Brain, Vol. 123, No. 2, 234-243,
February 2000
© 2000 Oxford University Press
Affective aggression in patients with temporal lobe epilepsy
A quantitative MRI study of the amygdala
1 Raymond Way Research Group, 2 Epilepsy Research Group, Institute of Neurology, London, UK, 3 Department of Psychiatry, Albert-Ludwigs-University, Freiburg, Germany
Correspondence to:
Dr L. Tebartz van Elst, Department of Psychiatry, Albert-Ludwigs-Universität, Hauptstrasse 5, D-79104 Freiburg, Germany
Recurrent episodes with interictal affective aggression are a rare but well-recognized problem in patients with temporal lobe epilepsy. They are referred to as episodic dyscontrol or, more precisely, as intermittent explosive disorder (IED). The amygdala play a crucial role in the affective evaluation of multimodal sensory input and the neurobiological mediation of aggressive behaviour. With hippocampal sclerosis, in the context of mesial temporal lobe sclerosis, being the most common cause of temporal lobe epilepsy, we hypothesized that the amygdala might be affected by the same pathogenic process in aggressive patients. We investigated 50 patients with temporal lobe epilepsy: 25 with and 25 without a history of IED. Data from clinical, electrophysiological, neuropsychological and psychometric investigations were obtained, as well as MRI scans for the quantitative assessment of possible amygdala pathology. We found no evidence of a higher prevalence of amygdala sclerosis in the aggressive patients. Hippocampal sclerosis was significantly less common in patients with temporal lobe epilepsy and IED. However, a significant subgroup of patients (20%) with temporal lobe epilepsy and aggressive behaviour had severe amygdala atrophy in the context of a history of encephalitis. Another subgroup of aggressive patients (28%) had different left temporal lesions affecting either the amygdala or periamygdaloid structures. IED was associated with left-sided or bilateral EEG and MRI abnormalities, low IQ and high scores in depression and anxiety.
amygdala; aggression; intermittent explosive disorder; MRI; temporal lobe epilepsy
AT2 = amygdala T2; IED = intermittent explosive disorder
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Tebartz van Elst, D. Ebert, and B. Hesslinger Amygdala Volume Status Might Reflect Dominant Mode of Emotional Information Processing Arch Gen Psychiatry, February 1, 2007; 64(2): 251 - -252. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Raine and Y. Yang Neural foundations to moral reasoning and antisocial behavior Soc Cogn Affect Neurosci, December 1, 2006; 1(3): 203 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Benini and M. Avoli Altered Inhibition in Lateral Amygdala Networks in a Rat Model of Temporal Lobe Epilepsy J Neurophysiol, April 1, 2006; 95(4): 2143 - 2154. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Schubert, H. Siegmund, H.-C. Pape, and D. Albrecht Kindling-induced changes in plasticity of the rat amygdala and hippocampus Learn. Mem., September 1, 2005; 12(5): 520 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Bufkin and V. R. Luttrell Neuroimaging Studies of Aggressive and Violent Behavior: Current Findings and Implications for Criminology and Criminal Justice Trauma Violence Abuse, April 1, 2005; 6(2): 176 - 191. [Abstract] [PDF]
|
|
|
|
|
|
D. D. Dougherty, S. L. Rauch, T. Deckersbach, C. Marci, R. Loh, L. M. Shin, N. M. Alpert, A. J. Fischman, and M. Fava Ventromedial Prefrontal Cortex and Amygdala Dysfunction During an Anger Induction Positron Emission Tomography Study in Patients With Major Depressive Disorder With Anger Attacks Arch Gen Psychiatry, August 1, 2004; 61(8): 795 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Wuerfel, E S Krishnamoorthy, R J Brown, L Lemieux, M Koepp, L Tebartz van Elst, and M R Trimble Religiosity is associated with hippocampal but not amygdala volumes in patients with refractory epilepsy J. Neurol. Neurosurg. Psychiatry, April 1, 2004; 75(4): 640 - 642. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Satishchandra, E. S. Krishnamoorthy, L. T. v. Elst, L. Lemieux, M. Koepp, R. J. Brown, and M. R. Trimble Mesial Temporal Structures and Comorbid Anxiety in Refractory Partial Epilepsy J Neuropsychiatry Clin Neurosci, November 1, 2003; 15(4): 450 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Nakaji, H. S. Meltzer, S. A. Singel, and J. F. Alksne Improvement of Aggressive and Antisocial Behavior After Resection of Temporal Lobe Tumors Pediatrics, November 1, 2003; 112(5): e430 - 430. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. C. Hallak, S. M. Dursun, R. Guarnieri, E. Almeida, K. Rezeck, J. A. S. Crippa, A. C. Sakamoto, A. W. Zuardi, and J. F. W. Deakin Olanzapine for Recurrent Aggression in a Patient with Temporal Lobe Epilepsy who had Temporal Lobectomy J Psychopharmacol, September 1, 2003; 17(3): 350 - 351. [Abstract] [PDF]
|
|
|
|
 |
|
 M. R. TRIMBLE and L. T. VAN ELST The Amygdala and Psychopathology Studies in Epilepsy Ann. N.Y. Acad. Sci., April 1, 2003; 985(1): 461 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Tebartz van Elst, D. Baeumer, L. Lemieux, F. G. Woermann, M. Koepp, S. Krishnamoorthy, P. J. Thompson, D. Ebert, and M. R. Trimble Amygdala pathology in psychosis of epilepsy: A magnetic resonance imaging study in patients with temporal lobe epilepsy Brain, January 1, 2002; 125(1): 140 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. T. van Elst, M. R. Trimble, D. Ebert, L Tebartz van Elst, and A. Raine Dual Brain Pathology in Patients With Affective Aggressive Episodes Arch Gen Psychiatry, December 1, 2001; 58(12): 1187 - 1187. [Full Text] [PDF]
|
|
|
|
|
|
L. T. van Elst, T. Thiel, B. Hesslinger, K. Lieb, M. Bohus, J. Hennig, and D. Ebert Subtle Prefrontal Neuropathology in a Pilot Magnetic Resonance Spectroscopy Study in Patients With Borderline Personality Disorder J Neuropsychiatry Clin Neurosci, November 1, 2001; 13(4): 511 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Whitwell, W. R. Crum, H. C. Watt, and N. C. Fox Normalization of Cerebral Volumes by Use of Intracranial Volume: Implications for Longitudinal Quantitative MR Imaging AJNR Am. J. Neuroradiol., September 1, 2001; 22(8): 1483 - 1489. [Abstract] [Full Text] [PDF]
|
|