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. 2019 Jul 1;85(1):11-30.
doi: 10.1093/neuros/nyy635.

Amygdala and Hypothalamus: Historical Overview With Focus on Aggression

Flavia Venetucci Gouveia  1 , Clement Hamani  2   3 , Erich Talamoni Fonoff  2 , Helena Brentani  4   5 , Eduardo Joaquim Lopes Alho  2 , Rosa Magaly Campêlo Borba de Morais  6 , Aline Luz de Souza  2 , Sérgio Paulo Rigonatti  4 , Raquel C R Martinez  1
Affiliations

Amygdala and Hypothalamus: Historical Overview With Focus on Aggression

Flavia Venetucci Gouveia et al. Neurosurgery. .

Abstract

Aggressiveness has a high prevalence in psychiatric patients and is a major health problem. Two brain areas involved in the neural network of aggressive behavior are the amygdala and the hypothalamus. While pharmacological treatments are effective in most patients, some do not properly respond to conventional therapies and are considered medically refractory. In this population, surgical procedures (ie, stereotactic lesions and deep brain stimulation) have been performed in an attempt to improve symptomatology and quality of life. Clinical results obtained after surgery are difficult to interpret, and the mechanisms responsible for postoperative reductions in aggressive behavior are unknown. We review the rationale and neurobiological characteristics that may help to explain why functional neurosurgery has been proposed to control aggressive behavior.

Keywords: Aggression; Amygdala; Deep brain simulation; Hypothalamus; Review; Stereotactic neurosurgery.

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Figures

Figure 1.
Figure 1.
Schematic representation of the participation of the amygdala and hypothalamus in the neurocircuitry underlying aggressive behavior. Overview of A, the main structures implicated in the control of aggressive behavior and B, the main connections between the hypothalamus and amygdala; C, between the hypothalamus and PAG; D, among the amygdala, hypothalamus, and frontal cortex; and E, between the amygdala and PAG. The 3-dimensional reconstructions are based on histological segmentations of the depicted structures (methods described in Alho et al). OMPFC: orbitomedial prefrontal cortex; PAG: periaqueductal gray; Fx: fornix; St: stria terminalis; Hyp: hypothalamus; So: supraoptic nucleus; Pv: paraventricular hypothalamic nucleus; MB: mammillary body; Mmt: mammillothalamic tract; Th: thalamus; DLF: dorsal longitudinal fasciculus; MFB: medial forebrain bundle; UF: uncinate fasciculus.
Figure 2.
Figure 2.
PRISMA flow diagram describing study selection in Tables 2 and 3.
Figure 3.
Figure 3.
Schematic representation of the main connections of the central, medial, basolateral, and basomedial amygdala nuclei. Acb: nucleus accumbens; AH: anterior hypothalamic area; AHN: anterior hypothalamic nucleus; AI: agranular insular cortex; AO: anterior olfactory nucleus; AOB: accessory olfactory bulb; Arc: arcuate nucleus of the hypothalamus; BNST: bed nucleus of the stria terminalis; Cl: claustrum; CM: central medial thalamic nucleus; CnF: cuneiform nucleus; DB: nucleus of the diagonal band; DM: dorsomedial hypothalamic nucleus; DR: dorsal raphe nucleus; En: endopiriform nucleus; Ent: entorhinal cortex; GP: globus pallidus; IL: infralimbic cortex; IMD: intermediodorsal thalamic nucleus; LC: locus coeruleus; LDTg: laterodorsal tegmental nucleus; LH: lateral hypothalamic area; LPO: lateral preoptic area; MD: mediodorsal thalamic nucleus; MG: medial geniculate nucleus; MPO: medial preoptic area; OB: olfactory bulb; Pa: paraventricular hypothalamic nucleus; PAG: periaqueductal gray; PaS: parasubiculum; PB: parabrachial nucleus; Pe: periventricular hypothalamic nucleus; PeF: perifornical nucleus; PFC: prefrontal cortex; Pir: piriform cortex; PM: premammillary nucleus; PoMn: posteromedial thalamic nucleus; PP: peripeduncular nucleus; PRh: perirhinal cortex; PrL: prelimbic cortex; PT: paratenial thalamic nucleus; PV: paraventricular nucleus of the thalamus; PVA: paraventricular nucleus of the hypothalamus; Re: reuniens thalamic nucleus; SG: suprageniculate thalamic nucleus; SI: substantia innominate; SN: substantia nigra; Sol: nucleus of the solitary tract; SPF: subparafascicular thalamic nucleus; Su: subiculum; SuM: supramammillary nucleus; Te: temporal cortex; TuLH: tuberal region of lateral hypothalamus; VMH: ventromedial hypothalamic nucleus; VTA: ventral tegmental area.
Figure 4.
Figure 4.
Main hypothalamic connections based on functions. Arc: arcuate nucleus of the hypothalamus; DLF: dorsal longitudinal fasciculus; FO: fornix; His: histamine projection; HNT: hypothalamo-neurohypophyseal tract; HST: hypothalamo-spinal tract; LH: lateral hypothalamic area; MFB: medial forebrain bundle; MTeT: mammillo-tegmental tract; MTT: mammillo-thalamic tract; RHT: retino-hypothalamic tract; SHT: spino-hypothalamic tract; ST: stria terminalis; TIT: tubero-infundibular tract; VMH: ventromedial hypothalamic nucleus.
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