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Aggressive, socially disruptive and antisocial behaviour associated with fronto-temporal dementia

Published online by Cambridge University Press:  03 January 2018

B. L. Miller*
Affiliation:
UCLA School of Medicine, Los Angeles, California, USA
A. Darby
Affiliation:
UCLA School of Medicine, Los Angeles, California, USA
D. F. Benson
Affiliation:
UCLA School of Medicine, Los Angeles, California, USA
J. L. Cummings
Affiliation:
UCLA School of Medicine, Los Angeles, California, USA
M. H. Miller
Affiliation:
UCLA School of Medicine, Los Angeles, California, USA
*
B. L. Miller, Professor of Neurology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA 90509, USA. Fax: 310-618 1273

Abstract

Background

Research suggests an association between frontal and temporal injury and antisocial conduct. We studied the frequency of antisocial behaviours in fronto-temporal dementia (FTD) where pathology is anterior frontal-temporal, compared with Alzheimer's disease (AD) where pathology is primarily posterior temporal-parietal.

Method

The presence of antisocial conduct was compared in 22 FTD versus 22 AD subjects. All FTD patients had anterior frontal or temporal hypoperfusion with single photon emission computed tomography, whereas those with AD had posterior temporal-parietal hypoperfusion.

Results

Ten FTD and one AD subject showed antisocial behaviours, which included assault, indecent exposure, shoplifting and hit-and-run driving. Three FTD subjects were arrested. This difference was highly significant (P = 0.004).

Conclusions

Degeneration of frontal and temporal lobes predisposes to antisocial behaviour. This study supports a relationship between frontal-temporal dysfunction and certain types of antisocial activities.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Binns, J. K. & Robetaon, E. E. (1962) Pick's disease in old age. Journal of Medical Science, 108, 804810.Google ScholarPubMed
Blake, P., Pincus, J. H. & Buckner, C. (1995) Neurologic abnormalities in murderers. Neurohgy, 45, 16411647.Google Scholar
Blumer, D. & Banson, D. F. (1975) Personality changes with frontal and temporal lobe lesions. In Psychiatric Aspects of Neurologic Disease (eds Benson, D. F. & Blumer, D.), pp 151170. New York: Grune and Stratton.Google Scholar
Boone, K. B., Miller, B. L., Rosenberg, L., et al (1988) Neuropsychological and behavioral abnormalities in an adolescent with frontal lobe seizures. Neurology, 39, 583586.Google Scholar
Burn, A. (1987) Frontal lobe degeneration of non-Alzheimer. I: Neuropathology. Archives of Gerontology and Geriatrics, 6, 193208.Google Scholar
Burn, A., Englund, B., Gustafson, L., et al (1994) Frontal lobe dementia of the non-Alzheimer type revisited. Dementia, 4, 126131.Google Scholar
Ciccone, J. R. (1992) Murder, insanity and medical expert witnesses. Archives of Neurology, 49, 608611.CrossRefGoogle ScholarPubMed
Cummings, J. L., Miller, B. L., Hill, M. A., et al (1987) Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Archives of Neurology, 44, 389393.CrossRefGoogle ScholarPubMed
Cummings, J. L., Miller, B. L., Hill, M. A., Mega, M., Gray, K., et al (1994) The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.Google Scholar
Damasio, A. R. & Van Hoesen, G. W. (1989) Emotional disturbances associated with focal lesions of the limbic frontal lobe. In The Neuropsychology of Human Emotion (eds Heilman, K. & Satz, P.), pp 85110. New York: Guilford Press.Google Scholar
Eagger, S., Syed, G. M., Burns, A., et al (1992) Morphologic (CT) and functional (rCBF-SPECT) correlates in Alzheimer's disease. Nuclear Medicine Communications, 13, 644647.Google Scholar
Fenwick, P. (1993) Brain mind and behavior: Some medicolegal aspects. British Journal of Psychiatry, 163, 565573.CrossRefGoogle Scholar
Folstain, M. P., Folstain, S. E. & McHugh, P. R. (1975) ‘Mini-Mental State’: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 185198.Google Scholar
Francis, P. T., Holmes, C., Webster, M. T., et al (1993) Preliminary neurochemical findings in non-Alzheimer dementia due to lobar atrophy Dementia, 4, 7279.Google ScholarPubMed
Frison, G. B., Pizzolato, G., Geroldi, C., et al (1995) Dementia of the frontal type: Neuropsychological and 99 Tc-HM-PAO SPECT features. Journal of Geriatric Psychiatry and Neurology, 8, 421–48.Google Scholar
Garattini, S., Bizzi, A. & Codegoni, A. M. (1992) Progress report on the anorexia induced by drugs believed to mimic some of the effects of serotonin on the cerebral nervous system. American Journal of Clinical Nutrition, 55, 160S166S.Google Scholar
Gustafson, L. (1987) Frontal lobe degeneration of non-Alzheimer type. II: Clinical picture and differential diagnosis. Archives of Gerontology and Geriatrics, 6, 209223.Google Scholar
Gustafson, L. (1993) Clinical picture of frontal lobe degeneration of non-Alzheimer type. Dementia, 4, 143148.Google Scholar
Hallack, S., Hoge, S. K., Miller, R. D., et al (1990) The use of psychiatric diagnoses in the legal process: Task force report of the American Psychiatric Association. Bulletin of the American Academy of Psychiatry and Law, 20, 481499.Google Scholar
Harlow, J., (1868) Recovery from passage of an iron bar through the head. Publications of the Massachussetts Medical Society, 2, 329346.Google Scholar
Johnson, A. (1959) Juvenile delinquency In American Handoook of Psychiatry (ed. Arieti, S.), pp. 240256. New York: Book Bank.Google Scholar
Kanno, L., Uemura, K., Miura, S., et al (1981) Headtome: A hybrid emission single-photon and positron emission tomograph for imaging of the brain. Journal of Computer Assisted Tomography, 5, 216226.Google Scholar
Kleist, K. (1934) Gehirnpathologie. Leipzig: Barth.Google Scholar
Lande, K. E. (1936) Forensic medicine in Europe: Legal medicine in America. New England Journal of Medicine, 18, 826834.Google Scholar
Labert, F., Pasquier, F. & Petit, H. (1995) Personality traits and frontal lobe dementia. International Journal of Geriatric Psychiatry, 10, 10471049.CrossRefGoogle Scholar
Lesser, I. M., Miller, B. L. Boone, K. B., et al (1991) Brain injury and cognitive function in late-onset psychotic depressioa Journal of Neuropsychiatry and Clinical Neuroscience, 3, 3340.Google Scholar
Levin, K. S. & Grossman, R. G. (1978) Behavioral sequelae of closed head injury. Archives of Neurology, 35, 720727.Google Scholar
Lewis, D. O., Pincus, J. H., Feldman, M., et al (1986) Psychiatric, neurological, and psychoeducational characteristics of 15 death row inmates in the United States. American Journal of Psychiatry, 143, 838845.Google Scholar
Lewis, D. O., Pincus, J. H., Feldman, M., Bard, B., et al (1988) Neuropsychiatric, psychoeducational and family characteristics of 14 juveniles condemned to death in the United States. American Journal of Psychiatry, 145, 584589.Google Scholar
Lilly, R., Cummings, J. L., Benson, D. F., et al (1982) Clinical occurrence of the human Kluver Bucy syndrome. Neurology, 32, A96.Google Scholar
Lynch, T., Sano, M., Marder, K. S., et al (1994) Clinical characteristics of a family with chromosome 17-linked disinhibition-dementia-parkinsonism-amyotrophy complex. Neurology, 44, 18781884.Google Scholar
McKhann, G., Drachman, D., Folstein, M., et al (1984) Diagnosis of AD disease: A report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 349, 939944.CrossRefGoogle Scholar
Menninger, K. (1973) Whatever Became of Sin? New York: Hawthorne.Google Scholar
Miller, B. L., Cummings, J. L., McIntyre, H. B., et al (1984) Hypersexuality or altered sexual preference following brain injury Journal of Neurology Neumsurgery & Psychiatry, 49, 671676.Google Scholar
Miller, B. L., Cummings, J. L., McIntyre, H. B., Villanueva-Meyer, J., et al (1991). Frontal lobe degeneration: Clinical, neuropsychological and SPECT characteristics. Neurology, 41, 13741382.Google Scholar
Miller, B. L., Cummings, J. L., McIntyre, H. B., Villanueva-Meyer, J., Chang, L., Mena, I., et al (1993) Clinical and imaging features of right focal frontal lobe degenerations. Dementio, 4, 204213.Google Scholar
Miller, B. L., Cummings, J. L., McIntyre, H. B., Villanueva-Meyer, J., Chang, L., Mena, I., Mena, I., Cummings, J. L., et al (1995a) Neuroimaging in clinical practice. In Comprehensive Textbook of Psychiarty, Vol. VI (eds Kaplan, H. I. & Sadock, B. J.). pp 257 276. Baltimore. MD; Williams and Wilkins.Google Scholar
Miller, B. L., Cummings, J. L., McIntyre, H. B., Villanueva-Meyer, J., Chang, L., Mena, I., Mena, I., Cummings, J. L., Itti, L., Li, J., et al (1995b) Atrophy-corrected cerebral blood flow in frontotemporal dementia. Facts in Research and Gerontology, 93 103.Google Scholar
Neery, D., Snowden, J. S., Northen, B., et al, (1988) Dementia of frontal lobe type. Journal of Neurology, Neurosurgery and Psychiatry, 51, 353361.Google Scholar
Neery, D., Snowden, J. S., Northen, B., Mann, D. M. A., et al (1990) Frontal lobe dementia and motor neuron disease. Journal of Neurology Neurosurgery and Psychiatry 53, 2332.Google Scholar
Neirinckx, R. D., Canning, L. R., Piper, I. M., et al (1987) Technetium-99m d, I-HMPAO: A new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. Journal of Nuclear Medicine. 28, 191202.Google Scholar
Neumann, M. A. & Cohn, R. (1967) Progressive subcortical gliosis, a rare form of presenile dementia. Brain, 90, 405418.Google Scholar
Nichols, I. C. & Weigner, W. C. (1938) Picks disease – a specific type of dementia. Brain, 61, 237.Google Scholar
Pick, A. (1892) On the relationship between asphasia and senile atrophy of the brain. In Neurological Classics in Modern Translation (eds Rottenberg, D. A. & Hochberg, F. H., translated by Schoene, W C.). pp 3540. New York: Hafner.Google Scholar
Read, S., Miller, B. L., Mena, I., et al, (1995) SPECT/pathology correlations in dementia. Journal of the American Geriatrics Society 43, 12431247.Google Scholar
Rekhman, W. E. (1995) Neuropsychiatric aspects of cerebrovascular diseases and tumors. In Comprehensive Textbook of Psychiatry Vol, VI (eds Kaplan, H. I. & Sadock, B I.) pp. 187198. Blatimore. MD: Williams and Wilkins.Google Scholar
Rickler, K. C. (1982) Episodic dyscontrol. In Psychiatric Aspects of Neurologic Disease (eds Benson, D. F. & Blumer, D.), pp. 4973. New York: Grune and Stratton.Google Scholar
Roy, A. & Linnoila, M. (1988) Suicidal behavior, impulsiveness and serotonia. Acta Psychiatrica Scandinavia. 781, 529535.CrossRefGoogle Scholar
Sparks, D. L. & Markesbery, W. R. (1991) Altered serotonergic and cholinergic synaptic markers in Picks disease. Archives of Neurology, 48, 760799.Google Scholar
Stuss, D. & Benson, D. F. (1986) The Frontal Lobes, New York: Raven Press.Google Scholar
Treiman, D. (1986) Epilepsy and violence: Medical and legal issues. Epilepsia, 27(suppl 2), S77S104.Google Scholar
Van Praag, H. (1991) Serontonergic dysfunction and aggression control. Psychological Medicine, 21, 1519.CrossRefGoogle Scholar
Virkunen, M. & Linnoila, M. (1993) Brain serotonin. Type II alcoholism and impulsive violence. Journal of Studies on Alcohol. 11, 163169.Google Scholar
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