Neurobiological factors of aggressive behavior in patients with multi-infarction dementia

Abstract

Introduction. In the modern literature, the problem of the influence of multifocal brain damage in vascular dementia on the development of aggressive behavior in patients is only partially covered.The purpose of this work is to study the influence of neurobiological factors (number, localization of lesions) on the development of aggressive behavior in multi-infarct dementia.Materials and methods. The study involved 98 subjects diagnosed in multi-infarct dementia (F 01.1), established according to the ICD-10 criteria (1992), in which 52 were men (53.1 %) and 46 women (46.9 %), aged 60 to 90 years, the average age was 74.5 [67; 81] years. Patients are divided into a main group – with aggressive behavior (n = 49), and a control group − without aggressive behavior (n = 49). The study used clinical-anamnestic, clinical-psychopathological, psychometric and neuroimaging methods.Results. The study showed that patients with aggressive behavior compared to patients without aggressive behavior have a greater number of lesions (p < 0.0001). The localization of which is statistically significantly more often determined in the left frontal lobe, subcortical nuclei on the left and in the left ventricular region (p = 0.0002, 0.0212, 0.0036), and patients without aggressive behavior often do not have frontal lobe lesions.Discussion. Patients who show aggression in general, or in isolation physical, verbal aggression, or irritability, have a statistically significantly greater number of lesions than patients without these symptoms (p < 0,0001). Each additional lesion increases the likelihood of developing aggression and its severity. In patients with irritability, lesions localized in the left frontal lobe and left ventricle.Conclusion The study suggests that the number of lesions from four or more, as well as their predominant localization in the left hemisphere of the brain, leads to the development of various types of aggressive behavior.