Kibitov A O, Mazo G E
Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia.
Serbsky National Medical Research Center on Psychiatry and Addictions, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(3):146-154. doi: 10.17116/jnevro2021121031146.
Anhedonia is indeed a pathogenetically important clinical phenotype and a promising endophenotype for depressive symptoms with a very high contribution of biological and genetic factors. Neurobiological mechanisms of anhedonia are impaired functioning of the reward system of the brain, which is confirmed by many neuroimaging, genetic and experimental studies. Anhedonia has a trans-diagnoctic character and should be understood as a complex phenomenon, and it is important to correctly evaluate it within the framework of a particular research paradigm. It seems optimal to form several complementary research strategies that evaluate the most important «facets» of anhedonia, regardless of the nosological form of the disease, within the framework of one study using various methods to search for adequate biomarkers of anhedonia severity (genetic, neuroimaging, biochemical). Given the high-quality organization of such comprehensive studies based on the correct methodology of evidence-based medicine, it is likely that significant biomarker systems will be available in the near future, which, if replicated in independent samples, can be used to personalize the diagnosis and treatment of depression.
快感缺失确实是一种在发病机制上具有重要意义的临床表型，也是抑郁症状的一种很有前景的内表型，其生物学和遗传因素的贡献非常高。快感缺失的神经生物学机制是大脑奖赏系统功能受损，这已被许多神经影像学、遗传学和实验研究所证实。快感缺失具有跨诊断特征，应被理解为一种复杂现象，在特定研究范式的框架内正确评估它很重要。在一项研究中，采用各种方法寻找快感缺失严重程度的合适生物标志物（遗传学、神经影像学、生物化学），形成几种互补的研究策略来评估快感缺失最重要的“方面”，而不考虑疾病的分类形式，似乎是最佳选择。鉴于基于循证医学正确方法的此类综合研究组织良好，很可能在不久的将来会有重要的生物标志物系统可用，如果能在独立样本中得到重复验证，这些生物标志物可用于抑郁症的个性化诊断和治疗。
