Title:The Conflict between Top-down and Bottom-up Impairments in
Consciousness Disorder in Schizophrenia
Volume: 20
Issue: 4
Author(s): Hesam Karbakhsh, Aliakbar Kouchakzadeh*Shahriar Gharibzadeh
Affiliation:
- Laboratory
for Theoretical Studies, Institute for Cognitive and Brain Sciences, Shahid Beheshti University,
Tehran, Iran
Keywords:
Consciousness disorder, schizophrenia, bottom-up impairment, top-down impairment, global neuronal workspace theory, dysfunction.
Abstract:
Introduction: Schizophrenia, a complex psychiatric disorder, is often associated
with consciousness disorders, typically characterized by an elevated threshold of conscious
perception. Over the years, a multitude of research has been dedicated to uncovering the primary
cause of these disorders, leading to the development of several theories.
Methods: In this article, two central answers to this problem have been reviewed. For this, the
articles that were more related to the topic were selected. Based on the relevance to the subject
of research, the main ideas of targeted articles are reordered to be comprehensible for the readers.
Finally, the judgment and conclusion of the authors about the discussed problem are presented
in this study.
Discussion: The first theory, which we will explore in this article, suggests that the root cause
of these disorders lies in defects within bottom-up processes. These processes, fundamental to
our understanding of the world, involve the progression of sensory information from low-level
perception to high-level awareness. In individuals with schizophrenia, these processes are believed
to be compromised, leading to a distorted perception of reality. The second theory, in
contrast, attributes the cause to impairments in top-down processes. These processes, which
refer to the influence of high-level cognitive functions on lower-level sensory perception, are
also considered dysfunctional in schizophrenic patients. This dysfunction is thought to disrupt
the integration of sensory information, thereby affecting the individual's consciousness. However,
a third perspective has emerged, suggesting the coexistence of impairments in both bottom-
up and top-down processing. This perspective argues that to fully comprehend the nature
of consciousness disorders in schizophrenia, it is crucial to determine the type and severity of
both bottom-up and top-down impairments.
Conclusion: In this review, we delve into these theories, examining the evidence supporting
each and discussing their implications for our understanding of schizophrenia. Considering
both bottom-up and top-down impairments, the third perspective offers a more holistic explanation
for these disorders. We further argue that this perspective underscores the need for a
more nuanced approach to studying schizophrenia. It suggests that future research should not
only focus on these processes in isolation but also explore their interaction and the potential
synergistic effects of their impairment. By doing so, we can hope to gain a more comprehensive
understanding of consciousness disorders in schizophrenia, which could ultimately lead to
more effective treatment strategies.
