Elevated Plasma Inflammatory Markers in Individuals With Intermittent Explosive Disorder and Correlation With Aggression in Humans
Elevated Plasma Inflammatory Markers in Individuals With Intermittent Explosive Disorder and Correlation With Aggression in Humans
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DOI：
10.1001/jamapsychiatry.2013.3297
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发表时间：
2014-02-01
期刊：
影响因子：
25.8
通讯作者：
Coussons-Read, Mary
中科院分区：
文献类型：
--
作者：
Coccaro, Emil F.;Lee, Royce;Coussons-Read, Mary
在人类攻击性中的重要神经化学研究指出了各种中枢神经递质的调节作用。其中一些神经递质起到抑制作用，而另一些则起到调节攻击性的促进作用。临床前研究表明，炎症标记物在攻击性中起促进作用。尽管如此，据我们所知，在精神病患者或有反复、有问题的冲动性攻击行为的个体中还没有关于攻击性和炎症标志物的研究报道。目的检验血浆炎症标志物与攻击性直接相关的假设，并在有反复、有问题的冲动性攻击行为的个体中升高。设计、设置和参与者在一个学术医学中心的冲动性攻击行为的临床研究项目中进行病例对照研究。研究对象为身体健康的间歇性爆发性精神障碍患者(69人)、非攻击性轴心I和/或II疾病患者(61人)和无轴心I或II疾病病史的非攻击性患者(67人)。主要研究结果和测量方法：根据攻击性和冲动性以及与间歇性爆发性疾病的关系，检测血浆C反应蛋白和白介素6水平。此外，这两个炎性标志物与攻击的综合测量直接相关，更具体地说，与反映所有参与者实际攻击行为的测量直接相关。结论和相关性这些数据表明血浆炎症过程与人类攻击之间存在直接关系。这一发现增加了攻击性在人类中枢神经调节作用的复杂图景。
IMPORTANCE Neurochemical studies in human aggression point to a modulatory role for a variety of central neurotransmitters. Some of these neurotransmitters play an inhibitory role, while others play a facilitatory role modulating aggression. Preclinical studies suggest a facilitatory role for inflammatory markers in aggression. Despite this, to our knowledge, no studies of aggression and inflammatory markers have been reported in psychiatric patients or in individuals with recurrent, problematic, impulsive aggressive behavior.OBJECTIVE To test the hypothesis that plasma inflammatory markers will correlate directly with aggression and will be elevated in individuals with recurrent, problematic, impulsive aggressive behavior.DESIGN, SETTING, AND PARTICIPANTS Case-control study in a clinical research program in impulsive aggressive behavior at an academic medical center. Participants were physically healthy individuals with intermittent explosive disorder (n = 69), nonaggressive individuals with Axis I and/or II disorders (n = 61), and nonaggressive individuals without history of an Axis I or II disorder (n = 67).MAIN OUTCOMES AND MEASURES Plasma levels of C-reactive protein and interleukin 6 were examined in the context of measures of aggression and impulsivity and as a function of intermittent explosive disorder.RESULTS Both plasma C-reactive protein and interleukin 6 levels were significantly higher in participants with intermittent explosive disorder compared with psychiatric or normal controls. In addition, both inflammatory markers were directly correlated with a composite measure of aggression and, more specifically, with measures reflecting history of actual aggressive behavior in all participants.CONCLUSIONS AND RELEVANCE These data suggest a direct relationship between plasma inflammatory processes and aggression in humans. This finding adds to the complex picture of the central neuromodulatory role of aggression in humans.