Platelet monoamine oxidase activity in mentally disordered violent offenders.

The activity of monoamine oxidase (MAO) in blood platelets among criminals undergoing forensic psychiatric examinations was studied. As compulsiveness, disturbed perceptions of reality, etc. are states not known to be related to MAO and yet possibly cause aggressiveness and violence among psychotic patients, we divided the patients into 2 groups, psychotic and nonpsychotic offenders. There was lower MAO activity among violent offenders than among nonviolent offenders. The difference between the violent and nonviolent offenders became greater when the subjects with a history of psychosis were removed. Furthermore, in the group of psychotic offenders, there was no statistical difference between violent and nonviolent individuals in this regard.     

Positron emission tomography in male violent offenders with schizophrenia

The FDG PET brain scans from 31 offenders with schizophrenia and schizoaffecive disorder from a maximum security mental hospital were compared with those of normal controls (N = 6) in terms of relative FDG uptake in a range of regions covering frontal and temporal regions. The patient sample was divided into those who had a history of repetitive violent offending (RVO, N = 17) and those without a repetitive violent history (NRVO, N = 14) according to the violence rating of their pre-admission convictions. Reduced FDG uptake was noted at both the right and left anterior inferior temporal (R and L AIT) regions in NRVOs but only at LAIT in RVOs. NRVOs had significantly lower FDG uptake at RAIT than RVOs. The findings suggest that metabolic changes at AIT may be related to different patterns of violent offending in patients with schizophrenia.     

CSF studies in violent offenders. I. 5-HIAA as a negative and HVA as a positive predictor of psychopathy

Summary. Low serotonin activity in man has been related to impulsive, self-destructive violence but not to instrumental aggression aimed at dominance. A relationship has also been suggested between aggression and high catecholaminergic activity. Several studies have reported signs of aberrant dopaminergic function in attention deficit hyperactivity disorder, autism, and schizophrenia. In 22 violent offenders undergoing pretrial forensic psychiatric investigation, interpersonal and behavioral features of psychopathy, measured by the Psychopathy Checklist Revised (PCL-R), were significantly predicted by low cerebrospinal fluid (CSF) concentrations of 5-HIAA and high CSF concentrations of HVA in multivariate regression models. CSF concentrations of MHPG did not contribute to the model. This seems to link the outward-directed aggression of psychopathy to serotonergic hypofunctioning and high dopamine turnover, which might account for disinhibition of destructive impulses. Received October 25, 2000; accepted February 21, 2001     

An exploration of individual differences in a sample of youth charged with violent sexual and non-sexual crimes

Youth who engage in violent crime, including sexual offences, remain understudied. Research conducted on adults suggests that factors linked to antisocial and violent behaviour may enhance the current understanding of sexual offences. These factors include a consideration of how dark personality traits (such as psychopathy) and childhood maltreatment may inform the likelihood of sexual offending. Utilizing a sample of juvenile alleged violent offenders (n?=?113), the present study examines the construct of adolescent psychopathy, with abuse as a potential moderator, in relation to offence perpetration. Contrary to some of the literature on adults, the findings indicate that neither psychopathy nor experience of abuse differentiates sexual from non-sexual violent offenders. They also suggest that scoring higher on psychopathy relates to violence more broadly. The importance of tailored programming for youth who may be at risk of offending or who require treatment in the justice system is explored.     

Increased activities of MAOA and MAOB in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy

Using radioenzymatic assays, activities of MAO_A and MAO_B were measured in autopsied brain tissue from cirrhotic patients who died in hepatic coma and in material from an equal number of age-matched subjects who were free from hepatic, neurological or psychiatric disorders. Activities of both MAO_A and MAO_B were significantly increased in frontal cortex and caudate nucleus, two brain regions shown previously to be the site of functional and morphological alterations of astrocytes and increased concentrations of the acid metabolites of dopamine and serotonin. These findings suggest that increased monoamine metabolism and subsequent modifications of monoaminergic synaptic function could contribute to the pathogenesis of hepatic encephalopathy.     

Disentangling possible effects of childhood physical abuse on gray matter changes in violent offenders with psychopathy

Violent offenders with psychopathy present a lifelong pattern of callousness and aggression and fail to benefit from rehabilitation programs. This study presents the first, albeit preliminary, evidence suggesting that some of the structural brain anomalies distinguishing violent offenders with psychopathy may result from physical abuse in childhood.     

Implications of fMRI and genetics for the law and the routine practice of forensic psychiatry

This review outlines recent neurobiological findings in humans relevant for the practice of law and forensic psychiatry. We focus on offenders with antisocial personality disorder and on sex offenders. In addition, the impact of risk polymorphisms in monoamine oxidase A (MAO-A), previously related to violence in interaction with the environment, on brain structure and function and on personality traits in healthy persons are presented. While increasing knowledge of functional and structural alterations provides a better understanding of the neurobiological underpinnings of delinquent behaviour, antisocial and violent behaviour arises from a complex pattern of biological, psychological, social and situational factors, precluding a stance of simple biological reductionism. Rather, optimal integration of neurobiological findings requires cooperation among many disciplines such as medicine, criminology, sociology, psychology, politics and neuroscience.     

Trace acid levels in the plasma and MAO activity in the platelets of violent offenders

The plasma concentrations of the unconjugated and conjugated so-called “trace acids,” phenylacetic acid (PAA), m- and p-hydroxyphenylacetic acid (mHPA, pHPA), and platelet monoamine oxidase (MAO) activity were measured in 103 male prisoners detained in a psychiatric institution. Twenty-three had been convicted of violent crimes, 18 of sexual offenses, 24 of armed robbery, 27 of nonviolent property offenses, and 11 of miscellaneous nonviolent offenses. Unconjugated pHPA and conjugated PAA were found to be significantly reduced in the violent offenders when compared with those of the “nonviolent” groups. The levels of pHPA were also found to be low in sexual offenders. Platelet MAO activities to phenylethylamine, tryptamine, and p-tyramine between any of the categories of prisoners were not significantly different.     

MAOA/B deletion syndrome in male siblings with severe developmental delay and sudden loss of muscle tonus

Deletion of the monoamine oxidase (MAO)-A and MAO-B was detected in two male siblings and in their mother. The approximately 800-kb deletion, extending from about 43.0 MB to 43.8 MB, was detected by array comparative genomic hybridization analysis. The MAOA and MAOB genes were included in the deletion, but the adjacent Norrie disease gene, NDP, was not deleted. The boys had short stature, hypotonia, severe developmental delays, episodes of sudden loss of muscle tone, exiting behavior, lip-smacking and autistic features. The serotonin levels in their cerebrospinal fluid were extremely elevated. Another set of siblings with this deletion was reported previously. We propose recognition of MAOA/B deletion syndrome as a distinct disorder.     

精神分裂症患者攻击行为与单胺氧化酶A、色氨酸羟化酶基因多态性的关联研究

目的探讨精神分裂症患者攻击行为与单胺氧化酶A(MAOA)、色氨酸羟化酶(TPH)基因多态性的相关性。方法参照ICD-10诊断标准,选取212例精神分裂症患者,应用修订版外显攻击行为量表(MOAS)进行评定,98例MOAS加权总分≥4分者纳入有攻击行为组(研究组),114例MOAS加权总分0分者为无攻击行为组(对照组)。采用聚合酶链式反应扩增及限制性片段长度多态性技术检测单胺氧化酶A基因、色氨酸羟化酶基因多态性,与精神分裂症患者攻击行为进行关联分析。结果 MAOA、TPH基因型频率和等位基因频率在有攻击行为患者组与无攻击行为患者组比较无显著差异(P0.05)。结论单胺氧化酶A、色氨酸羟化酶基因多态性与精神分裂症患者攻击行为无关联。     

Testing for association of the monoamine oxidase A promoter polymorphism with brain structure volumes in both autism and the fragile X syndrome

Background

Autism and the fragile X syndrome (FXS) are related to each other genetically and symptomatically. A cardinal biological feature of both disorders is abnormalities of cerebral cortical brain volumes. We have previously shown that the monoamine oxidase A (MAOA) promoter polymorphism is associated with cerebral cortical volumes in children with autism, and we now sought to determine whether the association was also present in children with FXS.

Methods

Participants included 47 2-year-old Caucasian boys with FXS, some of whom also had autism, as well as 34 2-year-old boys with idiopathic autism analyzed in a previous study. The MAOA promoter polymorphism was genotyped and tested for relationships with gray and white matter volumes of the cerebral cortical lobes and cerebro-spinal fluid volume of the lateral ventricles.

Results

MAOA genotype effects in FXS children were the same as those previously observed in idiopathic autism: the low activity MAOA promoter polymorphism allele was associated with increased gray and white matter volumes in all cerebral lobes. The effect was most pronounced in frontal lobe gray matter and all three white matter regions: frontal gray, F = 4.39, P = 0.04; frontal white, F = 5.71, P = 0.02; temporal white, F = 4.73, P = 0.04; parieto-occipital white, F = 5.00, P = 0.03. Analysis of combined FXS and idiopathic autism samples produced P values for these regions <0.01 and effect sizes of approximately 0.10.

Conclusions

The MAOA promoter polymorphism is similarly associated with brain structure volumes in both idiopathic autism and FXS. These data illuminate a number of important aspects of autism and FXS heritability: a genetic effect on a core biological trait of illness, the specificity/generalizability of the genetic effect, and the utility of examining individual genetic effects on the background of a single gene disorder such as FXS.     

Cerebrospinal fluid GABA concentration: relationship with impulsivity and history of suicidal behavior, but not aggression, in human subjects

The objective of this study was to assess the relationship between cerebrospinal fluid concentrations of the neurotransmitter gamma-aminobutyric acid (GABA) and measures of impulsivity and related behaviors (aggression and suicidality) in healthy volunteer and personality disordered subjects. CSF GABA levels, and measures of impulsivity, aggression, and history of suicidal behavior were obtained by morning lumbar puncture in 57 healthy volunteer subjects and in subjects with personality disorder. CSF GABA levels were not found to correlate with measures of aggression but were found to correlate directly with measures of impulsivity; e.g., a composite measure of impulsivity in all subjects (r = 0.35, df = 46, P = 0.015) and in personality disordered subjects examined separately (r = 0.39, df = 30, P = 0.029). In the personality disorder group, CSF GABA levels were higher among subjects with a history of suicidal behavior compared with those without this history. These data suggest that central GABAergic function correlates directly with impulsiveness and history of suicidal behavior, but not aggressiveness, in personality disordered subjects. This may be consistent with observations that high doses of benzodiazepines can lead to “behavioral disinhibition” in human subjects. Further work assessing this and other aspects of the central GABA system in personality disordered subjects are warranted.     

5-羟色胺转运体基因和单胺氧化酶A基因多态性与汉族男性反社会人格障碍患者的关联分析

目的 探讨5-羟色胺转运体基因(5-HTT)第2内含子的一个可变数串联重复序列(Stin2.VNTR)和单胺氧化酶A(MAOA)基因14外显子上的一种限制性片段长度多态性(EcoRV-RFLP)与汉族男性反社会人格障碍(APD),尤其是具有高度冲动性APD的遗传易感性的关系.方法 (1)APD组:对南京地区某监狱男性服刑人员进行人格诊断问卷(PDQ-4+)调查,在PDQ得分为阳性的可疑人群中由临床医师以美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)关于APD诊断标准进一步确诊,入组118例;全部进行Barratt冲动量表(BIS-11)评分,以冲动总分中位值为界,划分为高冲动APD组和低冲动APD组.(2)监狱对照组:经PDQ排除人格障碍的250名服刑人员作为监狱内对照.(3)正常对照组:同时期医院健康体检者300名设为正常对照.取所有人员血液标本提取DNA,应用聚合酶链反应(PCR)和限制性片段长度多态性方法,对等位基因频率和基因型频率进行对比分析.结果 (1)APD组与正常对照组比较,5-HTT-VNTR基因型多态、MAOA-EcoRV-RFLP多态差异无统计学意义(x2=2.819,P=0.244;x2=2.347,P=0.126).(2)高冲动APD组与正常对照组比较,5-HTT-VNTR基因型多态差异有统计学意义(x2=7.422,P=0.024),MAOA-EcoRV-RFLP的等位基因频率有统计学意义(x2=5.478,P=0.019).(3)2个位点的联合分析中,APD组和高冲动APD组分别与对照组比较,12/12/-多倍体型的差异均有统计学意义(x2=7.164,P=0.007;x2=9.590,P=0.002);12/10/+仅在高冲动APD组与正常对照组间差异有统计学意义(x2=5.378,P=0.020).结论 5-HTT基因第2内含子VNTR多态、MAOA基因EcoRV-RFLP多态与具有高冲动的APD关联,12/12/-多倍体型与中国汉族男性APD发病风险可能有关.     

Early and late components of error monitoring in violent offenders with psychopathy

BACKGROUND: One of the most recognizable features of psychopathy is the reduced ability to successfully learn and adapt overt behavior. This might be due to deficient processing of error information indicating the need to adapt controlled behavior. METHODS: Event-related potentials (ERPs) and behavioral components of error-monitoring processes were investigated in 16 individuals with psychopathy and in 18 healthy subjects. A letter version of the Eriksen flanker task was used in two conditions. The first condition (normal condition) required participants to press one of two buttons depending on the identity of the target stimulus. The second condition (signaling condition) required them to signal each time they had committed an error by making a second press on a signaling button. Early stages of error monitoring were investigated by using the error-related negativity (ERN/Ne) and post-error slowing as indexes. Later stages were explored by examining the error positivity (Pe) and signaling rates. RESULTS: Both groups showed similar ERN amplitudes and amounts of post-error slowing. The psychopathic group exhibited both reduced Pe amplitudes and diminished error-signaling rates compared with the control group. CONCLUSIONS: Individuals with psychopathy show intact early error processing and automatic behavioral adaptation but have deficits in later stages of error processing and controlled behavioral adaptation. This is an indication that individuals with psychopathy are unable to effectively use error information to change their behavior adequately.     

Quantitative distribution of monoamine oxidase A in brainstem monoamine nuclei is normal in major depression

An abnormal expression of noradrenergic proteins (e.g., tyrosine hydroxylase, norepinephrine transporters) in the locus coeruleus has recently been demonstrated in subjects with major depression and/or victims of suicide. Monoamine oxidase A (MAO-A) is a key enzyme in the catabolism of biogenic amines and is expressed in brain noradrenergic neurons. In this study, the binding of [3H]Ro41-1049 to MAO-A was measured by quantitative autoradiography at multiple levels along the rostral-caudal axis of the noradrenergic locus coeruleus from subjects with major depression and age- and postmortem interval-matched control subjects who were psychiatrically normal. [3H]Ro41-1049 binding to MAO-A was unevenly distributed along the axis of the locus coeruleus, paralleling an uneven number of neuromelanin-containing (noradrenergic) neurons throughout the nucleus. Accordingly, there was a significant correlation between the number of neuromelanin-containing neurons per section and the specific binding of [3H]Ro41-1049 at any particular level of the locus coeruleus in control subjects (r(2)=0.25; p<0.001) and in subjects with major depression (r(2)=0.14; p<0. 001). Moderate levels of [3H]Ro41-1049 binding were observed in regions surrounding the locus coeruleus, including the central gray and the dorsal and median raphe nuclei. No significant differences in [3H]Ro41-1049 binding to MAO-A were observed at any level of the locus coeruleus, or raphe nuclei, comparing subjects with major depression to psychiatrically normal control subjects. These findings demonstrate that the pathophysiology of major depression is not likely to involve abnormalities in MAO-A.     

MDL 72,974: a potent and selective enzyme-activated irreversible inhibitor of monoamine oxidase type B with potential for use in Parkinson's disease

Summary MDL 72,974, (E)-2-(4-fluorophenethyl)-3-fluoroallylamine, was designed to be a selective inhibitor of monoamine oxidase type B (MAO-B). In vitro, the compound inhibits rat brain mitochondrial MAO in a concentration and time-dependent fashion and shows marked selectivity for the B form (IC₅₀=680 and 3.6nM for MAO-A and MAO-B, respectively). After oral administration to rats, the compound shows preferential inhibition of brain MAO-B with ED₅₀ values of 8 and 0.18 mg/kg p.o. for the A and B forms, respectively. Selectivity is retained on repeat dosing. MDL 72,974 did not significantly potentiate the cardiovascular effects of intraduodenually-administered tyramine in anaesthetized rats and had only minor indirect sympathominatic effects in the pithed rat. At MAO-B selective doses the neurotoxic effect of MPTP in mice was blocked.Part of this work was presented at the 7th European Winter Conference on Brain Research (Zreika et al., 1987).     

Hippocampal development in youth with a history of childhood maltreatment

Childhood maltreatment (CM) is associated with enhanced risk of psychiatric illness and reduced subcortical grey matter in adulthood. The hippocampus and amygdala, due to their involvement in stress and emotion circuitries, have been subject to extensive investigations regarding the effect of CM. However, the complex relationship between CM, subcortical grey matter and mental illness remains poorly understood partially due to a lack of longitudinal studies. Here we used segmentation and linear mixed effect modelling to examine the impact of CM on hippocampal and amygdala development in young people with emerging mental illness. A total of 215 structural magnetic resonance imaging (MRI) scans were acquired from 123 individuals (age: 14–28 years, 79 female), 52 of whom were scanned twice or more. Hippocampal and amygdala volumes increased linearly with age, and their developmental trajectories were not moderated by symptom severity. However, exposure to CM was associated with significantly stunted right hippocampal growth. This finding bridges the gap between child and adult research in the field and provides novel evidence that CM is associated with disrupted hippocampal development in youth. Although CM was associated with worse symptom severity, we did not find evidence that CM-induced structural abnormalities directly underpin psychopathology. This study has important implications for the psychiatric treatment of individuals with CM since they are clinically and neurobiologically distinct from their peers who were not maltreated.     

The effect of electroconvulsive therapy on cerebral monoamine oxidase A expression in treatment-resistant depression investigated using positron emission tomography

Background

Electroconvulsive therapy (ECT) constitutes one of the most effective antidepressant treatment strategies in major depression (MDD). Despite its common use and uncontested efficacy, its mechanism of action is still insufficiently understood. Previously, we showed that ECT is accompanied by a global decrease of serotonin-1A receptors in MDD; however, further studies to investigate the involvement of the serotonergic system in the mechanism of action of ECT are warranted. The monoamine oxidase A (MAO-A) represents an important target for antidepressant treatments and was found to be increased in MDD. Here, we investigated whether ECT impacts on MAO-A levels in treatment-resistant patients (TRD).

Novel variants in aromatic L-amino acid decarboxylase deficiency: Case report of sisters with mild phenotype

BackgroundAromatic L-amino acid decarboxylase (AADC) deficiency, caused by a pathogenic variant in the dopa decarboxylase (DDC) gene, is a rare neurometabolic disorder in which catecholamine and serotonin are not synthesized. From a large number of reports, it has been recognized that most affected patients show severe developmental delay in a bedridden state and are unable to speak. On the other hand, patients with a mild phenotype with AADC deficiency have been reported, but they number only a few cases. Therefore, the variation of phenotypes of the disease appears to be broad, and it may be challenging to diagnose an atypical phenotype as AADC deficiency.Case reportWe report novel compound heterozygous variants in DDC (c.202G > A and c.254C > T) in two sisters, whose main complaint was mild developmental delay, by whole-exome sequencing (WES). Additionally, we describe their clinical features and provide an image that shows the variants located at different sites responsible for the catalysis of AADC in a three-dimensional structure. The patients were prescribed a Monoamine oxidase (MAO) inhibitor after diagnosis.InterpretationOur cases indicate that a comprehensive genomic approach helps to diagnose AADC deficiency with atypical features, and underscore the significance of understanding the variations of this disorder for diagnosis and appropriate treatment.     

Effect of a selective MAO-A inhibitor (Ro 41-1049) on striatal L-dopa and dopamine metabolism: An in vivo study

Summary We administered Ro 41-1049, an inhibitor of the enzyme monoamine oxidase type A (MAO-A) to rats and monitored extracellular catecholamine levels in the corpus striatum before and after the intraperitoneal (IP) administration of a bolus of L-dopa. Acute administration of Ro 41-1049 (1–50 mg/kg IP) produced a dose-dependent decrease in basal levels of the dopamine metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) and an increase in basal levels of dopamine. In rats treated with Ro 41-1049 (20 mg/kg IP), L-dopa administration (100 mg/kg IP) produced a greater increase in striatal levels of dopamine than it did in controls, while DOPAC and HVA formation was attenuated. We conclude that inhibition of central MAO-A activity promotes synaptic accumulation of dopamine following administration of pharmacological doses of L-dopa.