Serotonin transporter availability in impulsive aggressive personality disordered patients: A PET study with [11C]DASB

Elsmarieke van de Giessen, Daniel R. Rosell, Judy L. Thompson, Xiaoyan Xu, Ragy R. Girgis, Yosefa Ehrlich, Mark Slifstein, Anissa Abi-Dargham, Larry J. Siever

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24 Scopus citations

Abstract

Serotonin (5-HT) has consistently been implicated in the pathophysiology of impulsive aggression. In the current study, we tested the hypothesis that 5-HT transporter (5-HTT) binding is reduced in the anterior cingulate cortex (ACC) in impulsive aggressive patients. Additionally, we characterized pathological personality dimensions, with a specific focus on callousness (i.e. emotional indifference, a facet of psychopathy). Callousness is putatively positively correlated with presynaptic 5-HT, and thus could potentially confound the hypothesized negative relation between 5-HTT levels and trait aggression. We determined 5-HTT binding with positron emission tomography and [11C]DASB in 29 patients with intermittent explosive disorder (IED-IR) and 30 controls. We assessed group differences in 5-HTT binding in the pregenual ACC, amygdala and subcortical regions and examined correlations between 5-HTT binding and clinical measures. There were no significant differences in 5-HTT binding between IED-IR patients and controls. Trait callousness exhibited a significant, positive correlation with ACC 5-HTT availability. Among IED-IR patients, a trend-level negative partial correlation was observed between trait aggression and ACC 5-HTT availability, while covarying for callousness and age. Exploratory analyses revealed a significant negative correlation between state aggression levels and 5-HTT availability in subcortical regions, namely striatum and thalamus. We did not confirm our hypothesis of lower ACC 5-HTT availability in impulsive aggressive patients, however, the positive correlation between callousness and ACC 5-HTT availability likely played a confounding role. Subtypes of aggression (e.g., reactive vs. proactive aggression), which are differentially associated with pathological personality dimensions such as callousness, may contribute to variability between 5-HT functioning and aggression.

Original languageEnglish
Pages (from-to)147-154
Number of pages8
JournalJournal of Psychiatric Research
Volume58
DOIs
StatePublished - 1 Nov 2014

Keywords

  • Anterior cingulate cortex
  • Callousness
  • Impulsive aggression
  • Intermittent explosive disorder
  • Positron emission tomography
  • Serotonin transporter

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