Martin Hugo, Choi Ja Eun, Rodrigues Ariana R, Eshel Neir
Stanford University, Stanford, California.
JAACAP Open. 2024 Mar 8;3(1):29-41. doi: 10.1016/j.jaacop.2024.01.010. eCollection 2025 Mar.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a 1% to 2% prevalence in children. In addition to social communication deficits and restricted or repetitive behavior, ASD is often characterized by a heightened propensity for aggression. In fact, aggressive behavior is the primary reason for hospitalization in children with ASD, and current treatment options, despite some efficacy, are often associated with prominent side effects. Despite such high clinical toll, the neurobiology of aggression in ASD remains poorly understood.
The neural circuits linked to both ASD and aggression were reviewed, with the goal of identifying overlapping components to help guide future treatment development. In discussing the clinical phenotype of aggression in ASD, some of the triggers and risk factors were noted to differ from those that cause aggression in neurotypical children. Preclinical and clinical studies on the neurobiology of aggression and ASD were synthesized to combine evidence from genetics, neuroimaging, pharmacology, and circuit manipulations. Dopamine and serotonin, 2 neuromodulators that contribute to development and behavioral control, were specifically studied.
The literature indicates that the intricate interplay of the dopamine and serotonin systems has a pivotal role in shaping behavior, including the expression of aggression.
Understanding the balance between dopamine as an accelerator and serotonin as a brake may provide insights into the mechanisms of aggression in children with ASD. Although much work remains to be done, new perspectives promise to bridge the gap between human and animal studies and pinpoint the neurobiology of aggression in ASD.
DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group.
自闭症谱系障碍（ASD）是一种神经发育障碍，在儿童中的患病率为1%至2%。除社交沟通缺陷和受限或重复行为外，ASD的特征通常还包括攻击倾向增强。事实上，攻击行为是ASD儿童住院的主要原因，尽管目前的治疗方法有一定疗效，但往往伴有明显的副作用。尽管临床影响如此之大，但ASD中攻击行为的神经生物学仍知之甚少。
回顾了与ASD和攻击行为相关的神经回路，目的是确定重叠成分，以帮助指导未来治疗方法的开发。在讨论ASD中攻击行为的临床表型时，注意到一些触发因素和风险因素与导致典型神经发育儿童攻击行为的因素不同。综合了关于攻击行为和ASD神经生物学的临床前和临床研究，以整合来自遗传学、神经影像学、药理学和神经回路操纵的证据。特别研究了多巴胺和血清素这两种对发育和行为控制有影响的神经调节剂。
文献表明，多巴胺和血清素系统的复杂相互作用在塑造行为，包括攻击行为的表达方面起着关键作用。
了解多巴胺作为加速器和血清素作为制动器之间的平衡，可能有助于深入了解ASD儿童攻击行为的机制。尽管仍有许多工作要做，但新的观点有望弥合人类和动物研究之间的差距，并确定ASD中攻击行为的神经生物学机制。
本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的性取向和/或性别群体的成员。我们积极努力促进作者群体中的性别平衡。
