Anhedonia

快感缺乏症
  • 文章类型: Journal Article
    快感缺失是精神分裂症阴性症状的核心特征之一,可能是极其繁重的。我们的研究应用基于静息态功能磁共振成像(fMRI)的支持向量回归(SVR)来预测首发精神分裂症(FES)患者的快感缺失,并分析了基于小波的振幅低频波动(小波-ALFF)与快感缺失之间的相关性。我们从广州医科大学附属脑科医院招募了31例FES患者和33例健康对照(HCs)。所有受试者均完成了时间体验愉悦量表(TEPS)并接受了静息状态功能磁共振成像(rs-fMRI)。我们使用小波-ALFF方法和SVR来分析数据。FES患者的自我感觉得分低于健康受试者(t=-2.71,P<0.01)。FES在广泛的大脑皮层中显示可变的小波-ALFF(P<0.05,GFR校正)。SVR分析表明,小波-ALFF,主要基于右壳核(r=0.40,P<0.05)和右枕上回(r=-0.39,P<0.05),在预测完美愉悦分数方面是有效的,准确率为56.43%。我们的研究表明,FES中异常的自发神经活动可能与FES中完全性快感缺乏状态有关。右壳核和枕上回的小波-ALFF变化可能是具有快感的FES的生物学特征,并且可以作为具有快感的FES的潜在生物学标记。
    Anhedonia is one of the core features of the negative symptoms of schizophrenia and can be extremely burdensome. Our study applied resting-state functional magnetic resonance imaging (fMRI)-based support vector regression (SVR) to predict anhedonia in patients with first-episode schizophrenia (FES) and analysed the correlation between the wavelet-based amplitude low-frequency fluctuation (wavelet-ALFF) of the main brain region and anhedonia. We recruited 31 patients with FES and 33 healthy controls (HCs) from the Affiliated Brain Hospital of Guangzhou Medical University. All subjects completed the Temporal Experience of Pleasure Scale (TEPS) and received resting-state fMRI (rs-fMRI). We used the wavelet-ALFF method and SVR to analyse the data. Patients with FES had lower consummatory pleasure scores than healthy subjects (t = -2.71, P<0.01). FES displays variable wavelet-ALFF in a wide range of cerebral cortices (P<0.05, GFR corrected). The SVR analysis showed that wavelet-ALFF, based primarily on the right putamen (r = 0.40, P<0.05) and right superior occipital gyrus (r = -0.39, P<0.05), was effective in predicting consummatory pleasure scores with an accuracy of 56.43 %. Our study shows that abnormal spontaneous neural activity in FES may be related to the state of consummatory anhedonia in FES. Wavelet-ALFF changes in the right putamen and superior occipital gyrus may be a biological feature of FES with anhedonia and could serve as a potential biological marker of FES with anhedonia.
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  • 文章类型: Journal Article
    背景:目前的临床研究表明,伴有不良儿童期经历(ACEs)的重度抑郁症(MDD)与较高的快感缺乏相关。然而,对于患有ACEs的年轻MDD个体的奖励敏感性变化是否与快感缺乏有关,目前尚不清楚.
    方法:我们评估了每位患者的快感缺失和ACE。然后,我们在EEG期间进行了Iowa赌博任务,以测量86例MDD患者(31例无或1例ACE,55例有2个或2个以上ACE)和44例健康对照(HC)的奖励阳性(RewP)及其差异(ΔRewP).此外,我们构建了一个中介模型来评估异常ΔRewP是否可以介导ACE和快感缺失之间的关系。
    结果:与健康对照组和无ACE或有ACE的MDD患者相比,患有两种或两种以上ACE的MDD患者最严重的症状是快感缺失和决策受损,并显示奖励敏感性显着降低(最钝化的ΔRewP)。更重要的是,ΔRewP介导的ACEs与MDD快感缺乏之间的关系。
    结论:我们发现,在MDD患者中,ΔRewP部分介导ACEs与快感缺乏之间的关联,这为具有早期不良经历的MDD个体奖励系统异常变化的神经生物学基础提供了证据。
    BACKGROUND: Current clinical studies have indicated that major depressive disorder (MDD) with adverse childhood experiences (ACEs) is associated with greater anhedonia. However, little is known about whether the change in reward sensitivity among young MDD individuals with ACEs are related to anhedonia.
    METHODS: We evaluated anhedonia and ACEs of each patient. Then, we performed Iowa gambling task during EEG to measure the reward positivity (RewP) and its difference (ΔRewP) in 86 MDD patients (31 with no or one ACE and 55 with two or more ACEs) and 44 healthy controls (HCs). Furthermore, we constructed a mediation model to assessed whether aberrant ΔRewP could mediate the relationship between ACEs and anhedonia.
    RESULTS: Compared with healthy controls and MDD patients with no or one ACE, MDD patients with two or more ACEs had the most severe symptoms of anhedonia and impaired decision-making, and showed significantly reduced reward sensitivity (most blunted ΔRewP). More importantly, ΔRewP mediated relationship between ACEs and anhedonia in MDD.
    CONCLUSIONS: We found that the ΔRewP partially mediates the association between ACEs and anhedonia in MDD patients, which provides evidence for the neurobiological basis of abnormal changes in the reward system in MDD individuals with early adverse experiences.
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  • 文章类型: Journal Article
    慢性捕食者应激(CPS)是诱导动物快感缺乏症的重要且生态相关的工具,但是相关神经生物学变化背后的神经回路仍有待识别。使用细胞类型特定的操作,我们发现,中丘脑底核(mSTN)中促肾上腺皮质激素释放激素(CRH)神经元在不可避免的情况下增强挣扎行为,并导致快感缺失,主要通过投射到外部苍白球(GPe)。体内神经元活动的记录显示,CPS扭曲了mSTN-CRH神经元对阴性和阳性刺激的响应,这可能是CPS引起的行为绝望和快感缺失的基础。此外,我们发现了从终末纹床核(BNST)到投射到GPe的mSTN-CRH神经元的突触前输入,这些输入可能会调解这种行为。这项研究确定了一种神经回路,该神经回路可共同调节对捕食者压力的逃避反应和快感缺失。这种对捕食者应激反应的防御行为的神经基础的新理解可能会使我们对神经精神疾病的理解受益。
    Chronic predator stress (CPS) is an important and ecologically relevant tool for inducing anhedonia in animals, but the neural circuits underlying the associated neurobiological changes remain to be identified. Using cell-type-specific manipulations, we found that corticotropin-releasing hormone (CRH) neurons in the medial subthalamic nucleus (mSTN) enhance struggle behaviors in inescapable situations and lead to anhedonia, predominately through projections to the external globus pallidus (GPe). Recordings of in vivo neuronal activity revealed that CPS distorted mSTN-CRH neuronal responsivity to negative and positive stimuli, which may underlie CPS-induced behavioral despair and anhedonia. Furthermore, we discovered presynaptic inputs from the bed nucleus of the stria terminalis (BNST) to mSTN-CRH neurons projecting to the GPe that were enhanced following CPS, and these inputs may mediate such behaviors. This study identifies a neurocircuitry that co-regulates escape response and anhedonia in response to predator stress. This new understanding of the neural basis of defensive behavior in response to predator stress will likely benefit our understanding of neuropsychiatric diseases.
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  • 文章类型: Journal Article
    社会接触对人类发展和心理健康起着至关重要的作用。然而,缺乏评估社会接触经验和态度的个体差异的措施,尤其是在东方文化下。这项研究开发了社交接触体验和态度问卷-中文版(STEAQ-C),并研究了其对健康年轻中国成年人的心理测量特性。在研究1中,生成了项目库,并使用主成分分析(PCA)来识别STEAQ的因子结构。研究2招募了一个独立的样本,并检查了其信度和效度。网络分析进一步探讨了社会接触与各种亚临床特征和症状之间的相互关系。PCA确定了STEAQ-C的四个因素,关于童年的触摸体验,当前与亲密伴侣的联系,与家人和朋友,和不熟悉的人。研究2证实了四因素结构,并保持了其内部一致性和稳定性。对社交接触的积极态度和更多体验与感觉过度反应和感觉不敏感呈负相关,以及童年的创伤,特别是情感上的忽视,支持收敛有效性。标准相关有效性的证据是通过其与安全依恋风格的并发和预测性关联来积累的,更高水平的社会能力,和较低水平的社交焦虑。网络分析突出显示了对社交接触的改变感知,这可能是具有社交功能障碍的精神疾病的共同特征(例如,自闭症,社交焦虑和消极分裂)。新开发的STEAQ-C可能是评估东方文化下的社会接触经验和态度的及时工具。
    Social touch has a vital role in human development and psychological well-being. However, there is a lack of measures assessing individual differences in social touch experiences and attitudes, especially under Eastern cultures. This study developed the Social Touch Experiences and Attitudes Questionnaire - Chinese version (STEAQ-C) and examined its psychometric properties with healthy young Chinese adults. In Study 1, an item pool was generated and principal component analysis (PCA) was used to identify the factor structure of the STEAQ. Study 2 recruited an independent sample and examined its reliability and validity. Network analysis further explored the interrelations between social touch and a variety of subclinical traits and symptoms. PCA identified four factors of the STEAQ-C, relating to childhood touch experiences, current touch with intimate partners, with family and friends, and with unfamiliar people. Study 2 confirmed the four-factor structure and upheld its internal consistency and stability. Positive attitudes towards and greater experiences of social touch were negatively correlated with sensory over-responsiveness and sensory hyposensitivity, as well as childhood trauma particularly emotional neglect, supporting the convergent validity. Evidence of criterion-related validity was accrued via its concurrent and predictive associations with secure attachment style, higher levels of social competence, and lower levels of social anxiety. Network analysis highlighted altered perception of social touch may be a shared feature for psychiatric conditions with social dysfunctions (e.g., autism, social anxiety and negative schizotypy). The newly-developed STEAQ-C may be a timely tool in assessing social touch experiences and attitudes under Eastern cultures.
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  • 文章类型: Case Reports
    快感缺失和动机障碍是抑郁症的主要特征,常规抗抑郁药对其疗效有限。临床前调查和现有的临床试验数据证实了阿片受体调节剂在解决快感缺乏症方面的前景,抑郁症,和焦虑。虽然像地佐辛这样的合成阿片类药物通常用于镇痛,其独特的药理学特征引起了人们对其潜在抗抑郁特性和翻译应用的兴趣。在这里,我们介绍了一例安非他酮持续治疗无效的病例.然而,单次低剂量静脉注射地佐辛的偶然给药导致抑郁症状的快速和持续的改善,特别是快感缺乏和动机缺陷。我们的发现为“传统药物”地佐辛提出了潜在的新作用。
    Anhedonia and motivational impairments are cardinal features of depression, against which conventional antidepressants demonstrate limited efficacy. Preclinical investigations and extant clinical trial data substantiate the promise of opioid receptor modulators in addressing anhedonia, depression, and anxiety. While synthetic opioid agents like dezocine are conventionally employed for analgesia, their distinctive pharmacological profile has engendered interest in their potential antidepressant properties and translational applications. Herein, we present a case in which persistent bupropion treatment was ineffective. However, the incidental administration of a single low-dose intravenous injection of dezocine resulted in a rapid and sustained amelioration of depressive symptoms, particularly anhedonia and motivational deficits. Our findings posit a potentially novel role for the \"legacy drug\" dezocine.
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  • 文章类型: Journal Article
    实证研究结果表明,快感缺失,精神分裂症和重度抑郁症的核心症状和获得快感的能力下降,可能存在于患有高度社会快感障碍的人和患有亚综合征抑郁症的人中。很少有研究采用多维框架来研究这些亚临床样本中的快感缺失。我们招募了35名具有高社会快感(SA)的参与者,53名患有亚综合征抑郁症(SD)的参与者,20名同时存在两种特征(CO)的参与者,和47名这两种特征(CN)水平较低的参与者完成一份自我报告问卷,捕捉快乐体验,货币激励延迟(MID)任务和社会激励延迟(SID)任务捕获奖励的动机。结果表明,患有SA的人,与CN相比,SD和CO表现出较低的抽象预期愉悦。此外,SD和CO患者在社会激励下表现出特定的损害。一起,我们的发现表征了SA亚临床样本的快感缺失表现的多维特征,SD和CO,这可能有助于早期识别高危人群。
    Empirical findings suggested that anhedonia, a reduced capability to access pleasure and a core symptom in both schizophrenia and the major depressive disorder, can be present in people with high levels of social anhedonia and people with subsyndromal depression. Few studies have adopted a multidimensional framework to investigate anhedonia in these subclinical samples. We recruited 35 participants with high social anhedonia (SA), 53 participants with subsyndromal depression (SD), 20 participants with co-occurrence of both traits (CO), and 47 participants with low levels of both traits (CN) to complete a self-report questionnaire capturing the pleasure experience, and the Monetary Incentives Delay (MID) Task and the Social Incentives Delay (SID) Task capturing the motivation of reward. Results indicated that people with SA, SD and CO exhibited lower abstract anticipatory pleasure compared to CN. Moreover, people with SD and CO exhibited specific impairment in response to social incentives. Together, our findings characterized the multidimensional features of anhedonia performances of subclinical samples with SA, SD and CO, which may contribute to the formulation of early identification of at-risk groups.
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  • 文章类型: Journal Article
    背景:快感障碍是抑郁症的核心症状,与预后和治疗结果密切相关。然而,缺乏准确有效的快感缺乏症治疗方法,要求对潜在机制有更深入的了解。
    方法:采用Snaith-Hamilton快乐量表(SHAPS)和磁共振成像(MRI)对303例诊断为抑郁症和快感缺乏的患者进行评估。使用K-means算法将患者分为低快感组和高快感组。采用数据驱动的方法,基于MATLAB探讨不同快感程度的大脑结构和功能的差异。探索性地使用随机森林模型来测试大脑结构和功能差异对抑郁症快感缺乏的预测能力。
    结果:在抑郁症和高度快感缺失患者的几个脑区,结构和功能差异明显,包括颞叶,副带回,额上回,枕下回,右岛回,和上顶叶小叶。这些大脑区域的变化与SHAPS评分显着相关。
    结论:这些脑区可能是有用的生物标志物,可以更客观地评估抑郁症的快感缺失,为精准医疗奠定了基础,预后相对较差的组。
    BACKGROUND: Anhedonia is a core symptom of depression that is closely related to prognosis and treatment outcomes. However, accurate and efficient treatments for anhedonia are lacking, mandating a deeper understanding of the underlying mechanisms.
    METHODS: A total of 303 patients diagnosed with depression and anhedonia were assessed by the Snaith-Hamilton Pleasure Scale (SHAPS) and magnetic resonance imaging (MRI). The patients were categorized into a low-anhedonia group and a high-anhedonia group using the K-means algorithm. A data-driven approach was used to explore the differences in brain structure and function with different degrees of anhedonia based on MATLAB. A random forest model was used exploratorily to test the predictive ability of differences in brain structure and function on anhedonia in depression.
    RESULTS: Structural and functional differences were apparent in several brain regions of patients with depression and high-level anhedonia, including in the temporal lobe, paracingulate gyrus, superior frontal gyrus, inferior occipital gyrus, right insular gyrus, and superior parietal lobule. And changes in these brain regions were significantly correlated with scores of SHAPS.
    CONCLUSIONS: These brain regions may be useful as biomarkers that provide a more objective assessment of anhedonia in depression, laying the foundation for precision medicine in this treatment-resistant, relatively poor prognosis group.
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  • 文章类型: Journal Article
    目的:快感障碍是重度抑郁症(MDD)的关键诊断症状,与预后不良有关。了解快感缺失的神经机制对患有MDD的个体具有重要意义。它鼓励寻找能够可靠识别快感缺失的客观指标。
    方法:通过利用59例MDD患者的治疗前功能连接(FC)数据,开发了一种基于连接体的预测模型(CPM)用于快感缺失症状的预测模型。基于节点的FC分析用于比较忧郁和非忧郁MDD患者的FC模式差异。然后应用支持向量机(SVM)方法对MDD患者的这两种亚型进行分类。
    结果:CPM可以成功预测MDD患者的快感缺失症状(阳性网络:r=0.4719,p<0.0020,均方误差=23.5125,5000次迭代)。与非忧郁性MDD患者相比,忧郁性MDD患者左扣带回和右海马旁回之间的FC降低(p_bonferroni=0.0303)。这种独特的FC模式有效地区分了忧郁和非忧郁MDD患者,灵敏度达到93.54%,特异性为67.86%,采用支持向量机方法,总体准确率为81.36%。
    结论:本研究成功建立了基于FC的MDD快感缺失症状预测网络模型,以及区分忧郁和非忧郁MDD患者的分类模型。这些发现为临床治疗提供了指导。
    OBJECTIVE: Anhedonia is a critical diagnostic symptom of major depressive disorder (MDD), being associated with poor prognosis. Understanding the neural mechanisms underlying anhedonia is of great significance for individuals with MDD, and it encourages the search for objective indicators that can reliably identify anhedonia.
    METHODS: A predictive model used connectome-based predictive modeling (CPM) for anhedonia symptoms was developed by utilizing pre-treatment functional connectivity (FC) data from 59 patients with MDD. Node-based FC analysis was employed to compare differences in FC patterns between melancholic and non-melancholic MDD patients. The support vector machines (SVM) method was then applied for classifying these two subtypes of MDD patients.
    RESULTS: CPM could successfully predict anhedonia symptoms in MDD patients (positive network: r = 0.4719, p < 0.0020, mean squared error = 23.5125, 5000 iterations). Compared to non-melancholic MDD patients, melancholic MDD patients showed decreased FC between the left cingulate gyrus and the right parahippocampus gyrus (p_bonferroni = 0.0303). This distinct FC pattern effectively discriminated between melancholic and non-melancholic MDD patients, achieving a sensitivity of 93.54%, specificity of 67.86%, and an overall accuracy of 81.36% using the SVM method.
    CONCLUSIONS: This study successfully established a network model for predicting anhedonia symptoms in MDD based on FC, as well as a classification model to differentiate between melancholic and non-melancholic MDD patients. These findings provide guidance for clinical treatment.
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  • 文章类型: Journal Article
    背景:COVID-19后状况(PCC),也被称为“长科维德”,“的特点是持续的症状,对PCC患者的福祉产生负面影响。快感缺失(即,快乐能力降低)和社会心理功能受损是PCC患者的显着症状。我们旨在提供见解,以了解PCC患者的快感缺失和心理社会功能受损的影响。方法:这项事后分析使用了8周的数据,双盲,随机化,安慰剂对照试验,评估沃替西汀对PCC患者认知缺陷的影响(Clinicaltrials.gov标识符:NCT05047952)。共有147名符合条件的参与者被随机分配接受沃替西汀或匹配的安慰剂,为期八周的双盲治疗。我们的研究调查了快感缺失之间的关系,由Snaith-Hamilton快乐量表(SHAPS)评估,和心理社会功能,用COVID后功能状态(PCFS)量表测量。使用广义线性模型进行分析,对相关协变量如年龄进行调整,性别,教育,疑似与确诊的COVID诊断,MDD诊断,和酒精消费。结果:在147名参与者中,143名参与者有可用的基线数据进行分析。我们观察到基线PCFS评分与基线SHAPS评分呈统计学显著正相关(β=0.070,p=0.045,95%CI)。讨论:我们的分析显示,患有PCC的成年人的快感缺失程度与社会心理功能之间存在显着关系。旨在改善PCC患者报告结果的策略需要优先考虑预防和治疗PCC患者的享乐主义障碍。
    UNASSIGNED: Post-COVID-19 condition (PCC), also known as \"long COVID,\" is characterized by persistent symptoms, negatively affecting the well-being of individuals with PCC. Anhedonia (i.e. reduced capacity for pleasure) and compromised psychosocial functioning are notable symptoms in those with PCC. We aimed to provide insights to understand the effects of anhedonia and impaired psychosocial functioning of individuals with PCC.
    UNASSIGNED: This post-hoc analysis used data from an 8-week, double-blind, randomized, placebo-controlled trial which evaluated vortioxetine for cognitive deficits in individuals with PCC (Clinicaltrials.gov Identifier: NCT05047952). A total of 147 eligible participants were randomly assigned to receive vortioxetine or matching placebo over eight weeks of double-blind treatment. Our study investigated the relationship between anhedonia, assessed by the Snaith-Hamilton Pleasure Scale (SHAPS), and psychosocial functioning, measured with the Post-COVID Functional Status (PCFS) scale. The analysis was conducted using a generalized linear model, with adjustments for relevant covariates such as age, sex, education, suspected versus confirmed COVID diagnosis, MDD diagnosis, and alcohol consumption.
    UNASSIGNED: Of the 147 participants, 143 participants had available baseline data for analysis. We observed that baseline PCFS score was statistically significantly positively correlated to baseline SHAPS score (β = 0.070, p = 0.045, 95% CI).
    UNASSIGNED: Our analysis revealed a significant relationship between measures of anhedonia and psychosocial functioning in adults with PCC. Strategies that aim to improve patient-reported outcomes with PCC need to prioritize the prevention and treatment of hedonic disturbances in patients experiencing PCC.
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  • 文章类型: Journal Article
    生活压力事件与抑郁密切相关,因此,钝化或防止压力对大脑的负面影响的策略可能有利于抑郁症的治疗。尽管先前的研究表明蛋白激酶R(PKR)样ER激酶(PERK)在炎症相关性抑郁症中的作用,其参与慢性应激性抑郁症的神经病理学尚不清楚。我们试图探索阻断PERK通路是否会减轻慢性束缚应激(CRS)引起的动物抑郁样行为,并探讨其潜在机制。暴露于CRS的小鼠表现出抑郁样行为,包括蔗糖偏好测试(SPT)中的快感缺乏症,尾悬吊试验(TST)和强迫游泳试验(FST)的不动时间增加。ISRIB给药2周显着改善了暴露于CRS的雄性小鼠的抑郁样行为,这表现在FST和TST中显着增加了蔗糖的偏好并减少了不动时间。然而,我们观察到,在CRS雌性小鼠中暴露于相同剂量的ISRIB仅显示出改善的快感缺乏样缺陷,在FST和TST中留下不变的改进。机械上,我们发现ISRIB逆转了下丘脑-垂体-肾上腺(HPA)轴的过度活动,血清皮质酮水平下降,海马糖皮质激素受体(GR)的表达和下丘脑脑室旁核(PVN)中FosB的表达减少,伴随着保留的海马神经发生。本研究结果进一步扩展了ER应激在抑郁症中的潜在作用,并为PERK抑制剂在情绪障碍中的治疗路径提供了重要细节。
    Stressful life event is closely associated with depression, thus strategies that blunt or prevent the negative effect stress on the brain might benefits for the treatment of depression. Although previous study showed the role of protein kinase R (PKR)-like ER kinase (PERK) in inflammation related depression, its involvement in the neuropathology of chronic stress induced depression is still unknown. We tried to explore whether block the PERK pathway would alleviate the animals\' depression-like behavior induced by chronic restraint stress (CRS) and investigate the underlying mechanism. The CRS-exposed mice exhibited depression-like behavior, including anhedonia in the sucrose preference test (SPT), and increased immobility time in tail suspension test (TST) and forced swim test (FST). ISRIB administration for 2 weeks significantly improved the depression-like behavior in male mice exposed to CRS, which was manifested by markedly increasing the sucrose preference and reducing the immobility time in the FST and TST. However, we observed that exposure to the same dose of ISRIB in CRS female mice only showed improved anhedonia-like deficits,leaving unaltered improvement in the FST and TST. Mechanically, we found that ISRIB reversed the hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, indicating decreased levels of serum corticosterone, reduced hippocampal glucocorticoidreceptor (GR) expression and expression of FosB in hypothalamic paraventricularnucleus (PVN), which was accompanied by preserved hippocampal neurogenesis. The present findings further expand the potential role of ER stress in depression and provide important details for a therapeutic path forward for PERK inhibitors in mood disorders.
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