冲动行为背后的谷氨酸能系统异常:临床和临床前研究的启示。

IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY
Justin R. Yates
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引用次数: 0

摘要

冲动是一个广泛的概念,通常指几种不同行为中的一种,可以通过自我报告问卷和行为范式进行测量。有几种精神疾病以一种或多种形式的冲动行为为特征,其中最明显的是注意力缺陷/多动障碍(ADHD)的冲动/多动亚型、情绪障碍和药物使用障碍。众所周知,单胺类神经递质能介导冲动行为,并与各种精神疾病有关。然而,越来越多的证据表明,谷氨酸这种哺乳动物大脑中主要的兴奋性神经递质调节着重要的功能,而这些功能在多动症等疾病中会出现失调。本综述旨在讨论临床前和临床证据表明谷氨酸与冲动的不同方面有关,特别是运动冲动、冲动性选择和情感冲动。大脑皮层和小脑通路中过度活跃的谷氨酸能活动是运动冲动的主要决定因素。相反,额叶皮质区和海马的低活性谷氨酸能活动以及前扣带回皮质和伏隔核的高活性谷氨酸能活动则介导冲动性选择。情感冲动受控于与运动冲动类似的谷氨酸能功能障碍,但边缘系统的亢进也参与其中。前额叶和伏隔核谷氨酸平衡的丧失可能会分别导致运动冲动/情感冲动和冲动选择。这些结果非常重要,因为它们可以为那些对传统治疗方法有抵抗力的以冲动性增加为特征的患者提供新的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aberrant glutamatergic systems underlying impulsive behaviors: Insights from clinical and preclinical research

Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.

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来源期刊
CiteScore
12.00
自引率
1.80%
发文量
153
审稿时长
56 days
期刊介绍: Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.
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