Al-Adawi S, Dawe G S, Al-Hussaini A A
Department of Behavioral Medicine & Psychiatry, College of Medicine, Sultan Qaboos University, Al-Khoudh, Muscat, Oman.
Med Hypotheses. 2000 Apr;54(4):523-30. doi: 10.1054/mehy.1999.0890.
Recent advances in the understanding of the neural substrates of goal-directed behaviour have created new interest in unlocking the mystery behind those disorders that are characterized by poverty of thought and action. In this review, various studies will be considered which proffer converging evidence that the dopaminergic brain circuitry running from ventral tegmental areas in the midbrain, via nucleus accumbens in the forebrain, to the frontal cortex, tends to produce aboulia when its restitutive function fails. Such aboulic deficits occur in various neurological and psychiatric disorders in which they have profound implications for the patients' management, rehabilitation and social interactions. We begin by examining the consequences of dopamine agonism and antagonism in pre-clinical studies and draw on the inferences that can be made from studies in humans. We then go on to discuss aboulic features in neuropsychiatric conditions, focusing on clinical manifestation, animal models, abnormal dopamine activity and pharmacological interventions.
在对目标导向行为的神经基质的理解方面，最近的进展引发了人们对揭开那些以思维和行动匮乏为特征的疾病背后之谜的新兴趣。在这篇综述中，将考虑各种研究，这些研究提供了趋同的证据，即从中脑腹侧被盖区经前脑伏隔核到额叶皮质的多巴胺能脑回路，当其恢复功能失败时往往会导致意志缺失。这种意志缺失缺陷出现在各种神经和精神疾病中，对患者的管理、康复和社交互动具有深远影响。我们首先研究临床前研究中多巴胺激动和拮抗的后果，并借鉴从人类研究中得出的推论。然后我们继续讨论神经精神疾病中的意志缺失特征，重点关注临床表现、动物模型、多巴胺异常活动和药物干预。
