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Cited by 65Neural and Behavioral Psychology StudiesDementia and Cognitive Impairment ResearchHemispheric Asymmetry in Neuroscience

Damage to left frontal regulatory circuits produces greater positive emotional reactivity in frontotemporal dementia

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Sturm, Virginia E., Yokoyama, Jennifer S., Eckart, Janet A., Zakrzewski, Jessica, Rosen, Howard J., Miller, Bruce L., Seeley, William W., Levenson, Robert W.·2015·Cortex
DOI 10.1016/j.cortex.2014.10.002PMC PMC4346386
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Abstract

Positive emotions foster social relationships and motivate thought and action. Dysregulation of positive emotion may give rise to debilitating clinical symptomatology such as mania, risk-taking, and disinhibition. Neuroanatomically, there is extensive evidence that the left hemisphere of the brain, and the left frontal lobe in particular, plays an important role in positive emotion generation. Although prior studies have found that left frontal injury decreases positive emotion, it is not clear whether selective damage to left frontal emotion regulatory systems can actually increase positive emotion. We measured happiness reactivity in 96 patients with frontotemporal dementia (FTD), a neurodegenerative disease that targets emotion-relevant neural systems and causes alterations in positive emotion (i.e., euphoria and jocularity), and in 34 healthy controls. Participants watched a film clip designed to elicit happiness and a comparison film clip designed to elicit sadness while their facial behavior, physiological reactivity, and self-reported emotional experience were monitored. Whole-brain voxel-based morphometry (VBM) analyses revealed that atrophy in predominantly left hemisphere fronto-striatal emotion regulation systems including left ventrolateral prefrontal cortex, orbitofrontal cortex, anterior insula, and striatum was associated with greater happiness facial behavior during the film (pFWE < .05). Atrophy in left anterior insula and bilateral frontopolar cortex was also associated with higher cardiovascular reactivity (i.e., heart rate and blood pressure) but not self-reported positive emotional experience during the happy film (p < .005, uncorrected). No regions emerged as being associated with greater sadness reactivity, which suggests that left-lateralized fronto-striatal atrophy is selectively associated with happiness dysregulation. Whereas previous models have proposed that left frontal injury decreases positive emotional responding, we argue that selective disruption of left hemisphere emotion regulating systems can impair the ability to suppress positive emotions such as happiness.

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  • The insula is known for its role in moderating social cognition.

    “The insula is known for its role in moderating social cognition.44”

    From Automated Speech Analysis to Differentiate Frontal and Right Anterior Temporal Lobe Atrophy in Frontotemporal Dementia (2025) · cites this paper as [44]

    The Discussion describes the anterior insula as important for expressive suppression, behavioral inhibition, and autonomic control, supporting a role in regulating behavior and emotion. It does not specifically say the insula moderates social cognition; the Discussion instead links social regulation and socioemotional stimulus tracking to the orbitofrontal cortex. No page number is available in our copy. (LLM, conf=0.79)

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Cited by

Sorted by citations

Authors
Sturm, V. E., Yokoyama, J. S., Eckart, J. A., Zakrzewski, J., Rosen, H. J., Miller, B. L., Seeley, W. W., & Levenson, R. W.
Affiliations
  • University of California, San Francisco (US)
  • University of California, Berkeley (US)
Corresponding author
Sturm, Virginia E.
ORCID
Venue
Cortex
Publisher
Elsevier BV
Published
2015-03
Volume
64
Pages
55-67
ISSN
0010-9452 (ISSN-L)
DOI
10.1016/j.cortex.2014.10.002
PMC
PMC4346386
OpenAlex
W2022642054
Cited by
65
References
5
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 8 · 2018: 6 · 2017: 12 · 2016: 6 · 2015: 3
FWCI
3.91
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Cortex (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Larry L. Hillblom Foundation (2007/2I, 2005/2T, 2013-A-029-SUP)
  • Frances McClelland Institute for Children, Youth, and Families
  • National Institutes of Health (AG19724, 2002/2J)
  • National Institute on Aging (R37AG017766, R01AG041762, K23AG040127, AG-19724, K01AG049152, AG17766, R01AG032306, K24AG045333, P01AG019724, P50AG023501)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hemispheric Asymmetry in Neuroscience
Keywords
frontotemporal dementia, positive emotions, emotion regulation, left frontal lobe, ventrolateral prefrontal cortex, orbitofrontal cortex, anterior insula, frontopolar cortex, striatum, brain atrophy, cardiovascular reactivity, left hemisphere lateralization
MeSH terms
Aged, Atrophy, Emotions, Facial Expression, Female, Frontal Lobe, Humans, Functional Laterality, Male, Middle Aged, Nerve Net, Neuropsychological Tests, Frontotemporal Dementia

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