Evidence for a dysfunctional prefrontal circuit in patients with an impulsive aggressive disorder
Open accessAbstract
Humans with lesions to the orbital/medial prefrontal cortex and interconnected areas display impulsive aggressive behavior. To examine further the relationship between impulsive aggression and orbital/medial prefrontal dysfunction, we measured the behavioral performance of psychiatric patients with a disorder characterized by impulsive aggression, Intermittent Explosive Disorder (IED). Presently, no evidence exists for a localized brain lesion in IED subjects. However, on the basis of the location of brain lesions that produce acquired impulsive aggression, we hypothesized that IED subjects would exhibit test performance similar to patients with lesions to the orbital/medial prefrontal cortex. Subjects with IED and controls were administered three tests sensitive to lesions of the orbital/medial prefrontal circuit: the Iowa Gambling Task, facial emotion recognition, and odor identification, and two control tests of working memory. On the gambling task, IED subjects continued to make disadvantageous decisions throughout the 100 trials, whereas controls learned to avoid disadvantageous decisions. On the facial recognition test, IED subjects were impaired at recognizing “anger,” “disgust,” and “surprise,” and they were biased to label neutral faces with “disgust” and “fear.” On odor identification, IED subjects were mildly anosmic and were impaired relative to controls. However, on the working memory control tests, both groups performed similarly. Across tests, the performance of IED subjects resembles the performance of patients with orbital/medial prefrontal lesions in previous studies. These results extend the link between dysfunction of the orbital/medial prefrontal circuit and impulsive aggressive behavior.
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The orbital and ventromedial PFC is essential for the regulation of emotion, such as the inhibition of aggressive impulses.
“while the orbital and ventromedial PFC is essential for the regulation of emotion, such as the inhibition of aggressive impulses (Best et al., 2002; Izquierdo et al., 2005; Price et al., 1996)”
From Catecholamine influences on prefrontal cortical function: Relevance to treatment of attention deficit/hyperactivity disorder and related disorders (2011) · cites this paper as Best et al., 2002
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- Authors
- Best, M., Williams, J. M., & Coccaro, E. F.
- Affiliations
- Children's Hospital of Philadelphia (US)
- ORCID
- Coccaro, Emil F.
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2002-05-28
- Volume
- 99
- Issue
- 12
- Pages
- 8448-8453
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC123087
- OpenAlex
- W2097844598
- Cited by
- 325
- References
- 5
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 19 · 2023: 9 · 2022: 6 · 2021: 2 · 2020: 10 · 2019: 11 · 2018: 7 · 2017: 11 · 2016: 15 · 2015: 19 · 2014: 14 · 2013: 22 · 2012: 14
- FWCI
- 6.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01MH046948, R01 MH 46948)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- intermittent explosive disorder, impulsive aggression, orbitofrontal cortex, medial prefrontal cortex, prefrontal cortex dysfunction, Iowa Gambling Task, facial emotion recognition, odor identification, anosmia, working memory, decision-making, psychiatric patients
- MeSH terms
- Adult, Aggression, Cognition, Female, Humans, Disruptive, Impulse Control, and Conduct Disorders, Intelligence, Male, Reference Values, Smoking, Prefrontal Cortex
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