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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 (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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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
DEVELOPMENT OF THE EXECUTIVE PERSONAL FINANCE SCALE
Spinella, M., Yang, B., & Lester, D. (2007) · International Journal of Neuroscience · doi:10.1080/00207450500534043 · Cited by 40
“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
“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
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
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
“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
“…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 31
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 31
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
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 35
“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
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
“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
“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 30
“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
“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 25
“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
“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
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
Gainotti, G. (2018) · Brain and Cognition · doi:10.1016/j.bandc.2018.08.002 · Cited by 20
Sollberger, M. A., Rankin, K. P., & Miller, B. L. (2010) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000368261.15544.7c · Cited by 21
Herzig, D. A., Tracy, J. I., Munafo, M. R., & Möhr, C. (2010) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.04.003 · Cited by 18
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 16
Chapter 28 Neuropsychology of frontotemporal dementia
(2008) · Handbook of Clinical Neurology · doi:10.1016/s0072-9752(07)88028-6 · Cited by 16
School Shootings, High School Size, and Neurobiological Considerations
Kaiser, D. A. (2006) · Journal of Neurotherapy · doi:10.1300/j184v09n03_07 · Cited by 17
Bradicardia en la demencia frontotemporal
Bayón, A. R., Sampedro, F. G., & Quesada, J. M. T. (2013) · Neurología · doi:10.1016/j.nrl.2013.02.010 · Cited by 16
“FRI 18 62,1 (10,9) [67,1 (14,9)] 7 (38,8) [4 (36,3)]”
Moll, J., & de Oliveira‐Souza, R. (2009) · Springer eBooks · doi:10.1007/978-1-4020-6287-2_3 · Cited by 17
Neuropsychiatric Aspects of Frontotemporal Dementia
Younes, K., & Miller, B. L. (2020) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2020.02.005 · Cited by 18
Syndromes majeurs de l'hémisphère mineur
Carota, A., Annoni, J., Piccardi, L., & Bogousslavsky, J. (2005) · Encyclopédie médico-chirurgicale. Neurologie · doi:10.1016/j.emcn.2005.08.001 · Cited by 15
Klöppel, S. (2009) · Current Opinion in Neurology · doi:10.1097/wco.0b013e328332ba0f · Cited by 14
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 11
Metadata
- 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 › Clinical 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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