Departments of Neurology and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; and Neurology Service, Neurobehavior Unit, VA Greater Los Angeles Healthcare System.
J Neuropsychiatry Clin Neurosci. 2022 Fall;34(4):328-340. doi: 10.1176/appi.neuropsych.21080224. Epub 2022 Mar 21.
Behavioral variant frontotemporal dementia (bvFTD) is associated with social and criminal transgressions; studies from countries around the world have documented such behavior in persons with this condition. An overview and analysis of social and criminal transgressions in bvFTD and their potential neurobiological mechanisms can provide a window for understanding the relationship of antisocial behavior and the brain.
This review evaluated the literature on the frequency of social and criminal transgressions in bvFTD and the neurobiological disturbances that underlie them.
There is a high frequency of transgressions among patients with bvFTD due to impairments in neurocognition, such as social perception, behavioral regulation, and theory of mind, and impairments in social emotions, such as self-conscious emotions and empathy. Additionally, there is significant evidence for a specific impairment in an innate sense of morality. Alterations in these neurobiological processes result from predominantly right-hemisphere pathology in frontal (ventromedial, orbitofrontal, inferolateral frontal), anterior temporal (amygdala, temporal pole), limbic (anterior cingulate, amygdala), and insular regions.
Overlapping disturbances in neurocognition, social emotions, and moral reasoning result from disease in the mostly mesial and right-sided frontotemporal network necessary for responding emotionally to others and for behavioral control. With increased sophistication in neurobiological interventions, future goals may be the routine evaluation of these processes among individuals with bvFTD who engage in social and criminal transgressions and the targeting of these neurobiological mechanisms with behavioral, pharmacological, and other interventions.
行为变异型额颞叶痴呆（bvFTD）与社会和犯罪越轨行为有关；来自世界各地的研究都记录了这种情况下的人的这种行为。对 bvFTD 中社会和犯罪越轨行为及其潜在神经生物学机制的概述和分析，可以为理解反社会行为与大脑的关系提供一个窗口。
本综述评估了 bvFTD 中社会和犯罪越轨行为的频率以及潜在神经生物学紊乱的文献。
由于神经认知障碍，如社交感知、行为调节和心理理论，以及社交情感障碍，如自我意识情感和同理心，bvFTD 患者的越轨行为频率很高。此外，有大量证据表明存在一种特定的道德本能损伤。这些神经生物学过程的改变是由于额叶（腹内侧、眶额、下外侧额叶）、前颞叶（杏仁核、颞极）、边缘（前扣带回、杏仁核）和岛叶区域的主要右侧半球病理学导致的。
神经认知、社会情感和道德推理的重叠障碍是由对他人的情感反应和行为控制所需的内侧和右侧额颞叶网络的疾病引起的。随着神经生物学干预措施的日益复杂化，未来的目标可能是定期评估有社会和犯罪越轨行为的 bvFTD 个体的这些过程，并针对这些神经生物学机制进行行为、药物和其他干预。
