Lateralized Temporal-Limbic Dysfunction and Psychopathology

P. Flor-Henry, Annals of the New York Academy of Sciences, 1976, 28, 777-795.

Abstract: The evidence reviewed implies that the schizophrenic syndrome and psychopathy are manifestations of neuronal disorganization in the dominant orbital frontal temporal regions. The manic depressive syndromes reflect disorganization of the nondominant anterior limbic structures. Quite apart from the relationships existing between hemispheric dominance, language and speech abnormalities, thought disorder, and blunting of affect another association perhaps emerges. If one accepts that, for the reaons outlined earlier, subjective ‘consciousness’ is a function of brain stem mesial frontal connections on the left side, then it seems possible that the insidious feeling of personality change and ‘depersonalization’ often seen in schizophrenia may also be the reflection of lateralized hemispheric dysfunction. On neuropsychological evidence the periodic schizoaffective psychoses, like the manic depressives, have predominantly nondominant dysfunction, but some power spectral EEG data is available that shows that during the acute psychotic phase these have more extensive bitemporal involvement. How these laterality effects can be integrated with the gender related differential hemispheric organization of the male and female brain and thus immediately account, in a developmental perspective, for the different sex incidence of the major psychopathological syndromes has been discussed elsewhere. Infantile autism, aggressive psychopathy, and schizophrenia are overrepresented in males, compared to females, who, on the other hand, are more liable to affective disturbances, both psychotic and neurotic. The male, whose dominant hemisphere is relatively more vulnerable, but who, compared to the female has a more efficient nondominant hemispheric organization, will thus be more susceptible to syndromes of dominant dysfunction: autism, schizophrenia, psychopathy. The female, with relative dominant hemispheric superiority and nondominant vulnerability will have an increased susceptibility to syndromes of nondominant dysfunction: pathological disturbances of mood. Developmental aspects are of fundamental importance, for these phenomena are most prominent early in ontogenesis and progressively diminish with maturation.