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Published in: Journal of Neural Transmission 2/2010

01-02-2010 | Biological Psychiatry - Original Article

Cerebrospinal fluid 5-hydroxyindolacetic acid and homovanillic acid: reciprocal relationships with impulsive aggression in human subjects

Authors: Emil F. Coccaro, Royce Lee

Published in: Journal of Neural Transmission | Issue 2/2010

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Abstract

While the relationship between cerebrospinal fluid 5-HIAA (CSF 5-HIAA) and aggression is typically reported as inverse, studies of some groups of aggressive individuals demonstrate a positive (or no) relationship, between these two variables. It is possible that simultaneous examination of both CSF 5-HIAA and CSF homovanillic acid (HVA), which co-vary in human subjects may clarify differences in reported findings in different groups of aggressive individuals. CSF 5-HIAA and CSF HVA concentrations were simultaneously examined in 60 healthy human subjects (40 with personality disorder and 20 healthy controls) and were correlated with measures of aggression and impulsivity. CSF 5-HIAA concentrations correlated positively, and CSF HVA concentrations correlated inversely, with a composite measure of impulsive aggression in all subjects as well as in the personality disordered subjects. The CSF 5-HIAA findings are consistent with those demonstrating reduced post-synaptic 5-HT receptor responsiveness to 5-HT agent challenge and suggest differences in the pathophysiology between different groups of subjects with aggressive behavior, particularly with regard to severity of aggressive behavior.
Literature
go back to reference Agren H, Mefford IN, Rudorfer MV, Linnoila M, Potter WZ (1986) Interacting neurotransmitter systems. A non-experimental approach to the 5HIAA-HVA correlation in human CSF. J Psychiatr Res 20(3):175–193CrossRefPubMed Agren H, Mefford IN, Rudorfer MV, Linnoila M, Potter WZ (1986) Interacting neurotransmitter systems. A non-experimental approach to the 5HIAA-HVA correlation in human CSF. J Psychiatr Res 20(3):175–193CrossRefPubMed
go back to reference American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association Press, Washington, DC American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association Press, Washington, DC
go back to reference Ashby P, Verrier M, Warsh JJ, Price KS (1976) Spinal reflexes and the concentrations of 5-HIAA, MHPG, and HVA in lumbar cerebrospinal fluid after spinal lesions in man. J Neurol Neurosurg Psychiatry 39(12):1191–1200CrossRefPubMed Ashby P, Verrier M, Warsh JJ, Price KS (1976) Spinal reflexes and the concentrations of 5-HIAA, MHPG, and HVA in lumbar cerebrospinal fluid after spinal lesions in man. J Neurol Neurosurg Psychiatry 39(12):1191–1200CrossRefPubMed
go back to reference Barton DA, Esler MD, Dawood T, Lambert EA, Haikerwal D, Brenchley C et al (2008) Elevated brain serotonin turnover in patients with depression: effect of genotype and therapy. Arch Gen Psychiatry 65(1):38–46CrossRefPubMed Barton DA, Esler MD, Dawood T, Lambert EA, Haikerwal D, Brenchley C et al (2008) Elevated brain serotonin turnover in patients with depression: effect of genotype and therapy. Arch Gen Psychiatry 65(1):38–46CrossRefPubMed
go back to reference Brown GL, Goodwin FK, Ballenger JC, Goyer PF, Major LF (1979) Aggression in humans correlates with cerebrospinal fluid amine metabolites. Psychiatry Res 1(2):131–139CrossRefPubMed Brown GL, Goodwin FK, Ballenger JC, Goyer PF, Major LF (1979) Aggression in humans correlates with cerebrospinal fluid amine metabolites. Psychiatry Res 1(2):131–139CrossRefPubMed
go back to reference Brown GL, Ebert MH, Goyer PF, Jimerson DC, Klein WJ, Bunney WE et al (1982) Aggression, suicide, and serotonin: relationships to CSF amine metabolites. Am J Psychiatry 139(6):741–746PubMed Brown GL, Ebert MH, Goyer PF, Jimerson DC, Klein WJ, Bunney WE et al (1982) Aggression, suicide, and serotonin: relationships to CSF amine metabolites. Am J Psychiatry 139(6):741–746PubMed
go back to reference Bunce SC, Noblett KL, McCloskey MS, Coccaro EF (2005) High prevalence of personality disorders among healthy volunteers for research: implications for control group bias. J Psychiatr Res 39(4):421–430CrossRefPubMed Bunce SC, Noblett KL, McCloskey MS, Coccaro EF (2005) High prevalence of personality disorders among healthy volunteers for research: implications for control group bias. J Psychiatr Res 39(4):421–430CrossRefPubMed
go back to reference Buss AH, Durkee A (1957) An inventory for assessing different kinds of hostility. J Consult Psychol 21(4):343–349CrossRefPubMed Buss AH, Durkee A (1957) An inventory for assessing different kinds of hostility. J Consult Psychol 21(4):343–349CrossRefPubMed
go back to reference Castellanos FX, Elia J, Kruesi MJ, Gulotta CS, Mefford IN, Potter WZ et al (1994) Cerebrospinal fluid monoamine metabolites in boys with attention-deficit hyperactivity disorder. Psychiatry Res 52(3):305–316CrossRefPubMed Castellanos FX, Elia J, Kruesi MJ, Gulotta CS, Mefford IN, Potter WZ et al (1994) Cerebrospinal fluid monoamine metabolites in boys with attention-deficit hyperactivity disorder. Psychiatry Res 52(3):305–316CrossRefPubMed
go back to reference Coccaro E, Siever L (2002) Pathophysiology and treatment of aggression. In: Psychopharmacology: the fifth generation of progress, pp 1709–1723 Coccaro E, Siever L (2002) Pathophysiology and treatment of aggression. In: Psychopharmacology: the fifth generation of progress, pp 1709–1723
go back to reference Coccaro EF, Siever LJ (2005) Neurobiology of personality disorder. In: Oldham JM, Skodol AE, Bender D (eds) Textbook of personality disorders. American Psychiatric Press, Arlington, pp 155–169 Coccaro EF, Siever LJ (2005) Neurobiology of personality disorder. In: Oldham JM, Skodol AE, Bender D (eds) Textbook of personality disorders. American Psychiatric Press, Arlington, pp 155–169
go back to reference Coccaro EF, Kavoussi RJ, Sheline YI, Lish JD, Csernansky JG (1996) Impulsive aggression in personality disorder correlates with tritiated paroxetine binding in the platelet. Arch Gen Psychiatry 53(6):531–536PubMed Coccaro EF, Kavoussi RJ, Sheline YI, Lish JD, Csernansky JG (1996) Impulsive aggression in personality disorder correlates with tritiated paroxetine binding in the platelet. Arch Gen Psychiatry 53(6):531–536PubMed
go back to reference Coccaro EF, Berman ME, Kavoussi RJ (1997a) Assessment of life history of aggression: development and psychometric characteristics. Psychiatry Res 73(3):147–157CrossRefPubMed Coccaro EF, Berman ME, Kavoussi RJ (1997a) Assessment of life history of aggression: development and psychometric characteristics. Psychiatry Res 73(3):147–157CrossRefPubMed
go back to reference Coccaro EF, Kavoussi RJ, Cooper TB, Hauger RL (1997b) Central serotonin activity and aggression: inverse relationship with prolactin response to d-fenfluramine, but not CSF 5-HIAA concentration, in human subjects. Am J Psychiatry 154(10):1430–1435PubMed Coccaro EF, Kavoussi RJ, Cooper TB, Hauger RL (1997b) Central serotonin activity and aggression: inverse relationship with prolactin response to d-fenfluramine, but not CSF 5-HIAA concentration, in human subjects. Am J Psychiatry 154(10):1430–1435PubMed
go back to reference Coccaro EF, Kavoussi RJ, Trestman RL, Gabriel SM, Cooper TB, Siever LJ (1997c) Serotonin function in human subjects: intercorrelations among central 5-HT indices and aggressiveness. Psychiatry Res 73(1–2):1–14CrossRefPubMed Coccaro EF, Kavoussi RJ, Trestman RL, Gabriel SM, Cooper TB, Siever LJ (1997c) Serotonin function in human subjects: intercorrelations among central 5-HT indices and aggressiveness. Psychiatry Res 73(1–2):1–14CrossRefPubMed
go back to reference Coccaro EF, Schmidt CA, Samuels JF, Nestadt G (2004) Lifetime and 1-month prevalence rates of intermittent explosive disorder in a community sample. J Clin Psychiatry 65(6):820–824PubMedCrossRef Coccaro EF, Schmidt CA, Samuels JF, Nestadt G (2004) Lifetime and 1-month prevalence rates of intermittent explosive disorder in a community sample. J Clin Psychiatry 65(6):820–824PubMedCrossRef
go back to reference Curzon G, Gumpert EJ, Sharpe DM (1971) Amine metabolites in the lumbar cerebrospinal fluid of humans with restricted flow of cerebrospinal fluid. Nat New Biol 231(23):189–191PubMed Curzon G, Gumpert EJ, Sharpe DM (1971) Amine metabolites in the lumbar cerebrospinal fluid of humans with restricted flow of cerebrospinal fluid. Nat New Biol 231(23):189–191PubMed
go back to reference Emerson AJ, Kappenman DP, Ronan PJ, Renner KJ, Summers CH (2000) Stress induces rapid changes in serotonergic activity: restraint and exertion. Behav Brain Res 111(1–2):83–92CrossRefPubMed Emerson AJ, Kappenman DP, Ronan PJ, Renner KJ, Summers CH (2000) Stress induces rapid changes in serotonergic activity: restraint and exertion. Behav Brain Res 111(1–2):83–92CrossRefPubMed
go back to reference Engstrom G, Alling C, Blennow K, Regnell G, Traskman-Bendz L (1999) Reduced cerebrospinal HVA concentrations and HVA/5-HIAA ratios in suicide attempters. Monoamine metabolites in 120 suicide attempters and 47 controls. Eur Neuropsychopharmacol 9(5):399–405CrossRefPubMed Engstrom G, Alling C, Blennow K, Regnell G, Traskman-Bendz L (1999) Reduced cerebrospinal HVA concentrations and HVA/5-HIAA ratios in suicide attempters. Monoamine metabolites in 120 suicide attempters and 47 controls. Eur Neuropsychopharmacol 9(5):399–405CrossRefPubMed
go back to reference Eysenck SB, Eysenck HJ (1977) The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 16(1):57–68PubMed Eysenck SB, Eysenck HJ (1977) The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 16(1):57–68PubMed
go back to reference Fri CG, Wiesel FA, Sedvall G (1974) Simultaneous quantification of homovanillic acid and 5-hydroxyindoleacetic acid in cerebrospinal fluid by mass fragmentography. Life Sci 14(12):2469–2480CrossRefPubMed Fri CG, Wiesel FA, Sedvall G (1974) Simultaneous quantification of homovanillic acid and 5-hydroxyindoleacetic acid in cerebrospinal fluid by mass fragmentography. Life Sci 14(12):2469–2480CrossRefPubMed
go back to reference Garelis E, Young SN, Lal S, Sourkes TL (1974) Monoamine metabolites in lumbar CSF: the question of their origin in relation to clinical studies. Brain Res 79(1):1–8CrossRefPubMed Garelis E, Young SN, Lal S, Sourkes TL (1974) Monoamine metabolites in lumbar CSF: the question of their origin in relation to clinical studies. Brain Res 79(1):1–8CrossRefPubMed
go back to reference Geldof M, Freijer JI, Peletier LA, van Beijsterveldt L, Danhof M (2008) Mechanistic model for the acute effect of fluvoxamine on 5-HT and 5-HIAA concentrations in rat frontal cortex. Eur J Pharm Sci 33(3):217–229PubMed Geldof M, Freijer JI, Peletier LA, van Beijsterveldt L, Danhof M (2008) Mechanistic model for the acute effect of fluvoxamine on 5-HT and 5-HIAA concentrations in rat frontal cortex. Eur J Pharm Sci 33(3):217–229PubMed
go back to reference Gillman PK, Bartlett JR, Bridges PK, Hunt A, Patel AJ, Kantamaneni BD et al (1981) Indolic substances in plasma, cerebrospinal fluid, and frontal cortex of human subjects infused with saline or tryptophan. J Neurochem 37(2):410–417CrossRefPubMed Gillman PK, Bartlett JR, Bridges PK, Hunt A, Patel AJ, Kantamaneni BD et al (1981) Indolic substances in plasma, cerebrospinal fluid, and frontal cortex of human subjects infused with saline or tryptophan. J Neurochem 37(2):410–417CrossRefPubMed
go back to reference Grahame-Smith DG (1971) Studies in vivo on the relationship between brain tryptophan, brain 5-HT synthesis and hyperactivity in rats treated with a monoamine oxidase inhibitor and l-tryptophan. J Neurochem 18(6):1053–1066CrossRefPubMed Grahame-Smith DG (1971) Studies in vivo on the relationship between brain tryptophan, brain 5-HT synthesis and hyperactivity in rats treated with a monoamine oxidase inhibitor and l-tryptophan. J Neurochem 18(6):1053–1066CrossRefPubMed
go back to reference Higley JD, Mehlman PT, Taub DM, Higley SB, Suomi SJ, Vickers JH et al (1992) Cerebrospinal fluid monoamine and adrenal correlates of aggression in free-ranging rhesus monkeys. Arch Gen Psychiatry 49(6):436–441PubMed Higley JD, Mehlman PT, Taub DM, Higley SB, Suomi SJ, Vickers JH et al (1992) Cerebrospinal fluid monoamine and adrenal correlates of aggression in free-ranging rhesus monkeys. Arch Gen Psychiatry 49(6):436–441PubMed
go back to reference Kishida I, Aklillu E, Kawanishi C, Bertilsson L, Agren H (2007) Monoamine metabolites level in CSF is related to the 5-HTT gene polymorphism in treatment-resistant depression. Neuropsychopharmacology 32(10):2143–2151CrossRefPubMed Kishida I, Aklillu E, Kawanishi C, Bertilsson L, Agren H (2007) Monoamine metabolites level in CSF is related to the 5-HTT gene polymorphism in treatment-resistant depression. Neuropsychopharmacology 32(10):2143–2151CrossRefPubMed
go back to reference Limson R, Goldman D, Roy A, Lamparski D, Ravitz B, Adinoff B et al (1991) Personality and cerebrospinal fluid monoamine metabolites in alcoholics and controls. Arch Gen Psychiatry 48(5):437–441PubMed Limson R, Goldman D, Roy A, Lamparski D, Ravitz B, Adinoff B et al (1991) Personality and cerebrospinal fluid monoamine metabolites in alcoholics and controls. Arch Gen Psychiatry 48(5):437–441PubMed
go back to reference Linnoila M, Virkkunen M, Scheinin M, Nuutila A, Rimon R, Goodwin FK (1983) Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior. Life Sci 33(26):2609–2614CrossRefPubMed Linnoila M, Virkkunen M, Scheinin M, Nuutila A, Rimon R, Goodwin FK (1983) Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior. Life Sci 33(26):2609–2614CrossRefPubMed
go back to reference Mann JJ, McBride PA, Brown RP, Linnoila M, Leon AC, DeMeo M et al (1992) Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients. Arch Gen Psychiatry 49(6):442–446PubMed Mann JJ, McBride PA, Brown RP, Linnoila M, Leon AC, DeMeo M et al (1992) Relationship between central and peripheral serotonin indexes in depressed and suicidal psychiatric inpatients. Arch Gen Psychiatry 49(6):442–446PubMed
go back to reference Mehlman PT, Higley JD, Faucher I, Lilly AA, Taub DM, Vickers J et al (1994) Low CSF 5-HIAA concentrations and severe aggression and impaired impulse control in nonhuman primates. Am J Psychiatry 151(10):1485–1491PubMed Mehlman PT, Higley JD, Faucher I, Lilly AA, Taub DM, Vickers J et al (1994) Low CSF 5-HIAA concentrations and severe aggression and impaired impulse control in nonhuman primates. Am J Psychiatry 151(10):1485–1491PubMed
go back to reference Moller SE, Mortensen EL, Breum L, Alling C, Larsen OG, Boge-Rasmussen T et al (1996) Aggression and personality: association with amino acids and monoamine metabolites. Psychol Med 26(2):323–331CrossRefPubMed Moller SE, Mortensen EL, Breum L, Alling C, Larsen OG, Boge-Rasmussen T et al (1996) Aggression and personality: association with amino acids and monoamine metabolites. Psychol Med 26(2):323–331CrossRefPubMed
go back to reference Placidi GP, Oquendo MA, Malone KM, Huang YY, Ellis SP, Mann JJ (2001) Aggressivity, suicide attempts, and depression: relationship to cerebrospinal fluid monoamine metabolite levels. Biol Psychiatry 50(10):783–791CrossRefPubMed Placidi GP, Oquendo MA, Malone KM, Huang YY, Ellis SP, Mann JJ (2001) Aggressivity, suicide attempts, and depression: relationship to cerebrospinal fluid monoamine metabolite levels. Biol Psychiatry 50(10):783–791CrossRefPubMed
go back to reference Post RM, Kotin J, Goodwin FK, Gordon EK (1973) Psychomotor activity and cerebrospinal fluid amine metabolites in affective illness. Am J Psychiatry 130(1):67–72PubMed Post RM, Kotin J, Goodwin FK, Gordon EK (1973) Psychomotor activity and cerebrospinal fluid amine metabolites in affective illness. Am J Psychiatry 130(1):67–72PubMed
go back to reference Prochazka H, Agren H (2003) Self-rated aggression and cerebral monoaminergic turnover. Sex differences in patients with persistent depressive disorder. Eur Arch Psychiatry Clin Neurosci 253(4):185–192CrossRefPubMed Prochazka H, Agren H (2003) Self-rated aggression and cerebral monoaminergic turnover. Sex differences in patients with persistent depressive disorder. Eur Arch Psychiatry Clin Neurosci 253(4):185–192CrossRefPubMed
go back to reference Sher L, Mann JJ, Traksman-Benz L, Winchel R, Huang YY, Fertuck E, Stanley BH (2006a) Lower cerebrospinal fluid homovanillic acid levels in depressed suicide attempters. J Affective Disorders 90:83–89CrossRef Sher L, Mann JJ, Traksman-Benz L, Winchel R, Huang YY, Fertuck E, Stanley BH (2006a) Lower cerebrospinal fluid homovanillic acid levels in depressed suicide attempters. J Affective Disorders 90:83–89CrossRef
go back to reference Sher L, Carballo JJ, Grunebaum MF, Burke AK, Zalsman G, Huang YY et al (2006b) A prospective study of the association of cerebrospinal fluid monoamine metabolite levels with lethality of suicide attempts in patients with bipolar disorder. Bipolar Disord 8(5 Pt 2):543–550 Sher L, Carballo JJ, Grunebaum MF, Burke AK, Zalsman G, Huang YY et al (2006b) A prospective study of the association of cerebrospinal fluid monoamine metabolite levels with lethality of suicide attempts in patients with bipolar disorder. Bipolar Disord 8(5 Pt 2):543–550
go back to reference Soderstrom H, Blennow K, Manhem A, Forsman A (2001) CSF studies in violent offenders. I. 5-HIAA as a negative and HVA as a positive predictor of psychopathy. J Neural Transm 108(7):869–878CrossRefPubMed Soderstrom H, Blennow K, Manhem A, Forsman A (2001) CSF studies in violent offenders. I. 5-HIAA as a negative and HVA as a positive predictor of psychopathy. J Neural Transm 108(7):869–878CrossRefPubMed
go back to reference Spielberger CD (1996) State-trait anger expression inventory: professional manual. Psychological Assessment Resources, Inc, Odessa, FL Spielberger CD (1996) State-trait anger expression inventory: professional manual. Psychological Assessment Resources, Inc, Odessa, FL
go back to reference Stanley B, Molcho A, Stanley M, Winchel R, Gameroff MJ, Parsons B et al (2000) Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. Am J Psychiatry 157(4):609–614CrossRefPubMed Stanley B, Molcho A, Stanley M, Winchel R, Gameroff MJ, Parsons B et al (2000) Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. Am J Psychiatry 157(4):609–614CrossRefPubMed
go back to reference van der Vegt BJ, Lieuwes N, Cremers TI, de Boer SF, Koolhaas JM (2003) Cerebrospinal fluid monoamine and metabolite concentrations and aggression in rats. Horm Behav 44(3):199–208CrossRefPubMed van der Vegt BJ, Lieuwes N, Cremers TI, de Boer SF, Koolhaas JM (2003) Cerebrospinal fluid monoamine and metabolite concentrations and aggression in rats. Horm Behav 44(3):199–208CrossRefPubMed
go back to reference Virkkunen M, Nuutila A, Goodwin FK, Linnoila M (1987) Cerebrospinal fluid monoamine metabolite levels in male arsonists. Arch Gen Psychiatry 44(3):241–247PubMed Virkkunen M, Nuutila A, Goodwin FK, Linnoila M (1987) Cerebrospinal fluid monoamine metabolite levels in male arsonists. Arch Gen Psychiatry 44(3):241–247PubMed
go back to reference Virkkunen M, De Jong J, Bartko J, Goodwin FK, Linnoila M (1989) Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters. A follow-up study. Arch Gen Psychiatry 46(7):600–603PubMed Virkkunen M, De Jong J, Bartko J, Goodwin FK, Linnoila M (1989) Relationship of psychobiological variables to recidivism in violent offenders and impulsive fire setters. A follow-up study. Arch Gen Psychiatry 46(7):600–603PubMed
go back to reference Virkkunen M, Rawlings R, Tokola R, Poland RE, Guidotti A, Nemeroff C et al (1994) CSF biochemistries, glucose metabolism, and diurnal activity rhythms in alcoholic, violent offenders, fire setters, and healthy volunteers. Arch Gen Psychiatry 51(1):20–27PubMed Virkkunen M, Rawlings R, Tokola R, Poland RE, Guidotti A, Nemeroff C et al (1994) CSF biochemistries, glucose metabolism, and diurnal activity rhythms in alcoholic, violent offenders, fire setters, and healthy volunteers. Arch Gen Psychiatry 51(1):20–27PubMed
go back to reference Wolf WA, Youdim MB, Kuhn DM (1985) Does brain 5-HIAA indicate serotonin release or monoamine oxidase activity? Eur J Pharmacol 109(3):381–387CrossRefPubMed Wolf WA, Youdim MB, Kuhn DM (1985) Does brain 5-HIAA indicate serotonin release or monoamine oxidase activity? Eur J Pharmacol 109(3):381–387CrossRefPubMed
Metadata
Title
Cerebrospinal fluid 5-hydroxyindolacetic acid and homovanillic acid: reciprocal relationships with impulsive aggression in human subjects
Authors
Emil F. Coccaro
Royce Lee
Publication date
01-02-2010
Publisher
Springer Vienna
Published in
Journal of Neural Transmission / Issue 2/2010
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-009-0359-x

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