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      Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The role of Reward System

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          Abstract

          Anhedonia, the inability to feel pleasure, and amotivation, the lack of motivation, are two prominent negative symptoms of schizophrenia, which contribute to the poor social and occupational behaviors in the patients. Recently growing evidence shows that anhedonia and amotivation are tied together, but have distinct neural correlates. It is important to note that both of these symptoms may derive from deficient functioning of the reward network. A further analysis into the neuroimaging findings of schizophrenia shows that the neural correlates overlap in the reward network including the ventral striatum, anterior cingulate cortex and orbitofrontal cortex. Other neuroimaging studies have demonstrated the involvement of the default mode network in anhedonia. The identification of a specific deficit in hedonic and motivational capacity may help to elucidate the mechanisms behind social functioning deficits in schizophrenia, and may also lead to more targeted treatment of negative symptoms.

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          Most cited references58

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          Diagnostic and statistical manual of mental disorders.

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            Pain and emotion interactions in subregions of the cingulate gyrus.

            Brent Vogt (2005)
            Acute pain and emotion are processed in two forebrain networks, and the cingulate cortex is involved in both. Although Brodmann's cingulate gyrus had two divisions and was not based on any functional criteria, functional imaging studies still use this model. However, recent cytoarchitectural studies of the cingulate gyrus support a four-region model, with subregions, that is based on connections and qualitatively unique functions. Although the activity evoked by pain and emotion has been widely reported, some view them as emergent products of the brain rather than of small aggregates of neurons. Here, we assess pain and emotion in each cingulate subregion, and assess whether pain is co-localized with negative affect. Amazingly, these activation patterns do not simply overlap.
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              Emotion and motivation: the role of the amygdala, ventral striatum, and prefrontal cortex.

              Emotions are multifaceted, but a key aspect of emotion involves the assessment of the value of environmental stimuli. This article reviews the many psychological representations, including representations of stimulus value, which are formed in the brain during Pavlovian and instrumental conditioning tasks. These representations may be related directly to the functions of cortical and subcortical neural structures. The basolateral amygdala (BLA) appears to be required for a Pavlovian conditioned stimulus (CS) to gain access to the current value of the specific unconditioned stimulus (US) that it predicts, while the central nucleus of the amygdala acts as a controller of brainstem arousal and response systems, and subserves some forms of stimulus-response Pavlovian conditioning. The nucleus accumbens, which appears not to be required for knowledge of the contingency between instrumental actions and their outcomes, nevertheless influences instrumental behaviour strongly by allowing Pavlovian CSs to affect the level of instrumental responding (Pavlovian-instrumental transfer), and is required for the normal ability of animals to choose rewards that are delayed. The prelimbic cortex is required for the detection of instrumental action-outcome contingencies, while insular cortex may allow rats to retrieve the values of specific foods via their sensory properties. The orbitofrontal cortex, like the BLA, may represent aspects of reinforcer value that govern instrumental choice behaviour. Finally, the anterior cingulate cortex, implicated in human disorders of emotion and attention, may have multiple roles in responding to the emotional significance of stimuli and to errors in performance, preventing responding to inappropriate stimuli.
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                Author and article information

                Journal
                Curr Neuropharmacol
                Curr Neuropharmacol
                CN
                Current Neuropharmacology
                Bentham Science Publishers
                1570-159X
                1875-6190
                December 2015
                December 2015
                : 13
                : 6
                : 750-759
                Affiliations
                [1 ]Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Ilsan-ro 100, Ilsandong-gu, Goyang, Gyeonggi-do, Korea;
                [2 ]Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea;
                [3 ]Columbia University, New York, NY, United States;
                [4 ]Department of Psychiatry and Behavioral Neurosciences, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea;
                [5 ]Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
                Author notes
                [* ]Address correspondence to this author at the Department of Psychiatry, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, Korea 135- 720; Tel: 82-2-2019-3341; Fax: +82 2 3462 4304; E-mail: jaejkim@ 123456yonsei.ac.kr
                Article
                CN-13-750
                10.2174/1570159X13666150612230333
                4759314
                26630955
                669f1d55-e059-48eb-84b4-1806299f2def
                ©2015 Bentham Science Publishers

                This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                : 3 January 2015
                : 5 February 2015
                : 25 February 2015
                Categories
                Article

                Pharmacology & Pharmaceutical medicine
                amotivation,anhedonia,anterior cingulate cortex,orbitofrontal cortex,reward system,schizophrenia,ventralstriatum.

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