Anhedonia and Ambivalence in Schizophrenic Patients with Fronto-Cerebellar Metabolic Abnormalities: A Fluoro-D-Glucose Positron Emission Tomography Study

한글 요약

조현병의 핵심 정서 증상인 무쾌감증(즐거움을 느끼지 못함)과 양가감정(상반된 감정의 공존)이 전두엽과 소뇌의 기능 이상과 관련되는지를 살핀 연구입니다. 만성 조현병 환자와 건강한 대조군의 뇌 포도당 대사를 FDG 양전자방출단층촬영(PET)으로 측정하고, 환자 개개인별로 전전두엽의 대사 저하와 소뇌의 대사 항진이 있는지를 판별한 뒤 정서 자기보고 척도를 비교했습니다. 전전두엽 기능이 저하된 환자들은 그렇지 않은 환자들보다 무쾌감증이 심했고, 소뇌 기능이 항진된 환자들은 양가감정이 더 심했습니다. 이 결과는 전두-소뇌 회로의 이상이 조현병의 주요 정서 증상과 연관되어 있음을 보여 줍니다.

OBJECTIVE: Prefrontal and cerebellar abnormalities have been associated with higher cognitive deficits in schizophrenia. The current study aimed to show whether or not schizophrenic patients with fronto-cerebellar functional abnormalities show more anhedonia or ambivalence.

METHODS: Regional cerebral metabolic activity was measured using fluoro-D-glucose positron emission tomography and was compared between 24 patients with chronic schizophrenia and 22 healthy normal volunteers. The existence of regional prefrontal hypofunction and regional cerebellar hyperfunction was investigated in each patient. Demographic and clinical variables including the emotional self-report scales were compared between the subgroups of the patients categorized according to the existence and the absence of the regional dysfunctions.

RESULTS: Comparisons between each patient and the total normal controls revealed that 14 of the total twenty-four patients had regional hypofrontal functions, whereas 11 patients had regional hypercerebellar functions. Patients with prefrontal hypofunction showed more severe anhedonia than those without prefrontal hypofunction, whereas patients with cerebellar hyperfunction compared to those without cerebellar hyperfunction had more severe ambivalence.

CONCLUSION: It seems that fronto-cerebellar abnormalities may be associated with cardinal emotional features of schizophrenia, such as anhedonia and ambivalence.