Ryan J M
University of Rochester Medical Center, Monroe Community Hospital, Program in Neurobehavioral Therapeutics, 435 E. Henrietta Rd., Rochester, NY 14620, USA.
Semin Clin Neuropsychiatry. 2000 Oct;5(4):238-49. doi: 10.1053/scnp.2000.9553.
Aggressive behavior has been associated with numerous neurologic conditions including traumatic brain injury, mental retardation, developmental disorders, Huntington disease, and several dementias. Preclinical and human studies suggest that dysfunction of neural systems involving the brainstem, hypothalamus, amygdala, or prefrontal cortex can give rise to aggression. Several neurochemicals are felt to be relevant to modulation of aggression, including serotonin, dopamine, norepinephrine, GABA, acetylcholine, and androgens. Pharmacologic intervention studies have targeted these systems but have been limited by inconsistent definitions of aggression and a relative paucity of controlled trials. This article briefly reviews studies of neural systems and medication trials relevant to aggression and propose a clinical approach to treatment of patients manifesting aggressive behavior.
攻击性行为与多种神经系统疾病相关，包括创伤性脑损伤、智力障碍、发育障碍、亨廷顿病以及几种痴呆症。临床前研究和人体研究表明，涉及脑干、下丘脑、杏仁核或前额叶皮质的神经系统功能障碍可引发攻击行为。人们认为几种神经化学物质与攻击行为的调节有关，包括血清素、多巴胺、去甲肾上腺素、γ-氨基丁酸、乙酰胆碱和雄激素。药物干预研究针对这些系统，但受到攻击行为定义不一致以及对照试验相对较少的限制。本文简要回顾了与攻击行为相关的神经系统研究和药物试验，并提出了一种治疗表现出攻击行为患者的临床方法。
