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Hum Brain Mapp. 2017 Feb;38(2):656-665. doi: 10.1002/hbm.23406. Epub 2016 Sep 26.

Networks underlying trait impulsivity: Evidence from voxel-based lesion-symptom mapping.

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Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, Illinois.
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Molecular Neuroscience Department, George Mason University, Fairfax, Virginia.
Department of Psychology, George Mason University, Fairfax, Virginia.


Impulsivity is considered a multidimensional construct that encompasses a range of behaviors, including poor impulse control, premature decision-making, and the inability to delay gratification. In order to determine the extent to which impulsivity and its components share a common network, a voxel-based lesion-symptom mapping (VLSM) analysis was performed in a large sample of patients (N = 131) with focal, penetrating traumatic brain injuries (pTBI). Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11), a standard self-report measure that allows for unique estimates of global impulsivity and its factor analysis-derived components (e.g., "motor impulsivity"). Heightened global impulsivity was associated with damage to multiple areas in bilateral prefrontal cortex (PFC), left superior, middle and inferior temporal gyrus, and left hippocampus. Moreover, a cluster was identified within the left PFC associated specifically with motor impulsivity (defined as "acting without thinking"). The results were consistent with the existing literature on bilateral prefrontal cortical involvement in behavioral impulsivity, but also provided new evidence for a more complex neuroanatomical representation of this construct, characterized by left-lateralized temporal and hippocampal involvement, as well as a left-lateralized prefrontal network specifically associated with motor impulsivity. Hum Brain Mapp 38:656-665, 2017.


impulsivity; motor impulsivity; prefrontal cortex; traumatic brain injury; voxel-based lesion-symptom mapping

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