Estamos trabajando para incorporar este artículo al repositorio
Consulte el artículo en la página del editor
Consulte la política de Acceso Abierto del editor


Disinhibition syndromes, ranging from mildly inappropriate social behavior to full blown mania, may result from lesions to specific brain areas. Several studies in patients with closed head injuries, brain tumors, stroke lesions, and focal epilepsy have demonstrated a significant association between disinhibition syndromes and dysfunction of orbitofrontal and basotemporal cortices of the right hemisphere. Based on the phylogenetic origin of these cortical areas and their main connections with dorsal regions related to visuospatial functions, somatosensation, and spatial memory, the orbitofrontal and basotemporal cortices may selectively inhibit or release motor, instinctive, affective, and intellectual behaviors elaborated in the dorsal cortex. Thus, dysfunction of these heteromodal ventral brain areas may result in disinhibited behaviors.


Documento: Artículo
Título:Mechanism of disinhibition after brain lesions
Autor:Starkstein, S.E.; Robinson, R.G.
Filiación:Department of Neuropsychiatry, Raul Carrea Inst. of Neurol. Res., Montaneses 2325, 1428 Buenos Aires, Argentina
Department of Psychiatry, University of Iowa, Iowa City, IA 52242, United States
Palabras clave:affect; brain cortex; brain injury; frontal lobe; human; inhibition kinetics; intelligence; mania; short survey; social behavior; temporal lobe; Adult; Animals; Bipolar Disorder; Brain Diseases; Brain Injuries; Cerebral Cortex; Delirium, Dementia, Amnestic, Cognitive Disorders; Female; Frontal Lobe; Functional Laterality; Humans; Inhibition (Psychology); Male; Neural Pathways; Risk Factors; Temporal Lobe
Página de inicio:108
Página de fin:114
Título revista:Journal of Nervous and Mental Disease
Título revista abreviado:J. NERV. MENT. DIS.


  • (1987) Diagnostic and Statistical Manual of Mental Disorders, (Revised), , Washington, D.C.: American Psychiatric Press
  • (1994) Diagnostic and Statistical Manual of Mental Disorders, (4th Ed), , Washington, D.C.: American Psychiatric Press
  • Barczak, P., Edmunds, E., Betts, T., Hypomania following complex partial seizures (1988) Br J Psychiatry, 152, pp. 137-139
  • Bianchi, L., (1922) The Mechanism of the Brain and the Function of the Frontal Lobes, , Trans James H. MacDonald Edinburgh: E. & S. Livingstone
  • Blumer, D., Benson, D.F., Personality changes with frontal and temporal lobe lesions (1975) Psychiatric Aspects of Neurologic Disease, , DF Benson, D. Blumer (Eds), New York: Grune & Stratton
  • Damasio, H., Grabowski, T., Frank, R., Galaburda, A.M., Damasio, A.R., The return of Phineas Gage: Clues about the brain from the skull of a famous patient (1994) Science, 264, pp. 1102-1104
  • Drake, M.E., Episodic depression and hypomania with temporal EEG paroxysms (1988) Psychosom, 29, pp. 354-357
  • Fornazzari, L., Farenik, K., Smith, I., Heasman, G.A., Ichise, M., Violent visual hallucinations and aggression in frontal lobe dysfunction: Clinical manifestations of deep orbitofrontal foci (1992) J Neuropsychiat Clin Neurosci, 4, pp. 42-44
  • Gillig, P., Sackellares, J.C., Greenberg, H.S., Right hemisphere partial complex seizures: Mania, hallucinations, and speech disturbances during ictal events (1988) Epilepsia, 29, pp. 26-29
  • Goldar, J.C., (1993) Anatomia de la Mente, , Buenos Aires: Salerno
  • Jastrowitz, M., Beitrage zur Lokalisation im Grosshirn und uber deren praktische Verwerthung (1888) Dtsch Med Wochnschr, 14, pp. 81-83
  • Jorge, R.E., Robinson, R.G., Starkstein, S.E., Arndt, S.V., Forrester, A.W., Geisler, F.H., Secondary mania following traumatic brain injury (1993) Am J Psychiatiy, 150, pp. 916-921
  • Kennard, M.A., Spencer, S., Fountain, G., Lesions of the orbital cortex of the frontal lobe which invade the caudate nucleus produce locomotor hyperactivity (1941) J Neurophysiol, 4, pp. 512-524
  • Kling, A., Steklis, H.D., A neural substrate for affiliative behavior in nonhuman primates (1976) Brain Behav Evol, 13, pp. 216-238
  • Klüver, H., Bucy, P., Preliminary analysis of functions of the temporal lobes in monkeys (1939) Arch Neurol Psychiat, 42, pp. 979-1000
  • Krauthammer, C., Klerman, G.L., Secondary mania: Manic syndromes associated with antecedent physical illness or drugs (1978) Arch Gen Psychiatry, 35, pp. 1333-1339
  • Kumar, A., Schapiro, M.B., Haxby, J.V., Grady, C.L., Friedland, R.P., Cerebral metabolic and cognitive studies in dementia with frontal lobe behavioral features (1990) J Psychiatr Res, 24, pp. 97-109
  • Lapierre, D., Braun, C.M.J., Hodgins, S., Ventral frontal deficits in psychopathy: Neuropsychological test findings (1995) Neuropsychol, 33, pp. 139-151
  • Migliorelli, R., Starkstein, S.E., Teson, A., De Quiros, G., Vazquez, S., Leiguarda, R., Robinson, R.G., SPECT findings in patients with primary mania (1993) J Neuropsychiat Clin Neurosci, 5, pp. 379-383
  • Neary, D., Snowden, J.S., Northen, B., Goulding, P., Dementia of frontal lobe type (1988) J Neurol Neurosurg Psychiatry, 51, pp. 353-361
  • Oppenheim, H., Zur Pathologie der Grosshirngeschwulste (1890) Arch Psychiatr Nervenkr, 21, pp. 560-587
  • Petrides, M., Pandya, D.N., Comparative architectonic analysis of the human and macaque frontal cortex (1994) Handbook of Neuropsychology, pp. 17-58. , J Grafman, F Boller (Eds), Elsevier Science Publishers, Amsterdam
  • Raine, A., Buchsbaum, M.S., Stanley, J., Lottenberg, S., Abel, L., Stoddard, J., Selective reductions in prefrontal glucose metabolism in murderers (1994) Biol Psychiatry, 36, pp. 365-373
  • Robinson, R.G., Differential behavioral and biochemical effects of right and left hemispheric cerebral infarction in the rat (1979) Science, 205, pp. 707-710
  • Robinson, R.G., Boston, J.D., Starkstein, S.E., Price, T.R., Comparison of mania with depression following brain injury: Causal factors (1988) Am J Psychiatry, 145, pp. 172-178
  • Rylander, G., (1939) Personality Changes after Operations on the Frontal Lobes, , London: Oxford University Press
  • Sanides, F., Comparative architectonics of the neocortex of mammals and their evolutionary interpretation (1969) Ann NY Acad Sci, 167, pp. 404-423
  • Starkstein, S.E., Boston, J.D., Robinson, R.G., Mechanisms of mania after brain injury: 12 case reports and review of the literature (1988) J Nerv Ment Dis, 176, pp. 87-100
  • Starkstein, S.E., Fedoroff, J.P., Berthier, M.L., Robinson, R.G., Manic-depressive and pure manic states after brain lesions (1991) Br J Psychiatry, 29, pp. 149-158
  • Starkstein, S.E., Mayberg, H.S., Berthier, M.L., Fedoroff, P., Price, T.R., Dannals, R.F., Wagner, H.N., Robinson, R.G., Mania after brain injury: Neuroradiological and metabolic findings (1990) Ann Neurol, 27, pp. 652-659
  • Starkstein, S.E., Migliorelli, R., Tesón, A., Sabe, L., Vázquez, S., Turjanski, M., Robinson, R.G., Leiguarda, R., The specificity of cerebral blood flow changes in patients with frontal lobe dementia (1994) J Neurol Neurosurg Psychiatry, 57, pp. 790-796
  • Starkstein, S.E., Moran, T.H., Bowersox, J.A., Robinson, R.G., Behavioral abnormalities induced by frontal cortical and nucleus accumbens lesions (1988) Brain Res, 473, pp. 74-80
  • Starkstein, S.E., Pearlson, G.D., Boston, J.D., Robinson, R.G., Mania after brain injury: A controlled study of causative factors (1987) Arch Neurol, 44, pp. 1069-1073
  • Tonkonogy, J.M., Violence and temporal lobe lesion: Head CT and MRI data (1991) J Neuropsychiat Clin Neurosci, 3, pp. 189-196
  • Welt, L., Uber Charakterveränderungen der Menschen infolge von Läsionen des Stirnhirn (1888) Deutsch Arch f Klin Med, 42, pp. 339-390
  • Wing, J.K., Cooper, E., Sartorius, N., (1974) Measurements and Classification of Psychiatric Symptoms, , Cambridge: Cambridge University Press


---------- APA ----------
Starkstein, S.E. & Robinson, R.G. (1997) . Mechanism of disinhibition after brain lesions. Journal of Nervous and Mental Disease, 185(2), 108-114.
---------- CHICAGO ----------
Starkstein, S.E., Robinson, R.G. "Mechanism of disinhibition after brain lesions" . Journal of Nervous and Mental Disease 185, no. 2 (1997) : 108-114.
---------- MLA ----------
Starkstein, S.E., Robinson, R.G. "Mechanism of disinhibition after brain lesions" . Journal of Nervous and Mental Disease, vol. 185, no. 2, 1997, pp. 108-114.
---------- VANCOUVER ----------
Starkstein, S.E., Robinson, R.G. Mechanism of disinhibition after brain lesions. J. NERV. MENT. DIS. 1997;185(2):108-114.