Neurobiologia dos transtornos do controle dos impulsos

Abstract

A b s t r a c t Objective: To review the neurobiological substrates of impulse control disorders. Pathological gambling is a main focus of the review in that most biological studies of the formal impulse control disorders have examined this disorder. Method: The medical database Medline from 1966 to present was searched to identify relevant articles that were subsequently reviewed to generate this manuscript. Results: Preclinical studies suggest that differential brain monoamine neuromodulation is associated with impulsive decision-making and risk-taking behaviors. Clinical studies implicate multiple neurotransmitter systems (serotonergic, dopaminergic, adrenergic, and opioidergic) in the pathophysiology of pathological gambling and other impulse control disorders. Initial neuroimaging studies have implicated the ventromedial prefrontal cortex and ventral striatum in the pathophysiology of pathological gambling and other impulse control disorders. Genetic contributions to pathological gambling seem substantial and initial studies have implicated specific allelic polymorphisms, although genome-wide analyses have yet to be published. Conclusion: Although significant advances have been made in our understanding of the neurobiology of impulse control disorders, more research is needed to extend existing knowledge and translate these findings into clinical advances.Descriptors: Pathological gambling; Serotonin; Norepinephrine; Dopamine; Opioids Resumo Objetivo: Revisar os artigos sobre substratos neurobiológicos dos transtornos do controle do impulso. O jogo patológico é o foco central desta revisão na medida em que a maioria dos estudos biológicos dos formalmente classificados como transtornos do controle do impulso examinou este transtorno. Método: Foi feita uma busca no banco de dados Medline de artigos publicados de 1966 até o presente para identificar aqueles relevantes para serem revisados neste artigo. Resultados: Estudos pré-clínicos sugerem que a neuromodulação das monoaminas cerebrais está associada à tomada de decisões impulsivas e aos comportamentos de risco. Os estudos clínicos implicam diversos sistemas de neurotransmissores (serotoninérgico, dopaminérgico, adrenérgico e opióide) na fisiopatologia do jogo patológico e de outros transtornos do controle do impulso. Estudos de neuroimagem preliminares têm indicado o córtex pré-frontal ventromedial e o estriato ventral como atuantes na fisiopatologia do jogo patológico e de outros transtornos do controle do impulso. As contribuições genéticas para o jogo patológico parecem substanciais e os estudos iniciais têm relacionado esse transtorno a polimorfismos alélicos específicos, ainda que os achados de varredura genômica ainda tenham que ser publicados. Conclusão: Mesmo que tenham sido logrados avanços significativos em nossa compreensão sobre os transtornos do controle do impulso, mais pesquisas são necessárias para ampliar o conhecimento existente e traduzir esses achados em avanços clínicos.

Dependência De Internet Sintomas Depressivos Em Estudantes Universitários

“…Tanto no caso dos indivíduos deprimidos quanto nos que tem déficits de dopamina, o uso da internet pode ter sua origem como uma forma de 'automedicação', ou seja, uma forma de manter o indivíduo relaxado, tranquilo. Tornando-o, assim, extremamente predisposto ao desenvolvimento de dependência (5,32) .…”

Pathological Gambling: Compulsive-Impulsive Spectrum Disorder, Behavioural Addiction or Both? Phenotypic and Endophenotypic Evidence

“…Indeed, every study performed on PGs and ADs found decision-making impairments, whereas inconsistent results in regards to OCD have been reported. From an endophenotype perspective, such deficits are likely associated with anomalies in the circuits supposed to be responsible for impulsive choices and reward-seeking behaviours in PGs and SUDs (Everitt & Robbins, 2005;Potenza, 2006;Reuter et al, 2005;Volkow & Fowler, 2000;Williams & Potenza, 2008;Wrase et al, 2007). Therefore, findings from IGT performances claim analogous cognitive processes in PG and AD, suggesting the adequacy of considering PG a behavioural addiction.…”

“…Shared neurocircuitry is also supposed to underlie both PD and SUDs (Everitt & Robbins, 2005;Potenza, 2006;Reuter et al, 2005;Volkow & Fowler, 2000;Williams & Potenza, 2008;Wrase et al, 2007). In regards to biochemistry, serotoninergic (Fineberg et al, 2010;Potenza, 2001;Schlosser, Black, Repertinger, & Freet, 1994) and dopaminergic (Grant, Brewer et al, 2006) deficits seem to underlie both PG and AD symptoms.…”

Drug Treatment of Trichotillomania (Hair-Pulling Disorder), Excoriation (Skin-picking) Disorder, and Nail-biting (Onychophagia)

“…There are different interacting neurotransmitter systems involved in the pathophysiology of impulse-control disorders, implicating noradrenaline, serotonin, dopamine, opioid peptides [11] and glutamate [12,13], hence investigators focused on drugs able to act on these transmitters. Our aim was to critically review the efficacy of the drugs employed in impulse-control disorders by searching six databases for randomized controlled drug trials on either TTM, excoriation or nail-biting disorder.…”