自闭症谱系障碍中的社会和金钱奖励处理。
Processing of social and monetary rewards in autism spectrum disorders.
机构信息
Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
出版信息
Br J Psychiatry. 2023 Mar;222(3):100-111. doi: 10.1192/bjp.2022.157.
BACKGROUND
Reward processing has been proposed to underpin the atypical social feature of autism spectrum disorder (ASD). However, previous neuroimaging studies have yielded inconsistent results regarding the specificity of atypicalities for social reward processing in ASD.
AIMS
Utilising a large sample, we aimed to assess reward processing in response to reward type (social, monetary) and reward phase (anticipation, delivery) in ASD.
METHOD
Functional magnetic resonance imaging during social and monetary reward anticipation and delivery was performed in 212 individuals with ASD (7.6-30.6 years of age) and 181 typically developing participants (7.6-30.8 years of age).
RESULTS
Across social and monetary reward anticipation, whole-brain analyses showed hypoactivation of the right ventral striatum in participants with ASD compared with typically developing participants. Further, region of interest analysis across both reward types yielded ASD-related hypoactivation in both the left and right ventral striatum. Across delivery of social and monetary reward, hyperactivation of the ventral striatum in individuals with ASD did not survive correction for multiple comparisons. Dimensional analyses of autism and attention-deficit hyperactivity disorder (ADHD) scores were not significant. In categorical analyses, comparisons showed that ASD effects were most pronounced in participants with ASD without co-occurring ADHD.
CONCLUSIONS
Our results do not support current theories linking atypical social interaction in ASD to specific alterations in social reward processing. Instead, they point towards a generalised hypoactivity of ventral striatum in ASD during anticipation of both social and monetary rewards. We suggest this indicates attenuated reward seeking in ASD independent of social content and that elevated ADHD symptoms may attenuate altered reward seeking in ASD.
背景
奖赏处理被认为是孤独症谱系障碍(ASD)非典型社交特征的基础。然而,之前的神经影像学研究对于 ASD 中社交奖赏处理的特异性异常得出了不一致的结果。
目的
利用大样本,我们旨在评估 ASD 中对奖赏类型(社交、金钱)和奖赏阶段(预期、传递)的奖赏处理。
方法
对 212 名 ASD 患者(7.6-30.6 岁)和 181 名典型发育参与者(7.6-30.8 岁)进行了社会和金钱奖赏预期和传递期间的功能磁共振成像。
结果
在整个社会和金钱奖赏预期中,与典型发育参与者相比,ASD 患者的右侧腹侧纹状体整体激活不足。此外,两种奖赏类型的兴趣区域分析均显示 ASD 患者的左侧和右侧腹侧纹状体存在相关的激活不足。在社会和金钱奖赏传递过程中,ASD 患者的腹侧纹状体过度激活在经过多次比较校正后并不显著。自闭症和注意缺陷多动障碍(ADHD)评分的维度分析并不显著。在分类分析中,比较显示,在没有共患 ADHD 的 ASD 患者中,ASD 效应最为明显。
结论
我们的结果不支持将 ASD 中的非典型社交互动与社交奖赏处理的特定改变联系起来的现有理论。相反,它们表明 ASD 患者在预期社会和金钱奖励时,腹侧纹状体的总体活动减少。我们认为,这表明 ASD 中存在奖赏寻求的减弱,而与社交内容无关,并且 ADHD 症状的升高可能会减弱 ASD 中改变的奖赏寻求。