Reconsidering anhedonia in depression: lessons from translational neuroscience.
Reconsidering anhedonia in depression: lessons from translational neuroscience.
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DOI：
10.1016/j.neubiorev.2010.06.006
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发表时间：
2011-01
影响因子：
8.2
通讯作者：
Zald, David H.
中科院分区：
文献类型：
--
作者：
Treadway, Michael T.;Zald, David H.
关键词：
快感缺乏是重度抑郁症（MDD）的核心症状，其神经生物学机制仍知之甚少。尽管人们对多巴胺 (DA) 在快感缺失症状中的作用进行了数十年的猜测，但经验证据仍然难以捉摸，并且经常有相互矛盾的发现报道。在本综述中，我们认为这是由于对快感缺乏的定义不明确造成的，该定义未能区分奖励行为的完成性和动机方面。鉴于大量临床前证据表明 DA 主要参与奖励的动机方面，我们建议区分快乐和动机缺陷的快感缺失的精确定义对于识别其神经生物学基础至关重要。此外，弥合快感缺失的临床前模型和临床模型之间的差距可能需要摆脱将快感缺失概念化为一种稳态、类似情绪的现象。因此，我们引入“决策缺乏”一词来解决快感缺乏对奖励决策的影响。这些对快感缺失理论定义的修改对 MDD 的研究、评估和治疗具有影响。
Anhedonia is a core symptom of major depressive disorder (MDD), the neurobiological mechanisms of which remain poorly understood. Despite decades of speculation regarding the role of dopamine (DA) in anhedonic symptoms, empirical evidence has remained elusive, with frequent reports of contradictory findings. In the present review, we argue that this has resulted from an underspecified definition of anhedonia, which has failed to dissociate between consummatory and motivational aspects of reward behavior. Given substantial preclinical evidence that DA is involved primarily in motivational aspects of reward, we suggest that a refined definition of anhedonia that distinguishes between deficits in pleasure and motivation is essential for the purposes of identifying its neurobiological substrates. Moreover, bridging the gap between preclinical and clinical models of anhedonia may require moving away from the conceptualization of anhedonia as a steady-state, mood-like phenomena. Consequently, we introduce the term “decisional anhedonia” to address the influence of anhedonia on reward decision-making. These proposed modifications to the theoretical definition of anhedonia have implications for research, assessment and treatment of MDD.
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