Section of Experimental Psychopathology, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany.
Schizophr Res. 2010 May;118(1-3):154-61. doi: 10.1016/j.schres.2009.11.007. Epub 2009 Dec 16.
The present study employs a new framework to categorise the heterogeneous findings on the relationship between impaired reward processing and negative and affective symptoms of schizophrenia. Based on previous behavioural and neuroimaging studies we postulate that "wanting" (i.e. anticipation) of a reward is specifically related to apathy, whereas "liking" (i.e. hedonic impact) is related to anhedonia and depression--symptoms commonly observed in schizophrenia. Fifteen patients with schizophrenia or schizoaffective disorder treated with atypical antipsychotic drugs and fifteen healthy controls performed a probabilistic monetary incentive delay task while undergoing functional magnetic resonance imaging. At the group level we found no significant differences between patients and controls in neural activation during anticipation or receipt of a reward. However, in patients with schizophrenia specific relationships between ventral-striatal activation and symptoms were observed. Ventral-striatal activation during reward anticipation was negatively correlated with apathy, while activation during receipt of reward was negatively correlated with severity of depressive symptoms. These results suggest that the link between negative symptoms and reward anticipation might specifically relate to apathy, i.e. a lack of motivation and drive. Impaired hedonic reward processing might contribute to the development of depressive symptoms in patients with schizophrenia, but it is not directly associated with self-rated anhedonia. These results indicate the necessity of more specifically differentiating negative and affective symptoms in schizophrenia in order to understand the role of the reward system in their pathogenesis.
本研究采用了一种新的框架，对奖赏加工受损与精神分裂症的阴性和情感症状之间的关系的异质研究结果进行分类。基于先前的行为和神经影像学研究，我们假设“想要”（即预期）奖赏与淡漠有关，而“喜欢”（即享乐影响）与快感缺失和抑郁有关——这些症状在精神分裂症中常见。15 名接受非典型抗精神病药物治疗的精神分裂症或分裂情感障碍患者和 15 名健康对照者在进行功能磁共振成像时执行了概率性货币奖励延迟任务。在组水平上，我们没有发现患者和对照组在预期或获得奖励期间的神经激活方面存在显著差异。然而，在精神分裂症患者中，腹侧纹状体的激活与症状之间存在特定的关系。在奖励预期期间，腹侧纹状体的激活与淡漠呈负相关，而在获得奖励期间的激活与抑郁症状的严重程度呈负相关。这些结果表明，阴性症状与奖励预期之间的联系可能与淡漠有关，即缺乏动机和动力。享乐性奖励加工受损可能导致精神分裂症患者出现抑郁症状，但与自我报告的快感缺失并无直接关联。这些结果表明，有必要更具体地区分精神分裂症中的阴性和情感症状，以了解奖励系统在其发病机制中的作用。
