Schneider Mary L, Moore Colleen F, Ahlers Elizabeth O, Barnhart Todd E, Christian Bradley T, DeJesus Onofre T, Engle Jonathan W, Holden James E, Larson Julie A, Moirano Jeffrey M, Murali Dhanabalan, Nickles Robert J, Resch Leslie M, Converse Alexander K
Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States.
Harlow Center for Biological Psychology, University of Wisconsin-Madison, Madison, WI, United States.
Front Integr Neurosci. 2019 Jul 17;13:29. doi: 10.3389/fnint.2019.00029. eCollection 2019.
Sensory processing disorder (SPD), a developmental regulatory condition characterized by marked under- or over-responsivity to non-noxious sensory stimulation, is a common but poorly understood disorder that can profoundly affect mood, cognition, social behavior and adaptive life skills. Little is known about the etiology and neural underpinnings. Clinical research indicates that children with SPD show greater prevalence of difficulties in complex cognitive behavior including working memory, behavioral flexibility, and regulation of sensory and affective functions, which are related to prefrontal cortex (PFC), striatal, and midbrain regions. Neuroimaging may provide insight into mechanisms underlying SPD, and animal experiments provide important evidence that is not available in human studies. Rhesus monkeys ( = 73) were followed over a 20-year period from birth into old age. We focused on a single sensory modality, the tactile system, measured at 5-7 years, because of its critical importance for nourishment, attachment, and social reward in development. Positron emission tomography imaging was conducted at ages 12-18 years to quantify the availability of the D1 and D2 subtypes of the DA receptor (D1R and D2R), and the DA transporter (DAT). Heightened tactile responsivity was related to (a) elevated D1R in PFC overall, including lateral, ventrolateral, medial, anterior cingulate (aCg), frontopolar, and orbitofrontal (OFC) subregions, as well as nucleus accumbens (Acb), (b) reduced D2R in aCg, OFC, and substantia nigra/ventral tegmental area, and (c) elevated DAT in putamen. These findings suggest a mechanism by which DA pathways may be altered in SPD. These pathways are associated with reward processing and pain regulation, providing top-down regulation of sensory and affective processes. The balance between top-down cognitive control in the PFC-Acb pathway and bottom-up motivational function of the VTA-Acb-PFC pathway is critical for successful adaptive function. An imbalance in these two systems might explain DA-related symptoms in children with SPD, including reduced top-down regulatory function and exaggerated responsivity to stimuli. These results provide more direct evidence that SPD may involve altered DA receptor and transporter function in PFC, striatal, and midbrain regions. More work is needed to extend these results to humans.
感觉加工障碍(SPD)是一种发育调节性疾病,其特征是对无害感觉刺激明显反应不足或过度反应,是一种常见但了解甚少的疾病,会深刻影响情绪、认知、社会行为和适应性生活技能。关于其病因和神经基础知之甚少。临床研究表明,患有SPD的儿童在包括工作记忆、行为灵活性以及感觉和情感功能调节等复杂认知行为方面出现困难的患病率更高,这些与前额叶皮质(PFC)、纹状体和中脑区域有关。神经影像学可能有助于深入了解SPD的潜在机制,而动物实验提供了人体研究中无法获得的重要证据。对73只恒河猴从出生到老年进行了为期20年的跟踪研究。由于触觉系统在发育过程中对营养、依恋和社会奖励至关重要,我们重点研究了5至7岁时测量的单一感觉模态,即触觉系统。在12至18岁时进行正电子发射断层扫描成像,以量化多巴胺受体(D1R和D2R)的D1和D2亚型以及多巴胺转运体(DAT)的可用性。触觉反应增强与以下因素有关:(a)PFC整体,包括外侧、腹外侧、内侧、前扣带回(aCg)、额极和眶额(OFC)子区域以及伏隔核(Acb)中D1R升高;(b)aCg、OFC和黑质/腹侧被盖区中D2R降低;(c)壳核中DAT升高。这些发现提示了一种SPD中多巴胺通路可能发生改变的机制。这些通路与奖励处理和疼痛调节有关,对感觉和情感过程提供自上而下的调节。PFC-Acb通路的自上而下认知控制与VTA-Acb-PFC通路的自下而上动机功能之间的平衡对于成功的适应性功能至关重要。这两个系统的失衡可能解释了患有SPD的儿童中与多巴胺相关的症状,包括自上而下调节功能降低和对刺激的反应过度。这些结果提供了更直接的证据,表明SPD可能涉及PFC、纹状体和中脑区域中多巴胺受体和转运体功能的改变。需要开展更多工作将这些结果推广到人类。