Abnormal temporal lobe metabolism in violent subjects: correlation of imaging and neuropsychiatric findings.
OBJECTIVE
To search for metabolic correlates of clinical and electrophysiological abnormalities in violent subjects.


METHODS
Seven subjects with histories of extremely violent behavior were studied with positron emission tomography (PET) with fludeoxyglucose F 18 (FDG), brain electrical area mapping, MR imaging, neuropsychiatric and neuropsychological testing, and clinical examination during medical evaluation associated with legal proceedings. Nine control subjects without evidence of organic brain disease were also studied with FDG-PET. Quantitative PET data were calculated as standardized uptake values comparing the highest occipital region with the lowest temporal region.


RESULTS
Temporal lobe metabolism was decreased in the study group relative to the control subjects. Medial temporal lobe metabolism was 39% lower than that in the occipital cortex in study subjects and only 27% lower than that in control subjects. These groups differed by Mann-Whitney U test and Wilcoxon's two-sample test. Metabolic differences correlated with limbic neuropsychiatric and electrophysiological abnormalities in the violent group.


CONCLUSIONS
In this selected population of violent subjects, FDG-PET scans showed metabolic abnormalities in the temporal lobes. These abnormalities correlated with limbic abnormalities seen at electrophysiological and neuropsychiatric evaluation.
Seidenwurm
D
D
Radiological Associates of Sacramento 95814, USA.
Pounds
T R
TR
Globus
A
A
Valk
P E
PE
D000293:Adolescent; D000328:Adult; D001689:Biological Psychiatry; D001927:Brain Diseases / Q000175:diagnosis / Q000503:physiopathology; D003847:Deoxyglucose / Q000031:analogs & derivatives; D004569:Electroencephalography; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005555:Forensic Psychiatry; D006624:Hippocampus / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D019275:Radiopharmaceuticals; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism*; D014055:Tomography, Emission-Computed; D014754:Violence / Q000523:psychology
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose