Sustained resolution of suicidality following partial amygdalectomy in a patient with extensive prefrontal resection: A case report

Background Lesions in the frontotemporal regions often produce complex psychiatric and behavioral symptoms by disrupting prefrontal-limbic networks. However, the specific contributions of individual nodes within this network to suicidality in humans remain poorly defined. Observations from staged neurosurgical interventions provide a unique opportunity to examine node-specific contributions to suicidal behavior at the circuit level. Case description A right-handed man in his 40s with a history of recurrent right frontotemporal oligodendroglioma underwent extensive right prefrontal resection. Following the surgery, he developed disinhibition, marked anxiety, depressed mood, and he made repeated impulsive suicide attempts despite psychiatric interventions and stable seizure control. Owing to tumor recurrence, a subsequent resection was performed, expanding the prefrontal cavity and including a partial right amygdalectomy. After the third surgery, his previously severe anxiety, agitation, and pessimistic rumination became less prominent, with sustained resolution of suicidality over a 12-month follow-up, although some irritability and impulsivity persisted. Conclusion This case demonstrates a selective dissociation between suicidality and other behavioral symptoms following sequential disruption of the prefrontal-limbic network. It suggests that targeted alterations of the amygdala may modulate fear and anxiety sufficiently to reduce suicidal behavior, highlighting the critical role of specific network nodes in the emotional manifestations of neurological disease.