Anhedonia and emotional experience in schizophrenia: neural and behavioral indicators.
Anhedonia and emotional experience in schizophrenia: neural and behavioral indicators.
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DOI：
10.1016/j.biopsych.2009.10.020
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发表时间：
2010-05-15
影响因子：
10.6
通讯作者：
Barch, Deanna M.
中科院分区：
文献类型：
--
作者：
Dowd, Erin C.;Barch, Deanna M.
像快感缺乏这样的情绪障碍通常被认为是精神分裂症的主要特征。然而，自我报告研究表明，精神分裂症患者对情感诱发刺激的情绪体验是完整的。对情绪体验中的神经活动的调查可能有助于澄清快感缺乏的症状更可能反映的是当下享乐体验的改变还是目标导向行为的其他方面的损害。40名患有精神分裂症或分裂情感性障碍的患者和32名健康对照者接受了功能磁共振成像，同时对情绪图片、文字和面孔进行了效价和唤醒评级。比较患者和对照组的BOLD反应，并与快感缺乏症的问卷测量相关联。与对照组相比，患者对情绪刺激的反应表现出一些钝化的效价，但没有唤起，评级。在两组中，较高的快感缺乏症评分与钝化的效价评分相关，并且完全介导了效价评分的组间差异。除了右侧腹侧纹状体和左侧壳核区域对积极刺激的反应减弱外，患者的功能活动基本完好。高快感缺乏症与患者双侧杏仁核和右侧腹侧纹状体以及对照组双侧尾状体对正刺激和负刺激的激活减少有关。在患者和对照组中，快感缺乏症的增加与效价体验的降低有关，体验效价的组间差异可能是由快感缺乏症的个体差异引起的。纹状体和杏仁核的激活减少可能会导致快感缺乏症的症状，因为它们不能发出积极事件的显著信号。
Emotional impairments such as anhedonia are often considered key features of schizophrenia. However, self-report research suggests that emotional experience in response to affect-eliciting stimuli is intact in schizophrenia. Investigation of neural activity during emotional experience may help clarify whether symptoms of anhedonia more likely reflect alterations of in-the-moment hedonic experience or impairments in other aspects of goal-directed behavior. 40 individuals with DSM-IV-TR schizophrenia or schizoaffective disorder and 32 healthy controls underwent fMRI while making valence and arousal ratings in response to emotional pictures, words, and faces. BOLD responses were compared between patients and controls, and were correlated with questionnaire measures of anhedonia. Patients showed some evidence of blunted valence, but not arousal, ratings in response to emotional stimuli as compared to controls. Higher anhedonia scores were associated with blunted valence ratings in both groups, and fully mediated the group differences in valence ratings. Functional activity was largely intact in patients, except for regions in right ventral striatum and left putamen, which showed reduced responses to positive stimuli. Higher anhedonia was associated with reduced activation to positive versus negative stimuli in bilateral amygdala and right ventral striatum in patients, and in bilateral caudate in controls. Increased anhedonia is associated with a reduced experience of valence in both patients and controls, and group differences in experienced valence are likely driven by individual differences in anhedonia. Reduced activation of the striatum and amygdala may contribute to symptoms of anhedonia by failing to signal the salience of positive events.
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