Is depression associated with dysfunction of the central reward system?
Is depression associated with dysfunction of the central reward system?
复制标题
DOI：
10.1042/bst0370313
复制
发表时间：
2009-02-01
影响因子：
3.9
通讯作者：
Martin-Soelch, Chantal
中科院分区：
文献类型：
--
作者：
Martin-Soelch, Chantal
MDD(严重抑郁障碍)的神经基础是复杂的，目前还不完全清楚。在这篇综述中，我简要概述了支持抑郁症病理生理学中多巴胺系统功能障碍的假说的研究结果。由于中皮质边缘多巴胺系统参与奖赏的处理，因此假设该系统的功能降低可能是导致快感减退和抑郁相关的运动障碍的基础。这一假设得到了几个观察的支持，这些观察提供了抑郁症中枢多巴胺能传递减少的间接证据。然而，在对照组和抑郁症患者之间观察到的多巴胺功能的一些差异似乎只针对一小部分患者，并受到所选方法的影响。研究了一些MDD行为症状的神经基础，研究表明，快感缺乏、动力丧失以及集中注意力或做出决定的能力减弱，可能与一侧对积极增强剂和奖励的迟钝反应有关，而与另一侧的负面反馈倾向有关。只有几项研究调查了快感缺失的神经基础以及MDD受试者对奖励的反应，大多数研究证明，对奖励信号的反应迟钝，与大脑奖励系统相关区域的大脑激活减少有关。总而言之，有证据表明抑郁症患者的多巴胺系统功能失调，对奖赏信号的反应迟钝。然而，这种功能障碍的确切性质尚不清楚，需要在进一步的研究中进行调查。
The neural substrates of MDD (major depressive disorder) are complex and not yet fully understood. in the present review, I provide a short overview of the findings supporting the hypothesis of a dysfunctional dopamine system in the pathophysiology of depression. Because the mesocorticolimbic dopamine system is involved in reward processing, it has been hypothesized that a reduced function of this system could underlie the anhedonia and amotivation associated with depression. This hypothesis is supported by several observations providing indirect evidence for reduced central dopaminergic transmission in depression. However, some of the differences observed between controls and depressed patients in dopamine function seem to be specific to a subsample of patients, and influenced by the methods chosen. Studies that investigated the neural bases of some MDD behavioural symptoms showed that anhedonia, loss of motivation and the diminished ability to concentrate or make decisions could be associated with a blunted reaction to positive reinforcers and rewards on one side, and with a bias towards negative feedback on the other side. only a few studies have investigated the neural basis of anhedonia and the responses to rewards in MDD subjects, mostly evidencing a blunted response to reward signals that was associated with reduced brain activation in regions associated with the brain reward system. in conclusion, there is evidence for a dysfunction of the dopamine system in depression and for blunted response to reward signals. However, the exact nature of this dysfunction is not yet clear and needs to be investigated in further studies.