Agitation, aggression, and disinhibition syndromes after traumatic brain injury

Issue title: Evaluation and Management of Neurobehavioral Syndromes of Traumatic Brain Injury

Guest editors: Thomas W. McAllister

Article type: Research Article

Authors: Kim, Edward^{; *}

Affiliations: University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ, USA | Dartmouth Medical School, Department of Psychiatry, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Tel.: +1 603 650 5824; Fax: +1 603 650 5842; E-mail: Thomas.W.McAllister@Dartmouth.edu

Correspondence: [*] Address for correspondence: 671 Hoes Lane, Piscataway, NJ 08855-1392, USA. Tel.: +1 732 235 3490; Fax: +1 732 235 4699; E-mail: kimed@cmhc.umdnj.edu

Abstract: Traumatic brain injury (TBI) is frequently complicated by disinhibition and aggression. These often profound changes in personality, present obstacles to rehabilitative treatments and community reentry. Syndromal presentations may involve a loss of impulse control, spontaneous aggression, and dysphoric bipolar states. Common neuropathological findings of inferior frontal lobe dysfunction support both disinhibition and kindling models of TBI-induced aggression. Assessment of these highly disruptive symptoms requires detailed historical, clinical, and neuropsychological information to formulate appropriate strategies. Management of TBI-related aggression may involve pharmacological, environmental, and psychotherapeutic strategies that incorporate caregiver training and support.

Keywords: brain injury, aggression, agitation, behavior

DOI: 10.3233/NRE-2002-17404

Journal: NeuroRehabilitation, vol. 17, no. 4, pp. 297-310, 2002