Neural mechanisms of anhedonia in schizophrenia - A PET study of response to unpleasant and pleasant odors
Neural mechanisms of anhedonia in schizophrenia - A PET study of response to unpleasant and pleasant odors
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DOI：
10.1001/jama.286.4.427
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发表时间：
2001-07-25
影响因子：
120.7
通讯作者：
Hichwa, RD
中科院分区：
文献类型：
--
作者：
Crespo-Facorro, B;Paradiso, S;Hichwa, RD
丧失体验快乐的能力（快感缺失）是精神分裂症的核心临床特征。虽然功能成像技术已经成功地确定了精神分裂症认知障碍的神经基础，目的探讨精神分裂症患者和健康志愿者对嗅觉刺激的脑反应模式，探讨精神分裂症患者情绪加工的神经基础。设计精神分裂症患者的正电子发射断层扫描（PET）研究研究地点：美国爱荷华州，爱荷华州大学心理健康临床研究中心。研究对象：16名健康志愿者，平均年龄29.5岁;主要结果测量局部脑血流量相对增加或减少的区域，测量使用正电子发射断层扫描和[O-15]水的方法，而参与者进行的情绪-诱导嗅觉任务，以确定愉快（香草醛）和不愉快（4-甲基戊酸）气味的反应，患者和健康志愿者之间的比较。结果精神分裂症患者主观上经历了不愉快的气味的方式类似于健康志愿者，但在愉快的气味的经验表现出损害。局部脑血流量分析显示，患者在体验难闻气味的过程中，未能激活边缘系统/额叶边缘系统区域（如岛叶皮层、中脑核和海马旁回），而是激活了一组额叶皮层区域作为补偿。结论边缘系统与额叶之间复杂的功能相互作用异常可能是精神分裂症情绪障碍的基础。
Context Loss of the capacity to experience pleasure (anhedonia) is a core clinical feature of schizophrenia. Although functional imaging techniques have been successful in identifying the neural basis of cognitive impairments in schizophrenia, no attempts to date have been made to investigate neural systems underlying emotional disturbances.Objective To study the neural basis of emotional processing in schizophrenia by exploring the pattern of brain responses to olfactory stimuli in patients and healthy volunteers.Design Positron emission tomographic study of patients with schizophrenia and healthy volunteers, Positron emission tomographic data were collected between July 21, 1995, and September 11, 1997, and data analyses were conducted in 1999-2001.Setting The Mental Health Clinical Research Center at the University of Iowa, Iowa City.Participants Sixteen healthy volunteers with a mean age of 29.5; years and 18 patients with schizophrenia and a mean age of 30.0 years.Main Outcome Measure Areas of relative increase or decrease in regional cerebral blood flow, measured using positron emission tomography and the [O-15]water method while participants performed an emotion-induction olfactory task to determine response to pleasant (vanillin) and unpleasant (4-methylvaleric acid) odors, compared between patients and healthy volunteers.Results Patients with schizophrenia subjectively experienced unpleasant odors in a manner similar to healthy volunteers but showed impairment in the experience of pleasant odors. The analysis of the regional cerebral blood flow revealed that patients failed to activate limbic/paralimbic regions (eg, insular cortex, nucleus accumbens, and parahippocampal gyrus) during the experience of unpleasant odors, recruiting a compensatory set of frontal cortical regions instead.Conclusion Abnormalities in the complex functional interactions between mesolimbic and frontal regions may underlie emotional disturbances in schizophrenia.