Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Psychiatry Clin Neurosci. 2024 Jan;78(1):3-18. doi: 10.1111/pcn.13601. Epub 2023 Nov 28.
Sense of agency (SoA) indicates a person's ability to perceive her/his own motor acts as actually being her/his and, through them, to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual's functioning, as observed in several neuropsychiatric disorders. This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients. Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson's disease taking dopaminergic medications or reporting impulsive-compulsive behaviors. A decreased IB effect was observed in Tourette's disorder and functional movement disorders, whereas increased action-outcome binding was found in patients with the cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.
能动性意识(SoA)是指一个人能够感知到自己的运动行为实际上是由自己产生的,并通过这些行为对外部事件的进程施加控制。SoA 的破坏可能会深刻地影响个体的功能,这种现象在几种神经精神疾病中都有观察到。本文是第一篇系统性综述关于能动性意识的研究,包括了使用意向绑定(IB)作为 SoA 测量的定量指标,在神经和精神疾病患者中的研究。符合条件的研究包括了患有神经或/和精神疾病的患者的 IB 研究。我们共纳入了 15 项研究,涉及 692 名个体。所有研究的偏倚风险都较低。研究发现,精神分裂症和正在服用多巴胺能药物或报告冲动-强迫行为的帕金森病患者的动作-结果绑定异常增加;妥瑞氏症和功能性运动障碍患者的 IB 效应降低;皮质基底节综合征患者的动作-结果绑定增加。在几种疾病中,IB 与健康对照组的偏差程度与症状的严重程度相关。自闭症谱系障碍、神经性厌食症和边缘型人格障碍的研究结果不一致。这些发现为针对神经精神疾病中 IB 改变的 SoA 治疗方法铺平了道路。