单次服用艾司西酞普兰可削弱金钱损失期间丘脑和尾状核的神经反应。
A single dose of escitalopram blunts the neural response in the thalamus and caudate during monetary loss.
机构信息
From the Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (Lewis, Zsido, Sacher); the International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany (Lewis, Zsido); the Department of Psychiatry and Psychotherapy, Medical School, University of Tuebingen, Germany (Lewis); the Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (Mueller, Reinelt, Villringer); the Max Planck School of Cognition, Leipzig, Germany (Zsido); the Division of Clinical Pharmacology, Rudolf-Boehm-Institute of Pharmacology and Toxicology, University of Leipzig, Leipzig, Germany (Regenthal); the Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel (Okon-Singer); the Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Haifa, Israel (Okon-Singer); the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA (Forbes); and the Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany (Villringer, Sacher).
出版信息
J Psychiatry Neurosci. 2021 Apr 27;46(3):E319-E327. doi: 10.1503/jpn.200121.
BACKGROUND
Selective serotonin reuptake inhibitors (SSRIs) show acute effects on the neural processes associated with negative affective bias in healthy people and people with depression. However, whether and how SSRIs also affect reward and punishment processing on a similarly rapid time scale remains unclear.
METHODS
We investigated the effects of an acute and clinically relevant dose (20 mg) of the SSRI escitalopram on brain response during reward and punishment processing in 19 healthy participants. In a doubleblind, placebo-controlled study using functional MRI, participants performed a well-established monetary reward task at 3 time points: at baseline; after receiving placebo or escitalopram; and after receiving placebo or escitalopram following an 8-week washout period.
RESULTS
Acute escitalopram administration reduced blood-oxygen-level-dependent (BOLD) response during punishment feedback in the right thalamus (family-wise error corrected [FWE] p = 0.013 at peak level) and the right caudate head (pFWE = 0.011 at peak level) compared to placebo. We did not detect any significant BOLD changes during reward feedback.
LIMITATIONS
We included only healthy participants, so interpretation of findings are limited to the healthy human brain and require future testing in patient populations. The paradigm we used was based on monetary stimuli, and results may not be generalizable to other forms of reward.
CONCLUSION
Our findings extend theories of rapid SSRI action on the neural processing of rewarding and aversive stimuli and suggest a specific and acute effect of escitalopram in the punishment neurocircuitry.
背景
选择性 5-羟色胺再摄取抑制剂（SSRIs）在健康人群和抑郁症患者中显示出对与负性情感偏见相关的神经过程的急性影响。然而，SSRIs 是否以及如何在类似的快速时间尺度上也影响奖励和惩罚处理仍不清楚。
方法
我们研究了在 19 名健康参与者中，急性和临床相关剂量（20 毫克）的 SSRI 依他普仑对奖励和惩罚处理过程中的大脑反应的影响。在一项使用功能磁共振成像的双盲、安慰剂对照研究中，参与者在 3 个时间点进行了一项成熟的货币奖励任务：基线；服用安慰剂或依他普仑后；以及服用安慰剂或依他普仑后 8 周洗脱期后。
结果
与安慰剂相比，依他普仑急性给药减少了右丘脑（FWE 校正后 p = 0.013 于峰值水平）和右尾状核头部（pFWE = 0.011 于峰值水平）在惩罚反馈期间的血氧水平依赖性（BOLD）反应。我们没有发现奖励反馈期间任何显著的 BOLD 变化。
局限性
我们只纳入了健康参与者，因此，研究结果的解释仅限于健康人的大脑，需要在患者人群中进行进一步测试。我们使用的范式是基于货币刺激，结果可能不适用于其他形式的奖励。
结论
我们的研究结果扩展了关于快速 SSRI 对奖励和厌恶刺激的神经处理的作用的理论，并表明依他普仑在惩罚神经回路中有特定的急性作用。
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