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. 2015 Summer;27(3):193-8.
doi: 10.1176/appi.neuropsych.14060126. Epub 2015 May 11.

Areas of Brain Damage Underlying Increased Reports of Behavioral Disinhibition

Kristine M Knutson  1 , Olga Dal Monte  1 , Selene Schintu  1 , Eric M Wassermann  1 , Vanessa Raymont  1 , Jordan Grafman  1 , Frank Krueger  1
Affiliations

Areas of Brain Damage Underlying Increased Reports of Behavioral Disinhibition

Kristine M Knutson et al. J Neuropsychiatry Clin Neurosci. 2015 Summer.

Abstract

Disinhibition, the inability to inhibit inappropriate behavior, is seen in frontal-temporal degeneration, Alzheimer's disease, and stroke. Behavioral disinhibition leads to social and emotional impairments, including impulsive behavior and disregard for social conventions. The authors investigated the effects of lesions on behavioral disinhibition measured by the Neuropsychiatric Inventory in 177 veterans with traumatic brain injuries. The authors performed voxel-based lesion-symptom mapping using MEDx. Damage in the frontal and temporal lobes, gyrus rectus, and insula was associated with greater behavioral disinhibition, providing further evidence of the frontal lobe's involvement in behavioral inhibition and suggesting that these regions are necessary to inhibit improper behavior.

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Figures

Figure 1.
Figure 1.. Lesion density map.
Axial slices. Color indicates the number of pTBI veterans’ lesions overlapping at each voxel, where warmer colors indicate more veterans had lesions at those locations. The greatest overlap was found in prefrontal regions with 28 veterans having lesions in these areas (shown in red). Slice numbers are displayed below each slice. The left is on the viewer’s right.
Figure 2.
Figure 2.. Voxel-based lesion-symptom map for disinhibition.
Axial slices. Color indicates brain regions with a significant association between lesion location and NPI disinhibition (one-tailed t-test, q(FDR) =.05, minimum cluster size = 10 voxels), with yellow indicating the greatest impairment. The VLSM analysis was limited to those voxels where at least four pTBI veterans had damage. Slice numbers are displayed below each slice. The left is on the viewer’s right.
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