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Aggression and impulsivity in dementia can feel sudden and confusing—but there’s powerful neurology behind it. The amygdala is designed to protect us. It triggers the fight-or-flight response when we sense danger. But in dementia, the brain’s ability to accurately assess threats is compromised. That means everyday situations can feel scary or threatening—even when they’re not. Normally, the prefrontal cortex steps in to pause and evaluate the situation. But when that part of the brain is affecte
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Patient S.M. has bilateral amygdala damage from rare Urbach-Wiethe disease and shows almost no fear in response to external threats like snakes, spiders, horror movies, or haunted houses, yet she can still experience panic in response to suffocation-like CO₂ inhalation, showing fear is not a single brain signal. Feinstein, J. S., Buzza, C., Hurlemann, R., Follmer, R. L., Dahdaleh, N. S., Coryell, W. H., Welsh, M. J., Tranel, D., & Wemmie, J. A. (2013). Fear and panic in humans with bilateral amy
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