Interictal aggression in epilepsy: the Buss-Durkee Hostility Inventory

Area of Science:

• Neuroscience
• Psychiatry
• Epilepsy Research

Background:

• Temporal lobe epilepsy (TLE) is associated with behavioral changes.
• Understanding the neurobiological underpinnings of aggression in TLE is crucial for patient management.

Purpose of the Study:

• To investigate the relationship between the lateralization of seizure foci in temporal lobe epilepsy and aggressive tendencies.
• To explore differences in hostility patterns among patients with left TLE, right TLE, bitemporal TLE, absence epilepsy, and healthy controls.

Main Methods:

• Adult patients with TLE (left, right, or bilateral foci) or absence epilepsy, and normal controls, completed the Buss-Durkee Hostility Inventory (BDHI).
• Factor analysis was used to identify patterns of aggression (hostile feelings, covert aggression, overt aggression).
• Statistical comparisons were made between groups based on seizure focus lateralization and aggression scores.

Main Results:

• Patients with left TLE seizure foci scored higher on the Suspicion scale compared to other groups.
• Factor analysis revealed distinct aggression patterns: left TLE patients showed higher hostile feelings, normal controls higher covert aggression, and bitemporal patients higher overt aggression.
• Absence epilepsy patients did not differ significantly from controls in aggression patterns.

Conclusions:

• The lateralization of the seizure focus in temporal lobe epilepsy appears to influence the expression of aggressive behavior.
• Left-sided seizure foci may be linked to increased hostile feelings, while bilateral foci correlate with overt aggression.
• These findings highlight the importance of considering seizure focus lateralization in the assessment and treatment of aggression in TLE patients.