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1.
J Neuropsychiatry Clin Neurosci. 2019 Winter;31(1):6-16. doi: 10.1176/appi.neuropsych.18050112. Epub 2018 Oct 31.

Klüver-Bucy Syndrome Following Traumatic Brain Injury: A Systematic Synthesis and Review of Pharmacological Treatment From Cases in Adolescents and Adults.

Author information

1
From the Department of Psychiatry, University of Melbourne, Melbourne, Australia (FJC, AK, DL, EA, MJ, MH); the Department of Forensic Medicine, Monash University, Southbank, Australia (FJC); the Department of Psychiatry, Professorial Psychiatry Unit, Albert Road Clinic, University of Melbourne, Melbourne, Australia (FJC, MH); the School of Psychological Sciences, Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia (AJH, JLP); the Department of Psychiatry, Melbourne Neuropsychiatric Centre, University of Melbourne, Melbourne, Australia (DL); and the Faculty of Life Sciences, Bradford School of Pharmacy and Medical Sciences, University of Bradford, Bradford, United Kingdom (HZ).

Abstract

Klüver-Bucy syndrome (KBS) is a rare clinical presentation following traumatic brain injury (TBI). Symptoms include visual agnosia, placidity, hyperorality, sexual hyperactivity, changes in dietary behavior, and hypermetamorphosis. The purpose of this article was to identify and synthesize the available evidence from case reports and case series on the treatment profile of KBS among adolescents and adults after TBI. Four bibliographic databases (MEDLINE OVID, EMBASE, PsycINFO, and SCOPUS) were searched for relevant literature. No date or language restrictions were applied. All case reports containing original data on KBS following TBI among adolescents and adults were included. Articles were evaluated, and data were extracted according to predefined criteria. The literature search identified 24 case reports of KBS post-TBI published between 1968 and 2017. Most case subjects were male (70.1%), and the mean age at injury was 25.1 years (range, 13-67 years). Injury to one or both temporal lobes occurred in most cases. Inappropriate sexual hyperactivity was the most common KBS symptom, followed by a change in dietary behavior and hyperorality. Visual agnosia was the least reported. In 50% of cases, the patient fully recovered from KBS. One-half of all participants described pharmacological management; the most common medication prescribed was carbamazepine. Overall, there was a lack of data available on pharmacotherapy initiation and duration. The complex presentation of KBS presents challenges in terms of treatment options. Although overall individuals who were prescribed carbamazepine had positive outcomes, given the reliance on case reports, it is difficult to make a definitive recommendation to guide clinical practice.

KEYWORDS:

Drug/Psychotherapy Treatment of Neuropsychiatric Disorders; Organic Mental Disorders; Traumatic Brain Injury

[Indexed for MEDLINE]
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2.
Neurocase. 2018 Aug;24(4):180-187. doi: 10.1080/13554794.2018.1524497. Epub 2018 Sep 24.

Klüver & Bucy syndrome: an investigation of social and affective cognition.

Author information

1
a Inserm U1171 & Memory Resources and Research Centre , Lille University Hospital , Lille , France.
2
b Programa de Pós-Graduação em Neurociências , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil.
3
c Departamento de Clínica Médica , Faculdade de Medicina da UFMG , Belo Horizonte , Brazil.

Abstract

Klüver-Bucy syndrome (KBS) leads to important behavioral symptoms and social maladaptation. Rarely described, no previous study has investigated its social and affective cognitive profile. We report the case of ASP, a patient who developed a complete KBS at 9 years that evolved into an incomplete KBS. Orbitofrontal and temporal damages were evidenced. While a classic neuropsychological assessment showed a preserved global functioning, an extensive evaluation of her social and affective cognition (reversal learning, decision-making, emotion recognition, theory of mind, creative thinking) showed remarkable deficits. The relevancy of such findings for the characterization KBS and the field of neuropsychology are discussed.

KEYWORDS:

Klüver-Bucy syndrome; decision-making; reversal learning; social cognition

PMID:
30247092
DOI:
10.1080/13554794.2018.1524497
[Indexed for MEDLINE]
3.
Neuropediatrics. 2018 Oct;49(5):355. doi: 10.1055/s-0038-1667354. Epub 2018 Aug 7.

Response to Letter to the Editor.

Author information

1
Pediatric Neurology, Vall d'Hebron University Hospital, UAB, Barcelona, Spain.
2
Clinical Genetics, Vall d'Hebron University Hospital, UAB, Barcelona, Spain.
PMID:
30086556
DOI:
10.1055/s-0038-1667354
[Indexed for MEDLINE]
Icon for Georg Thieme Verlag Stuttgart, New York

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

4.
Neuropediatrics. 2018 Oct;49(5):353-354. doi: 10.1055/s-0038-1667353. Epub 2018 Aug 7.

Pediatric Klüver-Bucy Syndrome: Report of Two Cases and Review of the Literature.

Author information

1
Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schoen Klinik Vogtareuth, Vogtareuth, Germany.
2
Research Institute for Rehabilitation, Transition and Palliation, PMU Salzburg, Austria.
3
Entrepeneur salarié et associé chez ARCOOP, Gilhoc sur Ormèze, France.

Comment in

PMID:
30086555
DOI:
10.1055/s-0038-1667353
[Indexed for MEDLINE]
Icon for Georg Thieme Verlag Stuttgart, New York

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

5.
Neuropediatrics. 2018 Apr;49(2):104-111. doi: 10.1055/s-0037-1609036. Epub 2017 Dec 13.

Pediatric Klüver-Bucy Syndrome: Report of Two Cases and Review of the Literature.

Author information

1
Pediatric Neurology, Vall d'Hebron Hospital, UAB, Barcelona, Spain.
2
Clinical Genetics, Vall d'Hebron Hospital, UAB, Barcelona, Spain.
3
Pediatric Neuroradiology, Vall d'Hebron Hospital, UAB, Barcelona, Spain.
4
Pediatric Neurology Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.

Abstract

Klüver-Bucy syndrome (KBS) is a rare behavioral phenotype described in monkeys and humans that appears most often after bilateral temporal damage. The main features of KBS are compulsion to examine objects orally, increased sexual activity, placidity, hypermetamorphosis, visual agnosia, and amnesia. Cases in children are scarce, and the most frequently reported etiology is herpes encephalitis. Hyperorality (90%), hypersexuality (82%), and epilepsy (70%) were the most common features of the 51 cases reported in the literature to date. Carbamazepine, selective serotonin reuptake inhibitors (SSRIs), and neuroleptics have been used for symptomatic treatment with variable control. Corticosteroids or immunosupressive agents, such as rituximab, can be an option to use in some cases, according to etiology suspicion. Cognitive and behavioral disturbances after KBS are often severe, but improvement can occur over a long time and residual disabilities vary from major to fairly mild.We report two new encephalitis-associated pediatric patients and review all of the pediatric KBS cases in the literature to better describe the clinical features of this rare neurobehavioral condition.

PMID:
29237192
DOI:
10.1055/s-0037-1609036
[Indexed for MEDLINE]
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6.
Front Neurol Neurosci. 2018;41:77-89. doi: 10.1159/000475721. Epub 2017 Nov 16.

The Klüver-Bucy Syndrome.

Author information

1
VA Medical Center, Great Lakes VA Healthcare System, Tomah, WI, USA.

Abstract

In 1937, Heinrich Klüver and Paul Bucy described a dramatic behavioral syndrome in monkeys after bilateral temporal lobectomy. The full Klüver-Bucy syndrome (KBS) - hyperorality, placidity, hypermetamorphosis, dietary changes, altered sexual behavior, and visual agnosia - is evident within 3 weeks following operation. Some KBS features (i.e., hyperorality, placidity, hypermetamorphosis) persist indefinitely, whereas others gradually resolve over several years. Klüver and Bucy were initially unaware of an earlier report of KBS by Sanger Brown and Edward Schäfer in 1888. Human cases were recognized in the 1950s, as surgeons employed bilateral temporal lobectomies to treat seizures. Various attempts were made to localize the component features to specific areas of the temporal lobe, with mixed success. Bilateral ventral temporal ablations and bilateral temporal lobectomies produced marked impairment in visual discrimination, whereas lateral resections or unilateral lesions did not. Discrete bilateral lesions of the lateral amygdaloid nucleus produced a permanent "hypersexed state." By the 1970s, it was clear that the major symptoms of KBS are produced by destroying either the temporal neocortex or the amygdala bilaterally. KBS is now thought to be caused by disturbances of temporal portions of limbic networks that interface with multiple cortical and subcortical circuits to modulate emotional behavior and affect. The clinical features of KBS in man are similar to those in monkeys, but the full syndrome is rarely seen, probably because the anterior temporal lobe dysfunction is usually less severe than that following total temporal lobe ablation in monkeys. Human KBS does not occur in isolation, but is typically part of a complex behavioral syndrome that almost always includes amnesia and aphasia, and that may also include dementia and seizures. The treatment of KBS is difficult and often unsatisfactory.

PMID:
29145186
DOI:
10.1159/000475721
[Indexed for MEDLINE]
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7.
Neurosurg Focus. 2017 Sep;43(3):E2. doi: 10.3171/2017.6.FOCUS17265.

Sanger Brown and Edward Schäfer before Heinrich Klüver and Paul Bucy: their observations on bilateral temporal lobe ablations.

Author information

1
Department of Neurosurgery, University of Illinois at Chicago, Illinois; and.
2
Department of Neurosurgery, NYU Langone Medical Center, New York, New York.

Abstract

Fifty years before a report on the complete bitemporal lobectomy syndrome in primates, known as the Klüver-Bucy syndrome, was published, 2 talented investigators working at the University College in London, England-neurologist Sanger Brown and physiologist Edward Schäfer-also made this discovery. The title of their work was "An investigation into the functions of the occipital and temporal lobes of the monkey's brain," and it involved excisional brain surgery in 12 monkeys. They were particularly interested in the then-disputed primary cortical locations relating to vision and hearing. However, following extensive bilateral temporal lobe excisions in 2 monkeys, they noted peculiar behavior including apparent loss of memory and intelligence resembling "idiocy." These investigators recognized most of the behavioral findings that later came to be known as the Klüver-Bucy syndrome. However, they were working within the late-19th-century framework of cerebral cortical localizations of basic motor and sensory functions. Details of the Brown and Schäfer study and a glimpse of the neurological thinking of that period is presented. In the decades following the pivotal work of Klüver and Bucy in the late 1930s, in which they used a more advanced neurosurgical technique, tools of behavioral observations, and analysis of brain sections after euthanasia, investigators have elaborated the full components of the clinical syndrome and the extent of their resections. Other neuroscientists sought to isolate and determine the specific temporal neocortical, medial temporal, and deep limbic structures responsible for various visual and complex behavioral deficits. No doubt, Klüver and Bucy's contribution led to a great expansion in attention given to the limbic system's role in action, perception, emotion, and affect-a tide that continues to the present time.

KEYWORDS:

KBS = Klüver-Bucy syndrome; Klüver-Bucy syndrome; limbic system; neuropsychology; temporal lobectomy; visual agnosia

PMID:
28859570
DOI:
10.3171/2017.6.FOCUS17265
[Indexed for MEDLINE]
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8.
Neurosurg Focus. 2017 Sep;43(3):E3. doi: 10.3171/2017.6.FOCUS17416.

Editorial. The Klüver-Bucy syndrome and the golden age of localization.

Author information

1
Bronson Neuroscience Center, and Western Michigan University Homer Stryker School of Medicine, Kalamazoo, Michigan.
PMID:
28859563
DOI:
10.3171/2017.6.FOCUS17416
[Indexed for MEDLINE]
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9.
Rom J Morphol Embryol. 2017;58(2):665-669.

Clinical manifestations and morphological changes in one case with post-stroke Klüver-Bucy syndrome.

Author information

1
General Surgery Unit, Emergency County Hospital, Arad, Romania; carmen.neamtu@gmail.com.

Abstract

We present the case of a 71-year-old right-handed male, admitted to the Department of Neurology, Emergency County Hospital of Arad, Romania, on November 2015, with a rare case of Klüver-Bucy syndrome (KBS), following an ischemic stroke of the right temporal lobe, which was previously diagnosed in December 2014 and was treated accordingly. At the moment of second hospital admission, the patient was found somnolent and confused at home, with traumatic signs of biting of the tongue and urine emission. A couple days after admission, our patient became alert and presented hypersexuality, hypermetamorphosis, increased oral tendency, behavior changes including apathy with loss of anger and fear, and a very increased appetite, transient visual agnosia and right-left disorientation. In the initial phase, the patient could not recognize any members of his family, but he had a tendency to touch everything within his reach and place it into his mouth. The KBS presented in this case, following an ischemic stroke of the right temporal lobe provides distinct and intriguing insights into the possible pathophysiology of this syndrome. Often disruption of consciousness during recovery period may hide the clinical manifestation of the syndrome.

PMID:
28730259
[Indexed for MEDLINE]
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11.
Eur J Hum Genet. 2017 Feb;25(2):253-256. doi: 10.1038/ejhg.2016.149. Epub 2016 Nov 9.

Klüver-Bucy syndrome associated with a recessive variant in HGSNAT in two siblings with Mucopolysaccharidosis type IIIC (Sanfilippo C).

Author information

1
Max Planck Institute for Molecular Genetics, Berlin, Germany.
2
Department of Neuropediatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
3
Metabolic Unit, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
4
NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Abstract

Klüver-Bucy syndrome (KBS) comprises a set of neurobehavioral symptoms with psychic blindness, hypersexuality, disinhibition, hyperorality, and hypermetamorphosis that were originally observed after bilateral lobectomy in Rhesus monkeys. We investigated two siblings with KBS from a consanguineous family by whole-exome sequencing and autozygosity mapping. We detected a homozygous variant in the heparan-α-glucosaminidase-N-acetyltransferase gene (HGSNAT; c.518G>A, p.(G173D), NCBI ClinVar RCV000239404.1), which segregated with the phenotype. Disease-causing variants in this gene are known to be associated with autosomal recessive Mucopolysaccharidosis type IIIC (MPSIIIC, Sanfilippo C). This lysosomal storage disease is due to deficiency of the acetyl-CoA:α-glucosaminidase-N-acetyltransferase, which was shown to be reduced in patient fibroblasts. Our report extends the phenotype associated with MPSIIIC. Besides MPSIIIA and MPSIIIB, due to variants in SGSH and NAGLU, this is the third subtype of Sanfilippo disease to be associated with KBS. MPSIII should be included in the differential diagnosis of young patients with KBS.

PMID:
27827379
PMCID:
PMC5255949
DOI:
10.1038/ejhg.2016.149
[Indexed for MEDLINE]
Free PMC Article
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12.
BMJ Case Rep. 2016 Aug 16;2016. pii: bcr2016215926. doi: 10.1136/bcr-2016-215926.

Partial Kluver-Bucy syndrome secondary to tubercular meningitis.

Author information

1
Department of Psychiatry, All India Institute of Medical Sciences Patna, Patna, Bihar, India.
2
Department of Radiology, All India Institute of Medical Sciences Patna, Patna, Bihar, India.
3
Department of Critical Care Medicine, Children\'s Hospital of Los Angeles, Los Angeles, California, USA.

Abstract

Tubercular meningitis (TBM) is a devastating extra pulmonary manifestation of tuberculosis and demonstrates a high neurological morbidity. A rare complication of this condition is Kluver-Bucy syndrome (KBS), which is a neurobehavioral disorder characterised by hyper-sexuality, visual agnosia, bulimia, placidity, hyperorality and memory deficits caused by lesions to the amygdala. The amygdala lesions can be due to many causes, including traumatic brain injury, systemic conditions and infections such as tuberculosis. Here, we present a case of partial KBS in a patient undergoing treatment for TBM.

PMID:
27530874
PMCID:
PMC5015175
DOI:
10.1136/bcr-2016-215926
[Indexed for MEDLINE]
Free PMC Article
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13.
J Clin Psychiatry. 2016 Aug;77(8):e982-8. doi: 10.4088/JCP.14r09497.

Mesiotemporal Disconnection and Hypoactivity in Klüver-Bucy Syndrome: Case Series and Literature Review.

Author information

1
Department of Psychiatry and Psychology, Cleveland Clinic Foundation, 9500 Euclid Ave P57, Cleveland, OH, 44195. mario.caro@yale.edu.
2
Neurological Institute, Department of Psychiatry and Psychology, Cleveland Clinic Foundation, Ohio, USA.

Abstract

OBJECTIVE:

Klüver-Bucy syndrome (KBS) is often perceived as rare and limited to cases with bilateral amygdala destruction. In fact, various alternate mechanisms may be involved, warranting exploration of the syndrome's presentation, pathophysiology, prognosis, and management.

DATA SOURCES:

Clinical management and the electronic medical records were examined for 2 patients diagnosed with partial KBS (ICD-10 F07.0) after experiencing ≥ 3 of the following: placidity, indiscriminate dietary behavior, hyperorality, hypersexuality, visual agnosia, and hypermetamorphosis. A literature search was performed in April 2015 by using the keyword Kluver-Bucy in PubMed and Ovid databases for English language publications since inception. Additionally, the authors reviewed the reference list of these publications in order to identify additional reports.

STUDY SELECTION:

Studies were included if they had information about presentation, pathophysiology, syndrome treatment or management, and course of KBS.

DATA EXTRACTION:

Information about our KBS cases was obtained by reviewing electronic medical records and by direct observation of the patients. A total of 186 (PubMed) and 137 (Ovid) publications were identified in each database. We ultimately reviewed 109 articles containing information about KBS, finding 51 publications addressing relevant aspects of this syndrome.

RESULTS:

The first case demonstrates KBS secondary to mesiotemporal structural atrophy, and the second illustrates transient KBS due to functional, postictal, hypoactivity within such structures. Literature review and discussion regarding both prognosis and treatment of KBS follows.

CONCLUSIONS:

Klüver-Bucy syndrome may be underreported due to a limited understanding of the syndrome as one necessitating bilateral amygdaloid destruction. The syndrome can be seen with damage/hypofunction of the hippocampal-amygdaloid complex and its projections. The prognosis of KBS is variable, and its treatment is based on a combination of environmental and pharmacologic measures.

PMID:
27380585
DOI:
10.4088/JCP.14r09497
[Indexed for MEDLINE]
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14.
Neuropsychologia. 2016 Jan 8;80:165-175. doi: 10.1016/j.neuropsychologia.2015.11.016. Epub 2015 Nov 23.

Impaired acquisition of new words after left temporal lobectomy despite normal fast-mapping behavior.

Author information

1
Department of Neurology, Carver College of Medicine, University of Iowa, 2155-H RCP, 200 Hawkins Drive, Iowa City, IA 52242, USA. Electronic address: david-e-warren@uiowa.edu.
2
Department of Neurology, Carver College of Medicine, University of Iowa, 2155-H RCP, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Psychology, College of Liberal Arts and Sciences, University of Iowa, 121 SHC, 250 Hawkins Drive, Iowa City, IA 52242, USA.
3
Department of Neurology, Carver College of Medicine, University of Iowa, 2155-H RCP, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Communication Sciences and Disorders, College of Liberal Arts and Sciences, University of Iowa, 121 SHC, 250 Hawkins Drive, Iowa City, IA 52242, USA.

Abstract

Word learning has been proposed to rely on unique brain regions including the temporal lobes, and the left temporal lobe appears to be especially important. In order to investigate the role of the left temporal lobe in word learning under different conditions, we tested whether patients with left temporal lobectomies (N=6) could learn novel words using two distinct formats. Previous research has shown that word learning in contrastive fast mapping conditions may rely on different neural substrates than explicit encoding conditions (Sharon et al., 2011). In the current investigation, we used a previously reported word learning task that implemented two distinct study formats (Warren and Duff, 2014): a contrastive fast mapping condition in which a picture of a novel item was displayed beside a picture of a familiar item while the novel item's name was presented aurally ("Click on the numbat."); and an explicit encoding (i.e., control) condition in which a picture of a novel item was displayed while its name was presented aurally ("This is a numbat."). After a delay, learning of the novel words was evaluated with memory tests including three-alternative forced-choice recognition, free recall, cued recall, and familiarity ratings. During the fast-mapping study condition both the left temporal lobectomy and healthy comparison groups performed well, but at test only the comparison group showed evidence of novel word learning. Our findings indicate that unilateral resection of the left temporal lobe including the hippocampus and temporal pole can severely impair word learning, and that fast-mapping study conditions do not promote subsequent word learning in temporal lobectomy populations.

KEYWORDS:

Hippocampus; Language; Left temporal lobe; Memory; Unilateral temporal lobectomy; Word learning

17.
World Neurosurg. 2015 Oct;84(4):1127-35. doi: 10.1016/j.wneu.2015.04.031. Epub 2015 Apr 23.

The Legacy of Henry Molaison (1926-2008) and the Impact of His Bilateral Mesial Temporal Lobe Surgery on the Study of Human Memory.

Author information

1
Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
2
Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. Electronic address: ananda@lsuhsc.edu.

Abstract

In 1953, neurosurgeon William Beecher Scoville performed a bilateral mesial temporal lobe resection on patient Henry Molaison, who suffered from epilepsy. The operation was novel as a treatment for epilepsy and had an unexpected consequence: a severe compromise of Molaison's anterograde memory. In a landmark 1957 publication, Scoville and Milner concluded that mesial temporal lobe structures, particularly the hippocampi, were integral to the formation of new, recent memories. Over the next 5 decades, more than 100 researchers studied Molaison's memory, behavior, and learning skills, making him one of the most famous patients in the history of cognitive neuroscience. Following his death in 2008, his brain was scanned in situ and ex vivo and then sectioned into 2401 sections. Histological evaluation of Molaison's brain further elucidated which mesial temporal lobe structures were preserved or resected in his operation, shedding new light on the neuroanatomic underpinnings of short-term memory. Scoville regretted Molaison's surgical outcome and spoke vigorously about the dangers of bilateral mesial temporal lobe surgery. This report is the first historical account of Molaison's case in the neurosurgical literature, serving as a reminder of Molaison's contributions and of the perils of bilateral mesial temporal lobe surgery.

KEYWORDS:

Amnesia; Hippocampus; Mesial temporal lobe

PMID:
25913428
DOI:
10.1016/j.wneu.2015.04.031
[Indexed for MEDLINE]
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19.
Soc Cogn Affect Neurosci. 2015 May;10(5):636-44. doi: 10.1093/scan/nsu101. Epub 2014 Jul 25.

Social inference deficits in temporal lobe epilepsy and lobectomy: risk factors and neural substrates.

Author information

1
Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada Melanie.cohn@uhn.ca.
2
Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada.
3
Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada.

Abstract

In temporal lobe epilepsy and lobectomy, deficits in emotion identification have been found consistently, but there is limited evidence for complex social inference skills such as theory of mind. Furthermore, risk factors and the specific neural underpinnings of these deficits in this population are unclear. We investigated these issues using a comprehensive range of social inference tasks (emotion identification and comprehension of sincere, deceitful and sarcastic social exchanges) in individuals with temporal lobe epilepsy or lobectomy (n = 87). We observed deficits across patient groups which were partly related to the presence of mesial temporal lobe sclerosis, early age of seizure onset and left lobectomy. A voxel-based morphometry analysis conducted in the pre-operative group confirmed the importance of the temporal lobe by showing a relationship between left hippocampal atrophy and overall social inference abilities, and between left anterior neocortex atrophy and sarcasm comprehension. These findings are in keeping with theoretical proposals that the hippocampus is critical for binding diverse elements in cognitive domains beyond canonical episodic memory operations, and that the anterior temporal cortex is a convergence zone of higher-order perceptual and emotional processes, and of stored representations. As impairments were frequent, we require further investigation of this behavioural domain and its impact on the lives of people with epilepsy.

KEYWORDS:

emotion; hippocampus; mentalizing; temporal pole; theory of mind

PMID:
25062843
PMCID:
PMC4420742
DOI:
10.1093/scan/nsu101
[Indexed for MEDLINE]
Free PMC Article
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20.
J Neuropsychiatry Clin Neurosci. 2014 Summer;26(3):258-61. doi: 10.1176/appi.neuropsych.13060139.

Kissing or "osculation" in frontotemporal dementia.

Abstract

The authors investigated the neuropsychiatry of kissing in frontotemporal dementia. Among 15 patients, two had compulsive social kissing, bitemporal involvement, and Klüver-Bucy symptoms, and four pursued kissing with sexually disinhibited behavior. Future research should clarify the neuropsychiatric significance of kissing behavior.

[Indexed for MEDLINE]
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