Heilman K M, Gilmore R L
Department of Neurology, University of Florida, Gainesville 32610-0236, USA.
J Clin Neurophysiol. 1998 Sep;15(5):409-23. doi: 10.1097/00004691-199809000-00005.
Emotions may be classified into two major divisions: experience and behavior. Because the brain is critical for mediating emotional experience and behavior, diseases of the brain may induce changes in emotional behavior and experience. Disorders of almost all portions of the cerebral hemisphere, including the cortex, limbic system, and basal ganglia, have been associated with changes of emotional experience and behavior. Dysfunction of the cerebral cortex may be associated with disorders of emotional communication. Whereas deficits of the left hemisphere appear to impair the comprehension and expression of propositional language, deficits of the right hemisphere may be associated with an impaired ability to comprehend and express emotional gestures such as facial expression and emotional prosody. Some patients have either prosodic or facial emotional deficits. Some have only expressive or receptive deficits. However, others may be globally impaired, either within or across modalities. The posterior portions of the neocortex appear to be important for comprehension and the anterior for expression of both emotional prosody and faces. Injury and dysfunction of the limbic system may also alter emotional communication and experience. For example, damage to the amygdala may be associated with an impaired ability to recognized emotional faces and a reduction of affect, especially anger, rage, and fear. In contrast, lesions of the septal region may be associated with increased ragelike behaviors. Seizures frequently emanate from the limbic system, and seizures that start in the amygdala can induce fear and perhaps even rage. Disorders of the basal ganglia may also be associated with defects of emotional communication and experience. Patients with Parkinson's disease not only may be impaired at communicating emotions with both expressive and receptive deficits but also are often depressed and anxious. Patients with Huntington's disease may have emotional comprehension deficits with an impaired ability to recognize emotional faces and prosody. Patients with Huntington's disease may have mood changes even before motor dysfunction becomes manifest. Many of the defects in emotional experience may be related to the associated changes in neurotransmitter systems. Unfortunately, how alteration of neurotransmitters induce mood changes remains unknown. In this chapter we review the feedback and central theories of emotional experience. Although we argue against the postulates that feedback is critical to the experience of emotions, we do suspect that feedback may influence emotions. Emotions may be conditioned and may use thalamic-limbic circuits, as proposed by LeDoux. However, most emotional behaviors and experiences are induced by complex stimuli that an isolated thalamus could not interpret. The cerebral cortex of humans has complex modular systems that analyze stimuli, develop percepts, and interpret meaning. We discuss the proposal that the experience of emotions is dimensional. Almost all primary emotions can be described with two or three factors, including valence, arousal, and motor activation.
体验和行为。由于大脑在调节情绪体验和行为方面至关重要，脑部疾病可能会引发情绪行为和体验的变化。几乎大脑半球的所有部分，包括皮质、边缘系统和基底神经节，其功能紊乱都与情绪体验和行为的变化有关。大脑皮质功能障碍可能与情绪交流障碍有关。左半球功能缺陷似乎会损害命题语言的理解和表达，而右半球功能缺陷可能与理解和表达诸如面部表情和情感韵律等情绪手势的能力受损有关。有些患者存在韵律或面部情绪缺陷。有些患者只有表达或接受方面的缺陷。然而，其他患者可能在某种模式内或跨模式方面整体受损。新皮质的后部对于理解似乎很重要，而前部对于情绪韵律和面部表情的表达很重要。边缘系统的损伤和功能障碍也可能改变情绪交流和体验。例如，杏仁核受损可能与识别情绪面孔能力受损以及情感减少有关，尤其是愤怒、狂怒和恐惧。相比之下，隔区病变可能与类似愤怒的行为增加有关。癫痫发作常起源于边缘系统，始于杏仁核的癫痫发作可诱发恐惧甚至狂怒。基底神经节功能障碍也可能与情绪交流和体验缺陷有关。帕金森病患者不仅在表达和接受方面存在缺陷，导致情绪交流受损，而且常常抑郁和焦虑。亨廷顿病患者可能存在情绪理解缺陷，识别情绪面孔和韵律的能力受损。亨廷顿病患者甚至在运动功能障碍出现之前就可能有情绪变化。许多情绪体验缺陷可能与神经递质系统的相关变化有关。不幸的是，神经递质的改变如何引发情绪变化仍然未知。在本章中，我们将回顾情绪体验的反馈和中枢理论。尽管我们反对反馈对情绪体验至关重要的假设，但我们确实怀疑反馈可能会影响情绪。情绪可能是条件性的，并且可能如勒杜所提出的那样利用丘脑 - 边缘回路。然而，大多数情绪行为和体验是由孤立的丘脑无法解释的复杂刺激诱发的。人类的大脑皮质具有复杂的模块化系统，可分析刺激、形成感知并解释意义。我们将讨论情绪体验是维度性的这一观点。几乎所有的基本情绪都可以用两三个因素来描述，包括效价、唤醒和运动激活。
