Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Curr Top Behav Neurosci. 2022;58:237-254. doi: 10.1007/7854_2022_312.
Although autism spectrum disorder (ASD) is defined by impaired social communication and restricted and repetitive behaviors and interests, ASD is also characterized by impaired motivational processes. The "social motivation theory of autism" describes how social motivation disruptions in ASD in early childhood may impede the drive to engage in reciprocal social behaviors and ultimately interfere with the development of neural networks critical for social communication (Chevallier et al., Trends Cogn Sci 16:231-239, 2012b). Importantly, clinical studies and preclinical research using model organisms for ASD indicate that motivational impairments in ASD are not constrained to social rewards but are evident in response to a range of nonsocial rewards as well. Additionally, translational studies on certain genetically defined neurodevelopmental disorders associated with ASD indicate that these syndromic forms of ASD are also characterized by motivational deficits and mesolimbic dopamine impairments. In this chapter we summarize clinical and preclinical research relevant to reward processing impairments in ASD and related neurodevelopmental disorders. We also propose a nosology to describe reward processing impairments in these disorders that uses a three-axes model. In this triaxial nosology, the first axis defines the direction of the reward response (i.e., anhedonic, hyperhedonic); the second axis defines the construct of the reward process (e.g., reward liking, reward wanting); and the third axis defines the context of the reward response (e.g., social, nonsocial). A more precise nosology for describing reward processing impairments in ASD and related neurodevelopmental disorders will aid in the translation of preclinical research to clinical investigations which will ultimately help to speed up the development of interventions that target motivational systems for ASD and related neurodevelopmental disorders.
尽管自闭症谱系障碍 (ASD) 的定义是社交沟通受损以及受限的、重复的行为和兴趣，但 ASD 也以受损的动机过程为特征。“自闭症的社会动机理论”描述了 ASD 儿童早期的社会动机障碍如何阻碍他们进行互惠社交行为的动力，最终干扰对社交沟通至关重要的神经网络的发展 (Chevallier 等人，Trends Cogn Sci 16:231-239, 2012b)。重要的是，使用 ASD 模型生物的临床研究和临床前研究表明，ASD 中的动机障碍不仅限于社交奖励，而且在对各种非社交奖励的反应中也很明显。此外，对某些与 ASD 相关的具有明确遗传定义的神经发育障碍的转化研究表明，这些综合征形式的 ASD 也以动机缺陷和中脑边缘多巴胺损伤为特征。在这一章中，我们总结了与 ASD 和相关神经发育障碍的奖励处理障碍相关的临床和临床前研究。我们还提出了一种分类法来描述这些疾病中的奖励处理障碍，该分类法使用三轴模型。在这种三轴分类法中，第一个轴定义了奖励反应的方向（即快感缺乏，快感亢进）；第二个轴定义了奖励过程的结构（例如，奖励喜欢，奖励渴望）；第三个轴定义了奖励反应的上下文（例如，社交，非社交）。用于描述 ASD 和相关神经发育障碍中的奖励处理障碍的更精确分类法将有助于将临床前研究转化为临床研究，这最终将有助于加快针对 ASD 和相关神经发育障碍的动机系统的干预措施的开发。
