Nervenheilkunde 2011; 30(06): 394-400
DOI: 10.1055/s-0038-1628372
Soziale Neurowissenschaften
Schattauer GmbH

Neurobiologische Korrelate der Verarbeitung von Feedback bei antisozialer Persönlichkeitsstörung

Neurobiological correlates of feedback processing in antisocial personality disorder
B. Völlm
1   Section of Forensic Mental Health Research, Division of Psychiatry, University of Nottingham, UK
› Author Affiliations
Further Information

Publication History

Eingegangen am: 01 September 2010

angenommen am: 14 September 2010

Publication Date:
22 January 2018 (online)

Zusammenfassung

Gegenstand und Ziel: Wir untersuchten die neuronalen Mechanismen der Verarbeitung von Belohnungssignalen bei Personen mit antisozialer Persönlichkeitsstörung (APS) mithilfe der funktionellen Magnetresonanztomografie (fMRT) und die Modulation dieser Aktivierungsmuster durch eine serotonerge Substanz, mCPP. Material und Methoden: Studie 1: Acht Personen mit Cluster B (antisoziale oder Borderline)-Persönlichkeitsstörung und 14 Kontrollpersonen. Studie 2: 23 Probanden mit APS und 25 Kontrollprobanden. In beiden Studien kam eine Belohnungsaufgabe zum Einsatz, in Studie 1 wurde zusätzlich ein Verlustparadigma eingesetzt. In Studie 2 erhielt ein Teil der Teilnehmer mCPP vor der Belohnungsaufgabe. Ergebnisse: In Studie 1 zeigte sich eine verminderte Aktivierung vorwiegend präfrontaler Strukturen in der Patientenim Vergleich zur Kontrollgruppe. In Studie 2 konnte eine vermehrte Ansprechbarkeit des Belohnungssystems nach mCPP-Gabe, vor allem in der APSGruppe, gezeigt werden. Schlussfolgerungen: Die Studien bestätigten die Rolle präfrontaler Strukturen in der Entstehung der APS. Serotonin scheint nicht nur in impulsivem Verhalten, sondern auch in der Verarbeitung von Belohnungen eine Rolle zu spielen. Klinische Relevanz: Serotonerge Substanzen führen möglicherweise zu einer Normalisierung von neuronalen Aktivierungsmustern bei antisozialen Patienten.

Summary

Objective: To investigate the neuronal mechanisms of reward in individuals with antisocial personality disorder (ASPD) using functional magnetic resonance imaging (fMRI) and their modulation following a serotonergic intervention with mCPP. Material and methods: Study 1: Eight individuals with Cluster B (antisocial or borderline) PD and 14 control subjects. Study 2: 23 participants with ASPD and 25 control subjects. In both studies a block design reward task was used, in study 1 a loss task was also employed. Study 2 used mCPP to explore modulation of brain activations in both groups. Results: In study 1 we found decreased activations particularly in prefrontal brain structures in the patient compared to the control group. In study 2 increased neuronal activations were observed following mCPP compared to placebo, particularly in the patient group. Conclusions: Our studies confirmed that altered brain function, particularly in prefrontal structures, may underpin antisocial personality disorders. Serotonin appears to play a role not only in impulsivity but also in reward processing. Clinical relevance: Serotonergic substances might normalise neuronal activations in antisocial individuals.

 
  • Literatur

  • 1 American Psychiatric Association. (Hrsg.). Diagnostic and statistical manual of mental disorders, 4th revised edition (DSM-IV). Washington: American Psychiatric Association; 1994
  • 2 Berlin HA, Rolls ET, Iversen SD. Borderline personality disorder, impulsivity, and the orbitofrontal cortex. American Journal of Psychiatry 2005; 162: 2360-73.
  • 3 Blair RJR, Cipolotti L. Impaired social response reversal. A case of ‘acquired sociopathy’. Brain 2000; 123: 1122-41.
  • 4 Blair RJ, Jones L, Clark F, Smith M. The psychopathic individual: a lack of responsiveness to distress cues?. Psychophysiology 1997; 34: 192-8.
  • 5 Blum K. et al. Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. Journal of Psychoactive Drugs 2000; 32 Suppl. i–iv. 1-112.
  • 6 Buckholtz JW. et al. Mesolimbin dopamine reward system hypersensitivity in individuals with psychopathic traits. Nature Neuroscience 2010; 13: 419-21.
  • 7 Carroll ME, Lac ST, Asencio M, Kragh R. Fluoxetine reduces intravenous cocaine self-administration in rats. Pharmacology Biochemistry and Behavior 1990; 35: 237-44.
  • 8 Coccaro EF, Bergeman CS, Kavoussi RJ, Seroczynski AD. Heritability of aggression and irritability: a twin study of the Buss-Durkee aggression scales in adult male subjects. Biological Psychiatry 1997; 41: 273-84.
  • 9 Coid JW. Epidemiology, public health and the problem of personality disorder. British Journal of Psychiatry 2003; 182 (Suppl. 44) 3-10.
  • 10 Dolan M, Park I. The neuropsychology of antisocial personality disorder. Psychological Medicine 2000; 32: 417-27.
  • 11 Dolan M, Völlm B. Antisocial personality disorder and psychopathy in women: A literature review on the reliability and validity of assessment instruments. International Journal of Law and Psychiatry 2009; 32: 2-9.
  • 12 Dolan M, Völlm B. Serotonergic function in aggressive and impulsive behaviour: research findings and treatment implications. In: Taylor P, Gunn J. Forensic (eds.). Psychiatry: Clinical, Legal and Ethical Issues. Im Druck..
  • 13 Elliott R, Newman JL, Longe OA, Deakin JF. Differential response patterns in the striatum and orbitofrontal cortex to financial reward in humans: a parametric functional magnetic resonance imaging study. Journal of Neuroscience 2003; 23: 303-7.
  • 14 Goethals I. et al. Brain perfusion SPECT in impulsivity-related personality disorders. Behavioural Brain Research 2005; 157: 187-92.
  • 15 Gutmann P. Julius Ludwig August Koch (1841–1908): Christian, philosopher and psychiatrist. History of Psychiatry 2008; 19: 202-14.
  • 16 Hare R. Psychopathy, fear arousal and anticipated pain. Psychological Reports 1965; 16: 499-502.
  • 17 Hare RD. The Hare Psychopathy Checklist-Revised. Toronto: Multi-Health Systems; 2003
  • 18 Hare RD, Neumann CS. Psychopathy as a clinical and empirical construct. Annual review of clinical psychology 2008; 04: 217-46.
  • 19 Kiehl KA. et al. Limbic abnormalities in affective processing by criminal psychopaths as revealed by functional magnetic resonance imaging. Biological Psychiatry 2001; 50: 677-84.
  • 20 Lapierre D, Braun CM, Hodgins S. Ventral frontal deficits in psychopathy: neuropsychological test findings. Neuropsychologia 1995; 33: 139-51.
  • 21 Moran P. The epidemiology of antisocial personality disorder. Social Psychiatry & Psychiatric Epidemiology 1999; 34: 231-42.
  • 22 Singleton N. et al. Psychiatric morbidity among prisoners in England and Wales. London: HMSO; 1998
  • 23 Spitzer M. Editorial: Frontalhirn an Belohnungssystem. Nervenheilkunde 2008; 09: 785-8.
  • 24 Spitzer M. Lernen: Gehirnforschung und die Schule des Lebens. Spektrum Heidelberg: Akademischer Verlag; 2002
  • 25 Viding E, Blair RJ, Moffitt TE, Plomin R. Evidence for substantial genetic risk for psychopathy in 7-year-olds. Journal of Child Psychology & Psychiatry & Allied Disciplines 2005; 46: 592-7.
  • 26 Völlm B. et al. Neuronal correlates of reward and loss in Cluster B personality disorder: A functional magnetic resonance imaging study. Psychiatry Research: Neuroimaging 2007; 156: 151-67.
  • 27 Völlm B. et al. Neuronal correlates and serotonergic modulation of behavioural inhibition and reward in healthy and antisocial individuals. Journal of Psychiatric Research 2010; 44: 123-31.
  • 28 Walter H. Emotionale Dysfunktion, Psychopathie und kognitive Neurowissenschaft. Nervenarzt 2005; 76: 557-68.
  • 29 Weber S, Habel U, Amunts K, Schneider F. Structural brain abnormalities in psychopaths – a review. Behavioural Science and the Law 2008; 26: 7-28.
  • 30 Weber T, Sommer M, Hajak G, Müller J. Die emotionale Informationsverarbeitung bei Patienten mit einer dissozialen Persönlichkeitsstörung vom Subtyp “Psychopathy” nach Hare. Psychiatrische Praxis 2004; 31 (Suppl. 01) 68-9.
  • 31 Williamson S, Harpur TJ, Hare RD. Abnormal processing of affective words by psychopaths. Psychophysiology 1991; 28: 260-73.
  • 32 World Health Organisation. (Hrsg.). International statistical classification of diseases and related health problems,10th revision. Geneva: World Health Organisation; 1992
  • 33 Zanarini MC. et al. Axis II comorbidity of borderline personality disorder. Comprehensive Psychiatry 1998; 39: 296-302.
  • 34 Zimmermann M, Rothschild L, Zhelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry 2005; 162: 1911-8.
  • 35 Viding E, Blair RJ, Moffitt TE, Plomin R. Evidence for substantial genetic risk for psychopathy in 7-year-olds. Journal of Child Psychology & Psychiatry & Allied Disciplines 2005; 46: 592-7.
  • 36 Walter H. Emotionale Dysfunktion, Psychopathie und cognitive Neurowissenschaft. Der Nervenarzt 2005; 76: 557-68.