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August 2013

From Lichtheim to Rich ClubBrain Networks and Psychiatry

Author Affiliations
  • 1Behavioural and Clinical Neuroscience Institute, Department of Psychiatry, University of Cambridge, Cambridge, England
JAMA Psychiatry. 2013;70(8):780-782. doi:10.1001/jamapsychiatry.2013.212

As van den Heuvel et al1 point out in their article on rich club organization of brain networks in schizophrenia, the idea of brain network abnormality goes back a long way in psychiatry. Early (mostly German-speaking) pioneers of neuroanatomy and neurology or psychiatry, such as Meynert, Wernicke, Lichtheim, Dejerine, and Freud, appreciated the functional importance of the brain’s central white matter and its synaptic connectivity. They understood that white matter was organized as tracts that interconnected regions of cortex and subcortical nuclei. They reasoned, mainly by linking symptoms to lesions identified by dissection, that disorders could be caused by focal lesions to cortical network nodes or the white matter links between them.

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