Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
Int J Neuropsychopharmacol. 2019 Feb 1;22(2):105-118. doi: 10.1093/ijnp/pyy081.
Pleasure and motivation are important factors for goal-directed behavior and well-being in both animals and humans. Intact hedonic capacity requires an undisturbed interplay between a number of different brain regions and transmitter systems. Concordantly, dysfunction of networks encoding for reward have been shown in depression and other psychiatric disorders. The development of technological possibilities to investigate connectivity on a functional level in humans and to directly influence networks in animals using optogenetics among other techniques has provided new important insights in this field of research.In this review, we aim to provide an overview on the neurobiological substrates of anhedonia on a network level. For this purpose, definition of anhedonia and the involved reward components are described first, then current data on reward networks in healthy individuals and in depressed patients are summarized, and the roles of different neurotransmitter systems involved in reward processing are specified. Based on this information, the impact of different therapeutic approaches on reward processing is described with a particular focus on deep brain stimulation (DBS) as a possibility for a direct modulation of human brain structures in vivo.Overall, results of current studies emphasize the importance of anhedonia in psychiatric disorders and the relevance of targeting this phenotype for a successful psychiatric treatment. However, more data incorporating these results for the refinement of methodological approaches are needed to be able to develop individually tailored therapeutic concepts based on both clinical and neurobiological profiles of patients.
愉悦和动机是动物和人类追求目标行为和幸福感的重要因素。完整的享乐能力需要一系列不同的大脑区域和递质系统之间的相互作用不受干扰。相应地,在抑郁症和其他精神障碍中已经显示出编码奖励的网络功能障碍。开发技术手段来研究人类的功能连接,并使用光遗传学等技术直接影响动物的网络,为该研究领域提供了新的重要见解。在这篇综述中,我们旨在概述网络水平上快感缺失的神经生物学基础。为此,首先描述了快感缺失的定义和涉及的奖励成分,然后总结了健康个体和抑郁患者的奖励网络的当前数据,并确定了参与奖励处理的不同神经递质系统的作用。基于这些信息,描述了不同治疗方法对奖励处理的影响,特别关注深部脑刺激 (DBS) 作为一种在体内直接调节人类大脑结构的可能性。总的来说,当前研究的结果强调了快感缺失在精神障碍中的重要性,以及针对这种表型进行成功精神治疗的相关性。然而,需要更多的数据来整合这些结果,以改进方法学方法,从而能够根据患者的临床和神经生物学特征制定个性化的治疗概念。