2009 issue 4

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Volume 18, issue 4

Review

The neurobiology of impulsiveness and its clinical implications

Andrzej Jakubczyk1,2, Marcin Wojnar1,2,3
1. Katedra i Klinika Psychiatryczna Warszawskiego Uniwersytetu Medycznego
2. Szpital Nowowiejski w Warszawie
3. University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
Postępy Psychiatrii i Neurologii 2009; 18 (4): 357-365
Keywords: impulsiveness, serotonin system, dopamine system

Abstract

Objectives. Impulsiveness characterized by complexity of its clinical pattern seems to be a multidimensional construct not only in the aspect of symptomatology. The article presents research findings showing the influence of different brain areas and of particular neurotransmitter systems on the level of impulsivity.
Background. Cerebral areas associated with impulsiveness level are situated in the prefrontal cortex, limbic system and striatum. These brain regions have been found to play an important role in mediating different (cognitive and motor) aspects of impulsiveness. As far as neurotransmitters are concerned, there is growing evidence that impulsivity is affected by a number of interrelated systems described in the article. The serotonin system seems to be the most important, since it modifies impulsiveness level through involvement in dopaminergic, glutamatergic and GABAergic neurotransmission. Norepinephrine neurotransmission is considered to be responsible for state-related impulsivity increase. In pharmacological treatment of impulsive behaviour mood stabilizers and antidepressants, especially serotonin reuptake inhibitors, may be useful.
Conclusions. The treatment of impulsiveness remains a problem yet to be solved, mainly due to the fact thatparticular neurotransmitters may influence impulsivity in different ways, depending on the cerebral area involved, receptor type, and the actual level of impulsivity.

Address for correspondence:
Prof. nadzw. dr hab. n. med. Marcin Wojnar
Katedra i Klinika Psychiatryczna WUM
ul. Nowowiejska 27, 00-665 Warszawa
e-mail: marcin.wojnar@wum.edu.pl