[The neurobiology of impulse control disorders].
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.


METHODS
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.


CONCLUSIONS
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.
Williams
Wendol A
WA
Departamento de Psiquiatria, School of Medicine, Yale University, New Haven, Connecticut 06519, USA.
Potenza
Marc N
MN
D002540:Cerebral Cortex / Q000503:physiopathology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000235:genetics / Q000503:physiopathology*; D004298:Dopamine / Q000502:physiology; D005715:Gambling; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008995:Monoamine Oxidase / Q000502:physiology; D018377:Neurotransmitter Agents / Q000502:physiology; D009638:Norepinephrine / Q000502:physiology; D012701:Serotonin / Q000502:physiology
D018377:Neurotransmitter Agents; D012701:Serotonin; D008995:Monoamine Oxidase; D004298:Dopamine; D009638:Norepinephrine