From the Department of Psychiatry and Behavioral Sciences, Emory University.
Harv Rev Psychiatry. 2022;30(1):40-53. doi: 10.1097/HRP.0000000000000326.
Inflammatory phenomena are found in many psychiatric disorders-notably, depression, schizophrenia, and posttraumatic stress disorder. Inflammation has been linked to severity and treatment resistance, and may both contribute to, and result from, the pathophysiology of some psychiatric illnesses. Emerging research suggests that inflammation may contribute to symptom domains of reward, motor processing, and threat reactivity across different psychiatric diagnoses. Reward-processing deficits contribute to motivational impairments in depression and schizophrenia, and motor-processing deficits contribute to psychomotor slowing in both depression and schizophrenia. A number of experimental models and clinical trials suggest that inflammation produces deficits in reward and motor processing through common pathways connecting the cortex and the striatum, which includes the nucleus accumbens, caudate nucleus, and putamen.The observed effects of inflammation on psychiatric disorders may cut across traditional conceptualizations of psychiatric diagnoses. Further study may lead to targeted immunomodulating treatments that address difficult-to-treat symptoms in a number of psychiatric disorders. In this review, we use a Research Domain Criteria framework to discuss proposed mechanisms for inflammation and its effects on the domains of reward processing, psychomotor slowing, and threat reactivity. We also discuss data that support contributing roles of metabolic dysregulation and sex differences on the behavioral outcomes of inflammation. Finally, we discuss ways that future studies can help disentangle this complex topic to yield fruitful results that will help advance the field of psychoneuroimmunology.
在许多精神疾病中都发现了炎症现象——特别是抑郁症、精神分裂症和创伤后应激障碍。炎症与严重程度和治疗抵抗有关，可能既促成也源自某些精神疾病的病理生理学。新兴研究表明，炎症可能导致不同精神疾病诊断的奖赏、运动处理和威胁反应性等症状领域的问题。奖赏处理缺陷导致抑郁症和精神分裂症的动机障碍，运动处理缺陷导致抑郁症和精神分裂症的精神运动迟缓。许多实验模型和临床试验表明，炎症通过连接大脑皮层和纹状体的共同途径（包括伏隔核、尾状核和壳核）导致奖赏和运动处理缺陷，其中包括伏隔核、尾状核和壳核。炎症对精神疾病的观察到的影响可能跨越精神疾病诊断的传统概念化。进一步的研究可能会导致针对免疫调节的治疗方法，以解决多种精神疾病中难以治疗的症状。在这篇综述中，我们使用研究领域标准框架来讨论炎症及其对奖赏处理、精神运动迟缓、威胁反应性等领域影响的拟议机制。我们还讨论了支持代谢失调和性别差异对炎症行为结果的作用的相关数据。最后，我们讨论了未来研究如何帮助理清这一复杂问题，从而产生有助于推进心理神经免疫学领域的富有成效的结果。
