Psychological Science Faculty Publications and Presentations

Case Study on the Neuropsychology of Hypersexual Behavior

Document Type

Article

Publication Date

3-14-2020

Abstract

The literature on hypersexual behavior following acquired brain injury consists of single or small case series with findings often difficult to reconcile, due to non-systematic, clinical descriptions of the behavior and its associated neurocognitive factors across authors. The objective of this study was to advance an understanding of the behavioral manifestations and neuropathology of acquired hypersexual behavior via literature review with an illustrative case study including pre- and post-onset neuropsychological test results. The case involved acquired hypersexual behavior with an increased ease of arousal manifested as constant verbal demands upon his wife, sexually explicit talk, and insatiable performance followed bithalamic strokes in a 44-year-old male. Neuropsychological testing showed a dense anterograde amnesia and less severe executive impairment. Co-occurring compulsive eating and anosognosia were also observed. The hypersexual behavior and compulsive eating were interpreted as resulting from a disconnection syndrome that separated mesiotemporal limbic structures from orbitofrontal control. It was not part of a generalized disinhibition, as the behaviors that showed a post-injury increase were highly specific. This is consistent with dual control theoretical models of human sexuality whereby the human sexual response involves an interaction between independent sexual excitatory and inhibitory processes. Many questions about acquired hypersexual behavior remain, especially why it so rarely occurs even in cases of bilateral orbitofrontal and temporal injury. A large-scale, multi-site, prospective study to measure prevalence within the overall context of acute frontotemporal injury, although practically difficult to organize, would be informative.

Publication Title

Activitas Nervosa Superior

DOI

https://doi.org/10.1007/s41470-020-00068-y

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