児童・青年期の反応性愛着障害における腹側線条体の機能不全：機能的mri 研究

Background: Child maltreatment is a major risk factor for psychopathology, including reactive attachmentdisorder (RAD). Aims: To examine whether neural activity during reward processing was altered in children and adolescents with RAD. Method: Children and adolescents with RAD and typically-developing (TD) individuals performed tasks with high, low, and no monetary rewards during functional magnetic resonance imaging. We compared neural activations in response to monetary reward between the RAD and TD groups using whole -brain analyses. We then conducted a correlation analysis to investigate whether brain activations were associated with clinical symptoms. Results: Significantly reduced activity in the caudate and nucleus accumbens was observed during the high monetary reward condition in the RAD group (n = 16) compared to the TD group (n = 20) (p = 0.015, family-wise error- corrected cluster level). Significant negative correlations between bilateral striatal activity and avoidant attachment were observed in the RAD and TD groups. Conclusions: Striatal neural reward activity in the RAD group was markedly decreased. The present results suggest that dopaminergic dysfunction occurs in the striatum of children and adolescents with RAD, leading towards potential future risks for psychopathology.