 1988.Google Scholar
  55. 55.
    Adebimpe VR: Complex partial seizures simulating schizophrenia. JAMA 1977, 237:339–341.CrossRefGoogle Scholar
  56. 56.
    Heath RG: Studies in Schizophrenia. Cambridge: Harvard University Press; 1954.Google Scholar
  57. 57.
    Meldrum BS, Corsellis JAN: Epilepsy. In Greenfield’s Neuropathology, edn 4. Edited by Adams JH, Corsellis JAN, Duchen LW. New York: Wiley; 1984:921–950.Google Scholar
  58. 58.
    Bruton CJ: The Neuropathology of Temporal Lobe Epilepsy. New York: Oxford University Press; 1988.Google Scholar
  59. 59.
    Taylor DC: Factors influencing the occurrence of schizophrenia-like psychosis in patients with TLE. Psychol Med 1975, 5:249–254.CrossRefPubMedGoogle Scholar
  60. 60.
    • Markesbery WR: Neuropathologic alterations in mild cognitive impairment: a review. J Alzheimers Dis 2010, 19:221–228. The article summarizes the few available reports on the pathology of mild cognitive impairment. Other concomitant findings, such as Lewy bodies and argyrophilic granules, may reflect the fact that most autopsied mild cognitive impairment patients have been in the older age range (80–90 years of age).Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of LouisvilleLouisvilleUSA

Personalised recommendations