Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA.
Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA; Department of Psychology, UCLA, Los Angeles, CA, USA.
Neurosci Biobehav Rev. 2023 Sep;152:105307. doi: 10.1016/j.neubiorev.2023.105307. Epub 2023 Jul 6.
Anhedonia, as evidenced by impaired pleasurable response to reward, reduced reward motivation, and/or deficits in reward-related learning, is a common feature of depression. Such deficits in reward processing are also an important clinical target as a risk factor for depression onset. Unfortunately, reward-related deficits remain difficult to treat. To address this gap and inform the development of effective prevention and treatment strategies, it is critical to understand the mechanisms that drive impairments in reward function. Stress-induced inflammation is a plausible mechanism of reward deficits. The purpose of this paper is to review evidence for two components of this psychobiological pathway: 1) the effects of stress on reward function; and 2) the effects of inflammation on reward function. Within these two areas, we draw upon preclinical and clinical models, distinguish between acute and chronic effects of stress and inflammation, and address specific domains of reward dysregulation. By addressing these contextual factors, the review reveals a nuanced literature which might be targeted for additional scientific inquiry to inform the development of precise interventions.
快感缺失,表现为对奖赏的愉悦反应受损、奖赏动机降低和/或奖赏相关学习缺陷,是抑郁症的一个常见特征。这种奖赏处理缺陷也是一个重要的临床靶点,因为它是抑郁症发病的一个风险因素。不幸的是,奖赏相关缺陷仍然难以治疗。为了解决这一差距,并为制定有效的预防和治疗策略提供信息,了解驱动奖赏功能障碍的机制至关重要。应激诱导的炎症是奖赏缺陷的一个合理机制。本文的目的是综述这一心理生物学途径的两个组成部分的证据:1)应激对奖赏功能的影响;2)炎症对奖赏功能的影响。在这两个领域中,我们借鉴了临床前和临床模型,区分了应激和炎症的急性和慢性效应,并探讨了奖赏失调的特定领域。通过解决这些背景因素,该综述揭示了一个细致入微的文献,可能需要进一步的科学研究来为精确干预措施的制定提供信息。