Arousal theory as discussed within the present paper refers to those mechanisms and neural systems involved in central nervous system activation and more specifically the systems involved in cortical activation. Historical progress in the evolution of arousal theory has led to a better understanding of the functional neural systems involved in arousal or activation processes and ultimately contributed much to our current theories of emotion. Despite evidence for the dynamic interplay between the left and right cerebral hemispheres, the concepts of cerebral balance and dynamic activation have been emphasized in the neuropsychological literature. A conceptual model is proposed herein that incorporates the unique contributions from multiple neuropsychological theories of arousal and emotion. It is argued that the cerebral hemispheres may play oppositional roles in emotion partially due to the differences in their functional specializations and in their persistence upon activation. In the presence of a threat or provocation, the right hemisphere may activate survival relevant responses partially derived from hemispheric specializations in arousal and emotional processing, including the mobilization of sympathetic drive to promote heightened blood pressure, heart rate, glucose mobilization and respiratory support necessary for the challenge. Oppositional processes and mechanisms are discussed, which may be relevant to the regulatory control over the survival response; however, the capacity of these systems is necessarily limited. A limited capacity mechanism is proposed, which is familiar within other physiological systems, including that providing for the prevention of muscular damage under exceptional demand. This capacity theory is proposed, wherein a link may be expected between exceptional stress within a neural system and damage to the neural system. These mechanisms are proposed to be relevant to emotion and emotional disorders. Discussion is provided on the possible role of currently applied therapeutic interventions for emotional disorders.

Hostile men have reliably displayed an exaggerated sympathetic stress response across multiple experimental settings, with cardiovascular reactivity for blood pressure and heart rate concurrent with lateralized right frontal lobe stress (Trajanoski et al., in Diabetes Care 19(12):1412–1415, 1996; see Heilman et al., in J Neurol Neurosurg Psychiatry 38(1):69–72, 1975). The current experiment examined frontal lobe regulatory control of glucose in high and low hostile men with concurrent left frontal lobe (Control Oral Word Association Test [verbal]) or right frontal lobe (Ruff Figural Fluency Test [nonverbal]) stress. A significant interaction was found for Group × Condition, F (1,22) = 4.16, p ≤ .05 with glucose levels (mg/dl) of high hostile men significantly elevated as a function of the right frontal stressor (M = 101.37, SD = 13.75) when compared to the verbal stressor (M = 95.79, SD = 11.20). Glucose levels in the low hostile group remained stable for both types of stress. High hostile men made significantly more errors on the right frontal but not the left frontal stressor (M = 17.18, SD = 19.88) when compared to the low hostile men (M = 5.81, SD = 4.33). These findings support our existing frontal capacity model of hostility (Iribarren et al., in J Am Med Assoc 17(19):2546–2551, 2000; McCrimmon et al., in Physiol Behav 67(1):35–39, 1999; Brunner et al., in Diabetes Care 21(4):585–590, 1998), extending the role of the right frontal lobe to regulatory control over glucose mobilization.

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. Relatively little is known about right frontal lobe contributions to executive functioning given the paucity of measures sensitive to right frontal functioning. The present investigation reports the development and initial validation of a new measure designed to be sensitive to right frontal lobe functioning, the Figure Trail Making Test (FTMT). The FTMT, the classic Trial Making Test, and the Ruff Figural Fluency Test (RFFT) were administered to 42 right-handed men. The results indicated a significant relationship between the FTMT and both the TMT and the RFFT. Performance on the FTMT was also related to high beta EEG over the right frontal lobe. Thus, the FTMT appears to be an equivalent measure of executive functioning that may be sensitive to right frontal lobe functioning. Applications for use in frontotemporal dementia, Alzheimer’s disease, and other patient populations are discussed.

Clinical implications are discussed, including recommendations for therapy approaches based on functional cerebral space theory that may indicate the use of known techniques (e.g., for left hemibody neglect) that may also have therapeutic implications for treating other, more mercurial co-occurring syndromes of anosognosia and anosodiaphoria.

Background: It has been evidenced that the outcome of a CVA patient differs as a function of the cerebral hemisphere that is damaged by the stroke, especially in terms of emotional changes. In contrast, the Bi-Hemispheric Model of Emotion posits that each hemisphere has its own emotional specialization. The current experiment tested the competing predictions of the two theoretical perspectives in a mixed sample of left cerebrovascular accident (LCVA) patients and right cerebrovascular accident (RCVA) patients using a Dichotic Listening task and the Affective Auditory Verbal Learning Test (AAVLT). Heart Rate (HR) and Pulse Oxygen Saturation (SpO2) were recorded as sympathetic measures. It was expected that the predictions of the Bi-Hemispheric Model would be supported. A series of mixed design ANOVAs were used to analyze the data. Material/Methods: Participants consisted of 21 patients grouped into either post-acute status left cerebrovascular accident (LCVA) or right cerebrovascular accident (RCVA). Tests included the The Dichotic Listening test, The Affective Auditory Verbal Learning Test (AAVLT), HR and Sp02 measurement using a Fingertip Pulse Oximeter and the Mood Assessment Scale for depression. Results: Results revealed that both groups exhibited decreased auditory detection abilities in the ear contralateral to CVA location. Additionally, CVA patients recalled significantly more positive words than negative or neutral words and exhibited a significant learning curve. LCVA patients exhibited a recency effect, while RCVA patients exhibited a heigh tened primacy effect. Findings from the HR and Sp02 measures suggested a parasympathetic response to emotionally neutral information as well as an impaired sympathetic response to emotionally negative information in RCVA patients. Conclusions: The results lend partial support to the hypothesis drawn from the Bi-Hemispheric Model of Emotion, as evidenced by the diametrically opposite effects in these groups, which reflects opposing cerebral processes.