Table 2

Neuroimaging studies in violent and aggressive subjects

Reference Subjects Methods Results
Raine et al 51 21 community volunteers with ASPD, compared with 26 substance dependent subjects, 21 psychiatric controls, and 34 healthy controlsPrefrontal volume as measured using MRI brain scans• ASPD significant 11.0% reduction in prefrontal gray matter compared with controls; 13.9% reduction compared with substance dependent group
Woermann et al 52 24 aggressive patients with TLE, compared with 24 non-aggressive TLE patients and 35 controlsVoxel by voxel analysis of grey matter density using MRI brain scans• Aggressive TLE patients had decreased left frontal grey matter compared with non-aggressive TLE and controls
Kuruoglu et al 53 40 alcohol-dependent subjects (15 with ASPD), compared with 10 age and sex matched controlsResting SPECT• ASPD subjects had significant anterior frontal hypoperfusion compared with other alcohol dependent subjects and controls
Amen et al 54 40 aggressive psychiatric patients compared with 40 non-aggressive psychiatric controlsResting SPECT• Aggressive subjects showed decreased activity in prefrontal cortex, increased activity in left subcortical structures
Hirono et al 55 10 aggressive dementia patients compared with 10 non-aggressive dementia patientsResting SPECT• Aggressive subjects had significant left anterior temporal and bilateral dorsofrontal hypoperfusion
• No differences in orbitofrontal regions
Volkow and Tancredi56 Four forensic psychiatric patients with repetitive violence compared with four normal controlsResting PET (15O-water and 18FDG)• Significantly decreased left temporal CBF and metabolism in four patients
• Significant frontal decreases in two subjects with “no remorse”
Volkow et al 57 Eight psychiatric patients with repetitive violence compared with eight normal controlsResting18FDG PET• Seven of eight violent patients, one control subject, showed multiple areas with significantly decreased metabolism
• Violent patients showed significantly greater reduction in bilateral prefrontal and medial temporal regions
Goyer et al 58 17 subjects with DSM-III personality disorder (PD), 43 controls• Activated 18FDG PET• Increased MAS correlated with decreased orbitofrontal metabolism in PD subjects
• Self reported “impulsive aggression” on modified aggression scale (MAS)
• No differences in CPT performance
• CPT to assess prefrontal function
Raine et al 59 Attorney referrals of 41 persons charged with murder or manslaughter, matched controls 18FDG PET with frontal activation by CPT• “Murderers” showed significant bilateral metabolic decreases in prefrontal cortex, and left subcortical structures
• No differences in CPT performance
Pietrini et al 62 15 young healthy volunteers selected for visual imagery abilities 15O-water PET superimposed on averaged brain MR scans• Evoked aggressive imagery correlated with significant decreases in ventromedial frontal CBF
  • PET=Positron emission tomography; SPECT=single photon emission computed tomography;

  • 15O water=15Oxygen water;

  • 18FDG=18Flouorodeoxyglucose; CBF=cerebral blood flow; CPT=continuous performance task; TLE=temporal lobe epilepsy.