In their article, Santiago and Dalen1 state that the necessary link between cholesterol and serotonin levels and violence has not been demonstrated. The neurobiologic manifestations are suggested by a reduced serum cholesterol level correlating with increased motoric impulsivity in borderline personality disorder, and negatively with specific measures of impulsive aggression in subjects with personality disorder who have physically self-damaging behavior2 possibly due to decreased serotonergic-mediated inhibition of dopamine subserving coping behavior and mood. This hypothesis is supported by an optimal response organization at an intermediate dopamine tone in a medial-frontal-striatal activation system3,4 and by operant conditioning of hippocampal CA1 pyramidal cell bursting at different concentrations of dopamine showing a sharp peak at 1 mM and falling off abruptly when this optimal concentration of dopamine was either halved or doubled.5 It also is supported by the concept of cellular tone, and by a neurochemical model underlying differences
Friedman EH. Neurobiology of Cholesterol and Violent Behavior. Arch Intern Med. 1995;155(5):543–544. doi:10.1001/archinte.1995.00430050123015
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