Left frontotemporal hypoperfusion is associated with aggression in patients with dementia.
BACKGROUND
Aggressive behavior is common in patients with dementia. Temporolimbic and prefrontal cortical lesions can produce pathological aggression; however, involvement of these structures has not been established in aggressive patients with dementia.


OBJECTIVE
To study the relation between regional brain perfusion and aggressive behavior in patients with dementia.


METHODS
We compared the pattern of regional cerebral perfusion determined with technetium Tc 99m-labeled hexamethylpropelene amineoxime single photon emission computed tomography in 2 groups of 10 patients with dementia with and without aggression, that were comparable for demographic factors, severity of cognitive impairments, and other behavioral symptoms as measured by the Neuropsychiatric Inventory.


RESULTS
Patients with aggression revealed significant (P<.001) hypoperfusion in the left anterior temporal cortex; additional bilateral dorsofrontal and right parietal cortex were also found to be significantly hypoperfused.


CONCLUSIONS
These results indicated an association between aggression and decreased perfusion in the left anterior temporal cortex. Arch Neurol. 2000.
Hirono
N
N
Division of Clinical Neuroscience, Hyogo Institute for Aging Brain and Cognitive Disorders, 520 Saisho-ko, Himeji 670-0981, Japan. hirono@hiabcd.go.jp
Mega
M S
MS
Dinov
I D
ID
Mishkin
F
F
Cummings
J L
JL
D000368:Aged; D000374:Aggression / Q000502:physiology*; D001519:Behavior / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003704:Dementia / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D013702:Temporal Lobe / Q000098:blood supply* / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon