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Left or right temporal lesion might induce aggression or escape during awake surgery, respectively: role of the amygdala

Published online by Cambridge University Press:  24 June 2014

Nobusada Shinoura ,
Ryozi Yamada ,
Yusuke Tabei ,
Ryohei Otani ,
Chihiro Itoi ,
Seiko Saito  and
Akira Midorikawa
Nobusada Shinoura*
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan
Ryozi Yamada
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan
Yusuke Tabei
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan
Ryohei Otani
Affiliation:
Department of Neurosurgery, Komagome Metropolitan Hospital, Tokyo, Japan
Chihiro Itoi
Affiliation:
Department of Psychology, Chuo University of Literature, Tokyo, Japan
Seiko Saito
Affiliation:
Department of Psychology, Chuo University of Literature, Tokyo, Japan
Akira Midorikawa
Affiliation:
Department of Psychology, Chuo University of Literature, Tokyo, Japan
*
Nobusada Shinoura, Department of Neurosurgery, Komagome Metropolitan Hospital, 3-18-22 Hon-komagome, Bunkyo-ku, Tokyo 113-8677, Japan. Tel: +81 3 3823 2101; Fax: +81 3 3824 1552; E-mail: shinoura@cick.jp
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Extract

Objective: Some patients with temporal lobe brain tumours show aggressive or escape behaviour during awake surgery. As the amygdala plays a critical role in coping with stress, we evaluated whether the left or right amygdala was involved in aggressive or escape behaviour in six patients undergoing awake surgery for temporal lobe brain tumours.

Methods: Brain tumours were located in the left temporal lobe in cases 1–3 and in the right temporal lobe in cases 4–6. In cases 1, 2, 4 and 5, the tumours invaded the amygdala.

Results: In case 1, the patient showed aggressive behaviour before partial removal of the left amygdala during awake surgery; just after partial removal of left amygdala, the patient was calm and cooperative. In case 2, the patient showed aggressive behaviour when the tumour near the left amygdala was removed. In case 3, the patient showed aggressive behaviour when awakening during awake surgery. In case 4, the patient showed escape behaviour when removal of the tumour near the right amygdala was initiated. In cases 5 and 6, patients showed escape behaviour upon awakening and upon initiation of tumour removal from the temporal lobe.

Conclusion: In conclusion, these results suggest that left or right temporal lesions might induce aggressive or escape behaviour during awake surgery, respectively, and that the amygdala on the respective side may play a role in these behaviours.

Keywords

aggressionamygdalaawake surgerybrain tumourescapetemporal lobe
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 23 , Issue 3 , June 2011 , pp. 119 - 124
Copyright
Copyright © Cambridge University Press 2011

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