ABNORMAL TEMPORAL-LOBE METABOLISM IN VIOLENT SUBJECTS - CORRELATION OF IMAGING AND NEUROPSYCHIATRIC FINDINGS

PURPOSE: To search for metabolic correlates of clinical and electrophy siological abnormalities in violent subjects. METHODS: Seven subjects with histories of extremely violent behavior were studied with positro n emission tomography (PET) with fludeoxyglucose F 18 (FDG), brain ele ctrical area mapping, MR imaging, neuropsychiatric and neuropsychologi cal testing, and clinical examination during medical evaluation associ ated with legal proceedings. Nine control subjects without evidence of organic brain disease were also studied with FDG-PET. Quantitative PE T data were calculated as standardized uptake values comparing the hig hest occipital region with the lowest temporal region. RESULTS: Tempor al lobe metabolism was decreased in the study group relative to the co ntrol subjects. Medial temporal lobe metabolism was 39% lower than tha t in the occipital cortex in study subjects and only 27% lower than th at in control subjects. These groups differed by Mann-Whitney U test a nd by Wilcoxon's two-sample test. Metabolic differences correlated wit h limbic neuropsychiatric and electrophysiological abnormalities in th e violent group. CONCLUSION: In this selected population of violent su bjects, FDG-PET scans showed metabolic abnormalities in the temporal l obes. These abnormalities correlated with limbic abnormalities seen at electrophysiological and neuropsychiatric evaluation.