Common Dimensional Reward Deficits Across Mood and Psychotic Disorders: A Connectome-Wide Association Study.
Common Dimensional Reward Deficits Across Mood and Psychotic Disorders: A Connectome-Wide Association Study.
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DOI：
10.1176/appi.ajp.2016.16070774
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发表时间：
2017-07-01
期刊：
影响因子：
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通讯作者：
Satterthwaite TD
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文献类型：
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作者：
Sharma A;Wolf DH;Ciric R;Kable JW;Moore TM;Vandekar SN;Katchmar N;Daldal A;Ruparel K;Davatzikos C;Elliott MA;Calkins ME;Shinohara RT;Bassett DS;Satterthwaite TD
快感缺失是多种精神疾病的核心，并导致严重残疾。一个维度的概念化假设，快感缺失的严重程度涉及到一个跨诊断连续的奖励赤字在特定的神经网络。以前的调查功能连接相关的快感缺乏症集中在特定疾病的病例对照比较，使用特定区域的种子为基础的分析。在这里，作者探讨了整个功能连接体与奖励反应的关系，在人群中的成人异源性精神病理学。在来自五个诊断组的225名成年人的样本中，（重度抑郁症，n=32;双相情感障碍，n=50;精神分裂症，n=51;精神病风险，n=39;和健康对照，n=53），作者进行了一项连接组范围的分析，（行为激活量表的奖励敏感性子量表）和静息状态功能连接，使用多变量基于距离的矩阵回归。这种连接组范围的分析确定了与奖励反应相关的中枢神经核（NAc），默认模式网络（DMN）和扣带-鳃盖网络（CON）。后续分析显示，特定的大规模功能网络之间的连接障碍，以及它们与NAc的连接。奖励缺陷与NAc和DMN之间的连接减少以及NAc和CON之间的连接增加有关。受损的奖赏反应性与DMN超连接和DMN与CON之间的连接减少有关。这些结果强调了延髓核在奖赏缺陷的病理生理学中的中心地位，并表明大-规模网络是至关重要的神经生物学奖励功能障碍的临床诊断类别。
Anhedonia is central to multiple psychiatric disorders and causes substantial disability. A dimensional conceptualization posits that anhedonia severity relates to a trans-diagnostic continuum of reward deficits in specific neural networks. Prior investigations of functional connectivity related to anhedonia have focused on case-control comparisons in specific disorders, using region-specific seed-based analyses. Here, the authors explore the entire functional connectome in relation to reward responsivity across a population of adults with hetereogenous psychopathology. In a sample of 225 adults from five diagnostic groups (major depressive disorder, n=32; bipolar disorder, n=50; schizophrenia, n=51, psychosis risk, n=39; and healthy controls, n=53), the authors conducted a connectome-wide analysis examining the relationship between a dimensional measure of reward responsivity (reward sensitivity subscale of the Behavioral Activation Scale) and resting-state functional connectivity using multivariate distance-based matrix regression. This connectome-wide analysis identified foci of dysconnectivity associated with reward responsivity in the nucleus accumbens (NAc), default mode network (DMN) and cingulo-opercular network (CON). Follow-up analyses revealed dysconnectivity among specific large-scale functional networks and their connectivity with the NAc. Reward deficits were associated with decreased connectivity between the NAc and DMN and increased connectivity between the NAc and CON. In addition, impaired reward responsivity was associated with DMN hyper-connectivity and diminished connectivity between DMN and CON. These results emphasize the centrality of the nucleus accumbens in the pathophysiology of reward deficits and suggest that dissociable patterns of connectivity among large-scale networks are critical to the neurobiology of reward dysfunction across clinical diagnostic categories.