Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 3 Pasteur Street, 02-093Warsaw, Poland.
Medical University of Warsaw, Chair of Psychiatry, Nowowiejska 27, 00-665Warsaw, Poland.
Rev Neurosci. 2018 Sep 25;29(7):727-744. doi: 10.1515/revneuro-2017-0091.
Abnormalities in reward processing are crucial symptoms of major depressive disorder (MDD) and schizophrenia (SCH). Recent neuroscientific findings regarding MDD have led to conclusions about two different symptoms related to reward processing: motivational and consummatory anhedonia, corresponding, respectively, to impaired motivation to obtain rewards ('wanting'), and diminished satisfaction from consuming them ('liking'). One can ask: which of these is common for MDD and SCH. In our review of the latest neuroscientific studies, we show that MDD and SCH do not share consummatory anhedonia, as SCH patients usually have unaltered liking. Therefore, we investigated whether motivational anhedonia is the common symptom across MDD and SCH. With regard to the similarities and differences between the neural mechanisms of MDD and SCH, here we expand the current knowledge of motivation deficits and present the common underlying mechanism of motivational anhedonia - the dopamine dysregulation hypothesis - stating that any prolonged dysregulation in tonic dopamine signaling that exceeds the given equilibrium can lead to striatal dysfunction and motivational anhedonia. The implications for further research and treatment of MDD and SCH are also discussed.
异常的奖励处理是重性抑郁障碍(MDD)和精神分裂症(SCH)的关键症状。最近关于 MDD 的神经科学发现得出了两个与奖励处理相关的不同症状的结论:动机性和满足性快感缺失,分别对应于获得奖励的动机受损(“想要”)和消费它们时的满足感降低(“喜欢”)。人们会问:这两者在 MDD 和 SCH 中哪个更常见。在我们对最新神经科学研究的综述中,我们表明 MDD 和 SCH 并不共享满足性快感缺失,因为 SCH 患者通常没有改变的喜好。因此,我们调查了动机性快感缺失是否是 MDD 和 SCH 的共同症状。关于 MDD 和 SCH 的神经机制的相似性和差异,在这里我们扩展了动机缺陷的现有知识,并提出了动机性快感缺失的共同潜在机制——多巴胺失调假说——指出任何持续的、超过给定平衡的 tonic 多巴胺信号失调都可能导致纹状体功能障碍和动机性快感缺失。还讨论了对 MDD 和 SCH 的进一步研究和治疗的影响。