Levenson Robert W, Sturm Virginia E, Haase Claudia M
Department of Psychology and Institute of Personality and Social Research, University of California, Berkeley, Berkeley, California 94720; email:
Annu Rev Clin Psychol. 2014;10:581-606. doi: 10.1146/annurev-clinpsy-032813-153653. Epub 2014 Jan 15.
Disruptions in emotional, cognitive, and social behavior are common in neurodegenerative disease and in many forms of psychopathology. Because neurodegenerative diseases have patterns of brain atrophy that are much clearer than those of psychiatric disorders, they may provide a window into the neural bases of common emotional and behavioral symptoms. We discuss five common symptoms that occur in both neurodegenerative disease and psychopathology (i.e., anxiety, dysphoric mood, apathy, disinhibition, and euphoric mood) and their associated neural circuitry. We focus on two neurodegenerative diseases (i.e., Alzheimer's disease and frontotemporal dementia) that are common and well characterized in terms of emotion, cognition, and social behavior and in patterns of associated atrophy. Neurodegenerative diseases provide a powerful model system for studying the neural correlates of psychopathological symptoms; this is supported by evidence indicating convergence with psychiatric syndromes (e.g., symptoms of disinhibition associated with dysfunction in orbitofrontal cortex in both frontotemporal dementia and bipolar disorder). We conclude that neurodegenerative diseases can play an important role in future approaches to the assessment, prevention, and treatment of mental illness.
情绪、认知和社会行为的紊乱在神经退行性疾病和多种精神病理学形式中很常见。由于神经退行性疾病的脑萎缩模式比精神疾病的更为清晰，它们可能为常见情绪和行为症状的神经基础提供一个窗口。我们讨论了神经退行性疾病和精神病理学中都出现的五种常见症状（即焦虑、烦躁情绪、冷漠、脱抑制和欣快情绪）及其相关的神经回路。我们重点关注两种神经退行性疾病（即阿尔茨海默病和额颞叶痴呆），它们在情绪、认知和社会行为以及相关萎缩模式方面都很常见且特征明确。神经退行性疾病为研究精神病理症状的神经相关性提供了一个强大的模型系统；有证据表明其与精神综合征存在趋同现象（例如，额颞叶痴呆和双相情感障碍中与眶额皮质功能障碍相关的脱抑制症状），这支持了上述观点。我们得出结论，神经退行性疾病在未来精神疾病的评估、预防和治疗方法中可以发挥重要作用。
