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Reduction in ventral striatal activity when anticipating a reward in depression and schizophrenia: a replicated cross-diagnostic finding

机译:预期抑郁症和精神分裂症有奖赏时,腹侧纹状体活动减少:重复的交叉诊断发现

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In the research domain framework (RDoC), dysfunctional reward expectation has been proposed to be a cross-diagnostic domain in psychiatry, which may contribute to symptoms common to various neuropsychiatric conditions, such as anhedonia or apathy/avolition. We used a modified version of the Monetary Incentive Delay (MID) paradigm to obtain functional MRI images from 22 patients with schizophrenia, 24 with depression and 21 controls. Anhedonia and other symptoms of depression, and overall positive and negative symptomatology were also measured. We hypothesized that the two clinical groups would have a reduced activity in the ventral striatum when anticipating reward (compared to anticipation of a neutral outcome) and that striatal activation would correlate with clinical measures of motivational problems and anhedonia. Results were consistent with the first hypothesis: two clusters in both the left and right ventral striatum were found to differ between the groups in reward anticipation. Post-hoc analysis showed that this was due to higher activation in the controls compared to the schizophrenia and the depression groups in the right ventral striatum, with activation differences between depression and controls also seen in the left ventral striatum. No differences were found between the two patient groups, and there were no areas of abnormal cortical activation in either group that survived correction for multiple comparisons. Reduced ventral striatal activity was related to greater anhedonia and overall depressive symptoms in the schizophrenia group, but not in the participants with depression. Findings are discussed in relation to previous literature but overall are supporting evidence of reward system dysfunction across the neuropsychiatric continuum, even if the specific clinical relevance is still not fully understood. We also discuss how the RDoC approach may help to solve some of the replication problems in psychiatric fMRI research.
机译:在研究领域框架(RDoC)中,功能紊乱的报酬期望已被提出是精神病学中的交叉诊断领域,这可能会导致各种神经精神病状(例如快感缺乏症或情感淡漠/精神病)所共有的症状。我们使用了货币激励延迟(MID)范例的修改版本,从22位精神分裂症患者,24位抑郁症患者和21位对照患者获得功能性MRI图像。还测量了快感不足和其他抑郁症状,以及总体阳性和阴性症状。我们假设当预期奖励(与预期中性结果相比)时,这两个临床组的腹侧纹状体活动减少,并且纹状体激活与动机问题和快感缺乏症的临床措施相关。结果与第一个假设是一致的:在奖励预期中,左右腹侧纹状体的两个簇在两组之间存在差异。事后分析表明,这是由于与精神分裂症和右腹侧纹状体的抑郁症组相比,对照组中的活化更高,在左腹侧纹状体中也见到抑郁症和对照之间的活化差异。两组患者之间均未发现差异,并且两组中都没有异常皮质激活的区域,这些区域在进行多次比较后均得以校正。精神分裂症组的腹侧纹状体活动减少与快感不足和总体抑郁症状有关,但与抑郁症参与者无关。相对于先前的文献讨论了发现,但是总体上支持了整个神经精神连续体的奖励系统功能障碍的证据,即使仍未完全了解具体的临床意义。我们还将讨论RDoC方法如何帮助解决精神科功能磁共振成像研究中的某些复制问题。

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