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Letters to the Editor |

Frontal Lobe Pathology and Antisocial Personality Disorder

Erin D. Bigler, PhD
Arch Gen Psychiatry. 2001;58(6):609-611. doi:.
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In an elegant study recently published in the ARCHIVES, Raine et al%1 demonstrated a significant (11%) reduction in prefrontal gray but not white matter in antisocial personality disorder (APD). Reduced prefrontal gray matter volume in the subjects with APD was related to reduced autonomic arousal in association with a social stressor. Raine et al%1 discussed their findings as supporting the presence of prefrontal deficits that may underlie the social and moral impoverishment observed in APD.

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A, Axial computed tomographic images on immediate admission, just prior to neurosurgical intervention. This represents a self-inflicted injury with a .22-caliber pistol with entry at the base of the chin and entrance to the cranial vault via the frontal sinus. Note the anterior and bifrontal mesial damage along with the hemorrhagic mass in the left frontal region. At surgery, according to the neurosurgical report, the anterior 5 to 7 cm of tissue was removed bilaterally, and many of the branches of the anterior cerebral artery were found to be macerated. They were coagulated and the surrounding tissue was debrided. B, Similar axial images 2 days postsurgery showing extensive anterior and mesial frontal damage. For all images, the right side is on the left.

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June 1, 2001
Adrian Raine, DPhil; Lori LaCasse, BA; Patrick Colletti, MD
Arch Gen Psychiatry. 2001;58(6):611. doi:.
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