Neurobiology of social reward valuation in adults with a history of anorexia nervosa.
Neurobiology of social reward valuation in adults with a history of anorexia nervosa.
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DOI：
10.1371/journal.pone.0205085
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Zucker NL
中科院分区：
文献类型：
--
作者：
Sweitzer MM;Watson KK;Erwin SR;Winecoff AA;Datta N;Huettel S;Platt ML;Zucker NL
神经性厌食症 (AN) 是一种以非典型奖励评估模式（例如对饥饿的积极评估）为特征的疾病。非典型的奖励处理可能会扩展到社交领域。如果是这样，这样的发现将具有预后意义，因为社会功能受损预示着更糟糕的结果。我们探索了有 AN 病史且相对于对照组体重恢复的个体与社会奖励处理有关的神经回路，并检查了疾病过程对社会价值体验的影响。使用功能磁共振成像任务对 20 名有 AN 病史的体重恢复个体 (AN-WR) 和 24 名健康对照 (HC) 参与者进行评估，这些任务利用社会奖励：笑脸和吸引力和体重各异的完整人物。 AN-WR 与 HC 的吸引力评级按权重不同（AN-WR 呈负相关）。虽然观看笑脸时没有显着差异，但观看完整的数字会导致与 AN-WR 的奖励评估（右侧尾状核）相关的区域的激活减少，并且该区域与该疾病的持续病程呈负相关。探索性全脑分析显示，与社会奖励、自我参照处理和认知重新评估相关的区域（例如内侧前额叶皮层、纹状体和伏隔核）的激活减少，并伴有持续的紊乱过程。全身图像的奖励价值随着持续的疾病过程而降低。这可能反映了 AN-WR 中记录的非典型奖励处理的延伸，也许是饥饿抑制内脏动机信号的函数；部署减少奖励体验的认知策略；和/或刺激本身的性质会引发饮食失调症状（例如，瘦弱的身体）。这些发现并没有扩展到笑脸刺激。技术的进步（例如虚拟化身、短信）可能提供建立关系（包括治疗关系）的新方法，以支持改善的社会联系，而不会威胁到症状激发。
Anorexia nervosa (AN) is a disorder characterized by atypical patterns of reward valuation (e.g. positive valuation of hunger). Atypical reward processing may extend into social domains. If so, such findings would be of prognostic significance as impaired social functioning predicts worse outcome. We explore neural circuits implicated in social reward processing in individuals with a history of AN who are weight-restored relative to controls and examine the effects of illness course on the experience of social value. 20 weight-restored individuals with a history of AN (AN-WR) and 24 healthy control (HC) participants were assessed using fMRI tasks that tapped social reward: smiling faces and full human figures that varied in attractiveness and weight. AN-WR differed from HC in attractiveness ratings by weight (negatively correlated in AN-WR). While there were no significant differences when viewing smiling faces, viewing full figures resulted in decreased activation in regions implicated in reward valuation (the right caudate) for AN-WR and this region was negatively correlated with a sustained course of the disorder. Exploratory whole brain analyses revealed reduced activation in regions associated with social reward, self-referential processing, and cognitive reappraisal (e.g., medial prefrontal cortex, striatum, and nucleus accumbens) with sustained disorder course. The rewarding value of full body images decreases with a sustained disorder course. This may reflect an extension of atypical reward processing documented in AN-WR, perhaps as a function of starvation dampening visceral motivational signals; the deployment of cognitive strategies that lessen the experience of reward; and/or the nature of the stimuli themselves as provocative of eating disorder symptoms (e.g., thin bodies). These findings did not extend to smiling face stimuli. Advances in technology (e.g., virtual avatars, text messaging) may provide novel means to build relationships, including therapeutic relationships, to support improved social connections without threats to symptom provocation.
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