Amotivation in schizophrenia: integrated assessment with behavioral, clinical, and imaging measures.
Amotivation in schizophrenia: integrated assessment with behavioral, clinical, and imaging measures.
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DOI：
10.1093/schbul/sbu026
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发表时间：
2014-11
影响因子：
6.6
通讯作者：
D. Wolf;T. Satterthwaite;J. Kantrowitz;Natalie Katchmar;Lillie Vandekar;M. Elliott;K. Ruparel
中科院分区：
文献类型：
--
作者：
D. Wolf;T. Satterthwaite;J. Kantrowitz;Natalie Katchmar;Lillie Vandekar;M. Elliott;K. Ruparel
动机缺陷在精神分裂症引起的残疾中起着核心作用，并构成了一个主要的未满足的治疗需求。阴性症状以前被认为与腹侧纹状体（VS）功能减退有关，腹侧纹状体是大脑动机回路的核心组成部分。然而，目前还不清楚这种关系在多大程度上适用于特定的阴性症状，如失动，这个问题还没有得到解决的综合行为，临床和成像措施。在这里，41名精神分裂症患者和37名对照者进行了一项简短的计算机化渐进比率任务（PRT），该任务量化了追求金钱奖励所付出的努力。使用最近验证的阴性症状临床评估访谈（CAINS）评估临床动机。在功能磁共振成像过程中，使用货币猜测范式探索VS功能。我们发现，精神分裂症患者的个人减少的动机所测量的PRT，这显着和选择性相关的CAINS测量的临床动机。重要的是，精神分裂症患者的PRT动机较低也与VS功能减退有关。我们的研究结果表明，精神分裂症的行为动机，临床动机和VS功能减退之间存在着强有力的维度关联。整合行为测量，如PRT将促进翻译的努力，以确定生物标志物的失动和评估反应的新的治疗干预。
Motivational deficits play a central role in disability caused by schizophrenia and constitute a major unmet therapeutic need. Negative symptoms have previously been linked to hypofunction in ventral striatum (VS), a core component of brain motivation circuitry. However, it remains unclear to what extent this relationship holds for specific negative symptoms such as amotivation, and this question has not been addressed with integrated behavioral, clinical, and imaging measures. Here, 41 individuals with schizophrenia and 37 controls performed a brief, computerized progressive ratio task (PRT) that quantifies effort exerted in pursuit of monetary reward. Clinical amotivation was assessed using the recently validated Clinical Assessment Interview for Negative Symptoms (CAINS). VS function was probed during functional magnetic resonance imaging using a monetary guessing paradigm. We found that individuals with schizophrenia had diminished motivation as measured by the PRT, which significantly and selectively related to clinical amotivation as measured by the CAINS. Critically, lower PRT motivation in schizophrenia was also dimensionally related to VS hypofunction. Our results demonstrate robust dimensional associations between behavioral amotivation, clinical amotivation, and VS hypofunction in schizophrenia. Integrating behavioral measures such as the PRT will facilitate translational efforts to identify biomarkers of amotivation and to assess response to novel therapeutic interventions.