Mesocorticolimbic dopamine functioning in primary psychopathy: A source of within-group heterogeneity

• Published in: Psychiatry research Vol. 229; no. 3; pp. 633 - 677
• Main Authors: Yildirim, Bariş O, Derksen, Jan J.L
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 30.10.2015
• Subjects: Amygdala; Corpus Striatum - metabolism; Corpus Striatum - physiology; Dopamine - metabolism; Dopamine - physiology; Executive Function; Executive functioning; Humans; Impulsivity; Limbic System - metabolism; Limbic System - physiology; Motivation; Prefrontal cortex; Prefrontal Cortex - metabolism; Prefrontal Cortex - physiology; Psychiatry; Receptors, Dopamine - physiology; Receptors, Dopamine D1; Receptors, Dopamine D2 - metabolism; Reward; Risk-taking; Self-control; Serotonin - metabolism; Striatum; Striatum; Impulsivity; Self-control; Amygdala; Prefrontal cortex; Risk-taking; Executive functioning
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2015.07.005

Abstract Despite similar emotional deficiencies, primary psychopathic individuals can be situated on a continuum that spans from controlled to disinhibited. The constructs on which primary psychopaths are found to diverge, such as self-control, cognitive flexibility, and executive functioning, are crucially regulated by dopamine (DA). As such, the goal of this review is to examine which specific alterations in the meso-cortico-limbic DA system and corresponding genes (e.g., TH, DAT, COMT, DRD2, DRD4) might bias development towards a more controlled or disinhibited expression of primary psychopathy. Based on empirical data, it is argued that primary psychopathy is generally related to a higher tonic and population activity of striatal DA neurons and lower levels of D2-type DA receptors in meso-cortico-limbic projections, which may boost motivational drive towards incentive-laden goals, dampen punishment sensitivity, and increase future reward-expectancy. However, increasingly higher levels of DA activity in the striatum (moderate versus pathological elevations), lower levels of DA functionality in the prefrontal cortex, and higher D1-to-D2-type receptor ratios in meso-cortico-limbic projections may lead to increasingly disinhibited and impetuous phenotypes of primary psychopathy. Finally, in order to provide a more coherent view on etiological mechanisms, we discuss interactions between DA and serotonin that are relevant for primary psychopathy.