Single Case Study: Neuropsychological Functioning in a Patient Diagnosed with Intermittent Explosive Disorder Pre and Post Neurosurgery

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Publication Details

Author list: Jurado Barba R
Publisher: Cambridge University Press (CUP): STM Journals
Publication year: 2016
Volume number: 19
Start page: E21
Number of pages: 8
ISSN: 1138-7416
Languages: English-Great Britain (EN-GB)


Abstract

Intermittent explosive disorder (IED) is characterized by a difficulty
to resist the urge to carry out a recognized harmful behavior. The
central symptom is aggressiveness, expressed in isolated episodes.
Executive function impairments are habitually found in impulse control
disorders. Neuropsychology of impulsivity is related to dysfunctions in
the orbito-frontal cortex, dorsolateral cortex and anterior-cingulated
regions, being consequently involved in cognitive mechanisms of
inhibition. Lesions in those areas are common in IED. In the most severe
cases of IED, surgical procedures are required for treatment. In this
study, we examined JML; a patient suffering from a severe case of IED.
He experienced frequent episodes of auto and heteroaggression and
multiple psychiatric admissions, and thus stereotactic surgery was the
recommended treatment. The procedure consisted of an electrode situated
lateral to the lateral ventricle, targeting the projections between
frontal and subcortical affected regions. We aimed to study the
neuropsychological functioning of JML, before and after electrode
implantation. Our results suggested that surgery in IED improves
cognitive performance at some levels. JML significantly improved his
cognitive flexibility, measured with WCST, and alternate attention
assessed with CPT and TMT-B tests, after electrode implantation.
Cognitive flexibility deficits may be also related to increased
aggressiveness. Therefore, improvements at this level may involve a
reduction of impulsivity and aggressive behavior


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Last updated on 2019-13-08 at 00:45