The influence of right frontotemporal dysfunction on social behavior in frontotemporal dementia
Abstract
BACKGROUND: Frontotemporal dementia (FTD) is associated with a variety of cognitive and behavioral dysfunctions. Symptoms may be influenced by the relative involvement of the right versus the left hemisphere, with left-sided FTD manifesting language changes and right-sided FTD presenting with aggressive, antisocial, and other socially undesirable behaviors. OBJECTIVE: To test the hypothesis that right-sided FTD is associated with socially undesirable behavior. METHODS: The authors assessed 41 patients with FTD diagnosed by the new research criteria for FTD(1) including behavioral, neuropsychologic, and neurologic testing as well as SPECT and MRI. Based on visual inspection of SPECT scans, 12 patients were classified as having predominantly right-sided and 19 patients were classified as having predominantly left-sided FTD. A clinician blinded to the imaging data reviewed medical records to tabulate the frequency of the following socially undesirable behaviors: criminal behavior, aggression, loss of job, alienation from family/friends, financial recklessness, sexually deviant behavior, and abnormal response to spousal crisis. RESULTS: Eleven of 12 right-sided and 2 of 19 left-sided FTD patients had socially undesirable behavior as an early presenting symptom (chi = 23.3, p < 0.001). CONCLUSION: The authors conclude that right-sided frontotemporal degeneration is associated with socially undesirable behavior. The early presence of socially undesirable behavior in FTD differentiates right-sided from left-sided degeneration. The results highlight the importance of the right hemisphere, especially frontotemporal regions, in the mediation of social behavior. The potential mechanism for these social losses with right-sided disease is discussed.
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This becomes particularly important given the pervasive lack of empathy commonly reported by caregivers of patients with semantic dementia.
“This becomes particularly important given the pervasive lack of empathy commonly reported by caregivers of patients with semantic dementia (Mychack et al., 2001;Rankin et al., 2006).”
From Considering the role of semantic memory in episodic future thinking: evidence from semantic dementia (2012) · cites this paper as Mychack et al., 2001
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Arioli, M., Gianelli, C., & Canessa, N. (2020) · Brain Imaging and Behavior · doi:10.1007/s11682-020-00384-6 · Cited by 49 · see citing works
“The convergence of sensory pathways into the temporal pole (Olson et al. 2007), possibly supporting its role in multimodal perceptual analyses (Binney et al. 2012), fits with the effect of ATL damage on socio-affective processing (Kumfor et al. 2017) and social behavior (Mychack et al. 2001).”
BackgroundHofman, D., & Schutter, D. J. L. G. (2011) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsr060 · Cited by 45 · see citing works
“Patients suffering from damage to the right frontal lobe are characterized by poorly modulated affect, poor impulse control and become highly critical of others (Mychack et al., 2001).”
Cosentino, S., Chute, D. L., Libon, D. J., Moore, P., & Grossman, M. (2006) · Neuropsychology · doi:10.1037/0894-4105.20.3.307 · Cited by 45 · see citing works
Cerebral Lateralization of Pro- and Anti-Social Tendencies
Hecht, D. (2014) · Experimental Neurobiology · doi:10.5607/en.2014.23.1.1 · Cited by 43 · see citing works
Decomposition of metabolic brain clusters in the frontal variant of frontotemporal dementia
Salmon, É., Kerrouche, N., Herholz, K., Perani, D., Holthoff‐Detto, V., Beuthien‐Baumann, B., Degueldre, C., Lemaire, C. F., Luxen, A., Baron, J., et al. (2005) · NeuroImage · doi:10.1016/j.neuroimage.2005.10.016 · Cited by 44 · see citing works
“Moreover, patients with FTD often present with an asymmetric (left/right) frontotemporal impairment that is associated with differential clinical symptoms (Boone et al., 1999; Miller et al., 1993; Mychack et al., 2001; Rankin et al., 2004; Razani et al., 2001).”
The neurobiology of moral sense: facts or hypotheses?
Marazziti, D., Baroni, S., Landi, P., Ceresoli, D., & Dell’Osso, L. (2013) · Annals of General Psychiatry · doi:10.1186/1744-859x-12-6 · Cited by 45 · see citing works
“Much evidence in this sense is derived from functional magnetic nuclear resonance (fMRI) studies in healthy subjects, from neurological data on sociopathic individuals [21-26], and from investigations in patients presenting focal cerebral lesions or frontotemporal dementia (FTD) [27-31].”
BackgroundInfluentialSollberger, M. A., Neuhaus, J. M., Ketelle, R., Stanley, C. M., Beckman, V., Growdon, M. E., Jang, J., Miller, B. L., & Rankin, K. P. (2010) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2010.205047 · Cited by 43 · see citing works
Possin, K. L., Brambati, S. M., Rosen, H. J., Johnson, J. K., Pa, J., Weiner, M. W., Miller, B. L., & Kramer, J. H. (2009) · Journal of the International Neuropsychological Society · doi:10.1017/s135561770909050x · Cited by 42 · see citing works
“Patients with neurodegenerative disease or lesions involving the right frontal lobe more frequently violate social rules than their counterparts with left frontal lobe damage (Mychack et al., 2001 ; Tranel et al., 2002 ).”
BackgroundTourette's Syndrome and the Law
Jankovic, J. J., Kwak, C. H., & Frankoff, R. (2006) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.18.1.86 · Cited by 41 · see citing works
PREFRONTAL SYSTEM DYSFUNCTION AND CREDIT CARD DEBT
Spinella, M., Yang, B., & Lester, D. (2004) · International Journal of Neuroscience · doi:10.1080/00207450490476011 · Cited by 41 · see citing works
“People with frontotemporal dementia develop deficits of executive functioning and behavioral control, typically necessitating a caretaker to assume their financial responsibilities (Mychack et al., 2001; Talerico & Evans, 2001).”
BackgroundDistinct neural substrates of affective and cognitive theory of mind impairment in semantic dementia
Bejanin, A., Chételat, G., Laisney, M., Pèlerin, A., Landeau, B., Merck, C., Belliard, S., Sayette, V. D. L., Eustache, F., & Desgranges, B. (2016) · Social Neuroscience · doi:10.1080/17470919.2016.1168314 · Cited by 46 · see citing works
“This result can be considered in the light of reports in the literature of greater behavioural disturbance in right-lateralized patients with semantic dementia (Irish et al., 2013; Mychack et al., 2001; Seeley et al., 2005; Thompson et al., 2003).”
Anterior Temporal Lobe Tracks the Formation of Prejudice
Spiers, H. J., Love, B. C., Pelley, M. E. L., Gibb, C. E., & Murphy, R. A. (2016) · Journal of Cognitive Neuroscience · doi:10.1162/jocn_a_01056 · Cited by 40 · see citing works
Birba, A., Fittipaldi, S., Escobar, J. C., Campo, C. G., Legaz, A., Galiani, A., Rivera, M. D., Martorell, M., Alifano, F., Piña‐Escudero, S. D., et al. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab421 · Cited by 42 · see citing works
Jimura, K., Konishi, S., Asari, T., & Miyashita, Y. (2010) · Brain Research · doi:10.1016/j.brainres.2010.03.016 · Cited by 38 · see citing works
Relationship between antisocial behavior and regional cerebral blood flow in frontotemporal dementia
Nakano, S., Asada, T., Yamashita, F., Kitamura, N., Matsuda, H., Hirai, S., & Yamada, T. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2006.02.040 · Cited by 37 · see citing works
DEVELOPMENT OF THE EXECUTIVE PERSONAL FINANCE SCALE
Spinella, M., Yang, B., & Lester, D. (2007) · International Journal of Neuroscience · doi:10.1080/00207450500534043 · Cited by 36 · see citing works
“People with frontotemporal dementia also develop frontal lobe dysfunction leading to problems with managing personal finances (Mychack et al., 2001; Talerico & Evans, 2001).”
BackgroundNon-Alzheimer's Disease Dementias: Anatomic, Clinical, and Molecular Correlates
Hou, C. E., Carlin, D. A., & Miller, B. L. (2004) · The Canadian Journal of Psychiatry · doi:10.1177/070674370404900303 · Cited by 35 · see citing works
“Impaired social judgement and interaction were found to be common in FTD with predominant right frontal damage (19).”
BackgroundLiu, A. A., Werner, K. H., Roy, S., Trojanowski, J. Q., Morgan-Kane, U., Miller, B. L., & Rankin, K. P. (2009) · Neurocase · doi:10.1080/13554790802633213 · Cited by 34 · see citing works
Short, R. A., Broderick, D. F., Patton, A. C., Arvanitakis, Z., & Graff‐Radford, N. R. (2005) · Archives of Neurology · doi:10.1001/archneur.62.7.1106 · Cited by 33 · see citing works
Hsu, J., Lee, W., Liao, Y., Lirng, J.-F., Wang, S., & Fuh, J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0137121 · Cited by 33 · see citing works
“Another study showed that right fronto-temporal dysfunction may be linked to aggression behavior in dementia patients [54].”
BackgroundNeural basis of motivational approach and withdrawal behaviors in neurodegenerative disease
Shinagawa, S., Adhimoolam, B., Sturm, V. E., Shany‐Ur, T., Ross, P. T., Zackey, D. D., Poorzand, P., Grossman, S. N., Miller, B. L., & Rankin, K. P. (2015) · Brain and Behavior · doi:10.1002/brb3.350 · Cited by 30 · see citing works
“…narrowed preoccupations, with emotional blunting and a flat or bizarre affect, marked loss of empathy and interest in others, rigidity, and compulsivity, (Mychack et al. 2001; Thompson et al. 2003; Liu et al. 2004), symptoms which often precede cognitive findings by years (Seeley et al. 2005).”
BackgroundHuey, E. D., Lee, S., Brickman, A. M., Manoochehri, M., Griffith, E. Y., Devanand, D. P., Stern, Y., & Grafman, J. H. (2015) · Cortex · doi:10.1016/j.cortex.2015.08.002 · Cited by 29 · see citing works
An inter-hemispheric imbalance in the psychopath’s brain
Hecht, D. (2011) · Personality and Individual Differences · doi:10.1016/j.paid.2011.02.032 · Cited by 29 · see citing works
Acquired Extroversion Associated With Bitemporal Variant of Frontotemporal Dementia
Mendez, M. F., Chen, A. K., Shapira, J. S., Lu, P.-H., & Miller, B. L. (2006) · Journal of Neuropsychiatry · doi:10.1176/jnp.18.1.100 · Cited by 29 · see citing works
The structural brain correlates of callous-unemotional traits in incarcerated male adolescents
Caldwell, B. M., Anderson, N. E., Harenski, K. A., Sitney, M. H., Caldwell, M. F., Rybroek, G. J. V., & Kiehl, K. A. (2019) · NeuroImage Clinical · doi:10.1016/j.nicl.2019.101703 · Cited by 29 · see citing works
“Patients with right aTL atrophy often exhibit striking changes in social behavior and emotional processing (Mychack et al., 2001; Thompson et al., 2003).”
BackgroundDepression in Frontotemporal Dementia
Blass, D. M., & Rabins, P. V. (2009) · Psychosomatics · doi:10.1176/appi.psy.50.3.239 · Cited by 28 · see citing works
Quantitative analysis of grey matter degeneration in FTD patients using fractal dimension analysis
Raghavan, S., Rajagopalan, V., Chandran, A., Varghese, T., Zhang, L., Yue, G. H., Mathuranath, P. S., & Kesavadas, C. (2017) · Brain Imaging and Behavior · doi:10.1007/s11682-017-9784-x · Cited by 27 · see citing works
“These FD changes in skeleton and general structure implicates the role of right hemisphere in complex social behaviors (Mychack et al. 2001; Tranel et al. 2002) and role of left hemisphere in language (Hodges and Patterson 2007; Kipps et al.”
BackgroundNakatsuka, M., Meguro, K., Tsuboi, H., Nakamura, K., Akanuma, K., & Yamaguchi, S. (2013) · International Psychogeriatrics · doi:10.1017/s1041610213000094 · Cited by 25 · see citing works
“Our findings may support this interpretation, since TP dysfunction may cause a disrupted socioemotional cognition that is similar to the theory of mind (Mychack et al., 2001; Thompson et al., 2003; Olson et al., 2007).”
ResultFinger, E. C. (2011) · Journal of Molecular Neuroscience · doi:10.1007/s12031-011-9550-2 · Cited by 28 · see citing works
“1997) and up to 90% of patients with right side-predominant FTD, often as an early symptom (Miller et al. 1997; Mychack et al. 2001).”
BackgroundSteketee, R. M. E., Meijboom, R., Bron, E. E., Osse, R. J., de Koning, I., Jiskoot, L. C., Klein, S., de Jong, F. J., van der Lugt, A., Swieten, J. C. V., et al. (2016) · NeuroImage Clinical · doi:10.1016/j.nicl.2016.03.019 · Cited by 25 · see citing works
“In addition, frontotemporal atrophy lateralized to the right hemisphere is more often associatedwith socially undesirable behavior in FTD than when lateralized to the left (Mychack et al., 2001).”
BackgroundLee, G. J., Lu, P. H., Mather, M. J., Shapira, J. S., Jimenez, E. E., Leow, A., Thompson, P. M., & Mendez, M. F. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-132219 · Cited by 24 · see citing works
“Mychack and colleagues [29] found that even among FTD patients, those with predominantly right-sided hypoperfusion on brain imaging were more likely to exhibit “socially undesirable behaviors” as an early symptom compared to those with more left-sided hypoperfusion.”
Sociopathic behavior and dementia
Cipriani, G., Borin, G., Vedovello, M., Fiorino, A. D., & Nuti, A. (2012) · Acta Neurologica Belgica · doi:10.1007/s13760-012-0161-7 · Cited by 23 · see citing works
“Patients with right sided FTD appear to have particular difficulty with autonoetic awareness [37] that is the cornerstone of self regulation, in that it supports the formulation of goals and the implementation of a behavioral guidance system to achieve them [38].”
BackgroundLexical acquisition in progressive aphasia and frontotemporal dementia
Murray, R. C., Koenig, P. L., Antani, S., McCawley, G., & Grossman, M. (2006) · Cognitive Neuropsychology · doi:10.1080/02643290600890657 · Cited by 23 · see citing works
Behavioral Evolution of Progressive Semantic Aphasia in Comparison with Nonfluent Aphasia
Gómez‐Tortosa, E., Rigual, R., Jurczynska, C. P., Mahíllo, I., Guerrero, R., Pérez‐Pérez, J., & Sainz, M. J. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000439521 · Cited by 21 · see citing works
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Neuropsychiatric symptoms and imbalance of atrophy in behavioral variant frontotemporal dementia
Sokołowski, A., Roy, A. R. K., Goh, S. M., Hardy, E. G., Datta, S., Cobigo, Y., Brown, J. A., Spina, S., Grinberg, L. T., Kramer, J. H., et al. (2023) · Human Brain Mapping · doi:10.1002/hbm.26428 · Cited by 15 · see citing works
Chapter 28 Neuropsychology of frontotemporal dementia
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School Shootings, High School Size, and Neurobiological Considerations
Kaiser, D. A. (2006) · Journal of Neurotherapy · doi:10.1300/j184v09n03_07 · Cited by 17 · see citing works
Bradicardia en la demencia frontotemporal
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“FRI 18 62,1 (10,9) [67,1 (14,9)] 7 (38,8) [4 (36,3)]”
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Neuropsychiatric Aspects of Frontotemporal Dementia
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Syndromes majeurs de l'hémisphère mineur
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Clinical characteristics of frontotemporal patients with symmetric brain atrophy
Boccardi, M., Bresciani, L. C., Geroldi, C., Beltramello, A., Frisoni, G. B., & Laakso, M. P. (2002) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-002-0388-z · Cited by 13 · see citing works
- Authors
- Mychack, P., Kramer, J. H., Boone, K. B., & Miller, B. L.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Neurology
- Published
- 2001-06-12
- Volume
- 56
- Issue
- suppl_4
- Pages
- S11-5
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W1979781351
- Cited by
- 168
- References
- 33
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 8 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 8 · 2014: 7 · 2013: 6 · 2012: 5
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Keywords
- frontotemporal dementia, right hemisphere dominance, aggression, antisocial behavior, hemispheric lateralization, social behavior, SPECT imaging
- MeSH terms
- Aggression, Crime, Dementia, Humans, Functional Laterality, Social Alienation, Social Behavior Disorders, Chi-Square Distribution
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