Abstract
Purpose of ReviewThis paper aims to provide a comprehensive discussion of single-photon emission computed tomography (SPECT) and positron emission tomography (PET) studies of antisocial personality disorder (ASPD) and aggression.Recent FindingsAmong ASPD males with high impulsivity, the density of brainstem serotonin (5-HT) transporters shows a relationship with impulsivity, aggression, and ratings of childhood trauma. 5-HT1B receptor (R) binding in the striatum, anterior cingulate cortex, and orbitofrontal cortex (OFC) correlated with anger, aggression, and psychopathic traits in another study of violent offenders, most of whom were diagnosed with ASPD. Finally, the density of monoamine oxidase-A (MAO-A), a mitochondrial enzyme that degrades 5-HT, norepinephrine, and dopamine (DA), was reported as lower in the OFC and ventral striatum of ASPD. Among non-clinical populations, 5-HT4R binding, as an index of low cerebral 5-HT levels, has been associated with high trait aggression, but only in males. Furthermore, evidence suggests that individuals with high-activity MAO-A genetic variants compared with low-activity MAO-A allelic variants release more DA in the ventral caudate and putamen when exposed to violent imagery.SummaryThere are very few PET or SPECT studies that exclusively sample individuals with ASPD. However, among ASPD samples, there is evidence of regional serotonergic abnormalities in the brain and alteration of neural MAO-A levels. Future studies should consider employing additional molecular probes that could target alternative neurotransmitter systems to investigate ASPD. Furthermore, examining different typologies of aggression in clinical and non-clinical populations using SPECT/PET is another important area to pursue and could shed light on the neurochemical origins of these traits in ASPD.
Highlights
Most violent crime is perpetrated by a small group of males who display conduct-disordered behavior in childhood and meet diagnostic criteria for antisocial personality disorder (ASPD) as adults
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A subsequent, multi-modal positron emission tomography (PET)-functional magnetic resonance imaging study based on the same sample reported that functional coupling of ventral striatum (VS) seeds to frontal regions and hippocampus were positively and negatively associated with VS monoamine oxidase-A (MAO-A) VT, respectively, and that VS resting state networks were negatively correlated with impulsivity [63]
Summary
Most violent crime is perpetrated by a small group of males who display conduct-disordered behavior in childhood and meet diagnostic criteria for antisocial personality disorder (ASPD) as adults. ASPD is not as prevalent as other psychiatric conditions in the community (some estimates indicate that ASPD affects 1% of American adults [1]), nearly 50% of incarcerated individuals meet criteria for the disorder [2]. 85% of individuals with ASPD have acted violently toward others [3, 4]. These statistics underscore the importance of a research framework that takes into account multiple levels of information to understand the pathology, including neurochemistry, of ASPD. A common mistake made by clinicians and researchers is the interchangeable use of the terms ASPD and psychopathy
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