Phillips Mary L, Drevets Wayne C, Rauch Scott L, Lane Richard
Division of Psychological Medicine, Institute of Psychiatry, London, United Kingdom
Biol Psychiatry. 2003 Sep 1;54(5):515-28. doi: 10.1016/s0006-3223(03)00171-9.
To date, there has been little investigation of the neurobiological basis of emotion processing abnormalities in psychiatric populations. We have previously discussed two neural systems: 1) a ventral system, including the amygdala, insula, ventral striatum, ventral anterior cingulate gyrus, and prefrontal cortex, for identification of the emotional significance of a stimulus, production of affective states, and automatic regulation of emotional responses; and 2) a dorsal system, including the hippocampus, dorsal anterior cingulate gyrus, and prefrontal cortex, for the effortful regulation of affective states and subsequent behavior. In this critical review, we have examined evidence from studies employing a variety of techniques for distinct patterns of structural and functional abnormalities in these neural systems in schizophrenia, bipolar disorder, and major depressive disorder. In each psychiatric disorder, the pattern of abnormalities may be associated with specific symptoms, including emotional flattening, anhedonia, and persecutory delusions in schizophrenia, prominent mood swings, emotional lability, and distractibility in bipolar disorder during depression and mania, and with depressed mood and anhedonia in major depressive disorder. We suggest that distinct patterns of structural and functional abnormalities in neural systems important for emotion processing are associated with specific symptoms of schizophrenia and bipolar and major depressive disorder.
迄今为止,针对精神疾病患者情绪加工异常的神经生物学基础的研究甚少。我们之前讨论过两个神经系统:1)腹侧系统,包括杏仁核、脑岛、腹侧纹状体、腹侧前扣带回和前额叶皮质,用于识别刺激的情感意义、产生情感状态以及自动调节情绪反应;2)背侧系统,包括海马体、背侧前扣带回和前额叶皮质,用于对情感状态及后续行为进行努力调节。在这篇批判性综述中,我们审视了来自多项研究的证据,这些研究采用了各种技术,以探究精神分裂症、双相情感障碍和重度抑郁症患者这些神经系统中不同模式的结构和功能异常。在每种精神疾病中,异常模式可能与特定症状相关,包括精神分裂症中的情感平淡、快感缺失和被害妄想,双相情感障碍在抑郁和躁狂发作期间的显著情绪波动、情绪不稳定和注意力分散,以及重度抑郁症中的抑郁情绪和快感缺失。我们认为,对情绪加工至关重要的神经系统中不同模式的结构和功能异常与精神分裂症、双相情感障碍和重度抑郁症的特定症状相关。