Temporal lobe abnormalities in semantic processing by criminal psychopaths as revealed by functional magnetic resonance imaging

Altered local intrinsic neural activity and molecular architecture in internet use disorders

BACKGROUND

Internet gaming disorder (IGD) is mainly characterized by its core dysfunction in higher-order brain cortices involved in inhibitory control, whose neurobiological basis remains unclear. Then, we will investigate local intrinsic neural activity (INA) alterations in IGD, ascertain whether these potential alterations are related to clinical characteristics, and further explore the underlying molecular architecture.

METHOD

In this study, we performed the fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) derived from resting-state functional magnetic resonance imaging (rs-fMRI) to explore the impact of IGD on local INA. Correlation analysis revealed the relationship between ReHo and fALFF in terms of group differences and clinical characteristics. Moreover, correlations between fALFF, ReHo, and PET- and SPECT-driven maps were investigated to elucidate the specific molecular architecture alternations in IGD. Finally, receiver operating characteristic curve (ROC) analysis was used to show the potential abilities of fALFF and ReHo in distinguishing individuals with IGD (IGDs) from healthy controls (HCs).

RESULT

Compared with HCs, IGDs revealed increased ReHo and fALFF in the prefrontal cortex. Significantly decreased ReHo was observed in the temporal lobe, occipital lobe, and cerebellum. In addition, the ReHo values in the cerebellum_7b_R were positively correlated with internet addiction severity. ROC curve analysis showed that ReHo and fALFF-altered brain regions could effectively distinguish IGDs from HCs. More importantly, cross-modal correlations revealed local INA changes in brain regions associated with the monoamine neurotransmitter system and the less studied cholinergic/GABAergic system.

CONCLUSION

These results suggest that local functional impairments are shown in the audiovisual and inhibitory control circuits in IGDs. This may be associated with underlying neurotransmitter system alterations. Therefore, this study provides the possibility of GABAergic receptor agonists and cholinergic receptor inhibitors for the treatment of IGD.

Psychopathy and medial frontal cortex: A systematic review reveals predominantly null relationships

Theories have posited that psychopathy is caused by dysfunction in the medial frontal cortex, including ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), and dorsomedial prefrontal cortex (dmPFC). Recent reviews have questioned the reproducibility of neuroimaging findings within this field. We conducted a systematic review to describe the consistency of magnetic resonance imaging (MRI) findings according to anatomical subregion (vmPFC, ACC, dmPFC), experimental task, psychopathy assessment, study power, and peak coordinates of significant effects. Searches of PsycInfo and MEDLINE databases produced 77 functional and 24 structural MRI studies that analyzed the medial frontal cortex in relation to psychopathy in adult samples. Findings were predominantly null (85.4 % of 1573 tests across the three medial frontal regions). Studies with higher power observed null effects at marginally lower rates. Finally, peak coordinates of significant effects were widely dispersed. The evidence failed to support theories positing the medial frontal cortex as a consistent neural correlate of psychopathy. Theory and methods in the field should be revised to account for predominantly null neuroimaging findings.

Sensitivity to moral and conventional rules in temporal lobe epilepsy

OBJECTIVES

Sensitivity to moral and conventional rules (SMCR) is supported by bilateral brain networks and psychosocial input both of which may be altered in temporal lobe epilepsy (TLE). This study evaluated the components of SMCR in patients with TLE, aiming to clarify their preservation and link to psychopathological and cognitive aspects.

METHODS

Adult patients with unilateral TLE and healthy controls were evaluated using neuropsychological tests for SMCR, memory, language, and executive functions, the Empathy Questionnaire (EQ), and the Symptom Checklist-90-R (SCL-90-R).

RESULTS

The SMCR test items showed good reliability and validity, yielding the Severity and Rules factors distinct from the Executive, Lexical and Memory factors. Patients with right TLE scored worse in moral rules recognition than controls, but this difference was nullified by a significant influence for age and sex. The Severity and Rules factors related to semantic fluency and age and, respectively, TLE side and psychoticism. However, these factors did predict TLE membership.

CONCLUSIONS

In adult patients with TLE, the SMCR test reflects a distinct cognitive domain. Conventional rules are well-retained, while moral reasoning may be only affected in right TLE if unfavorable demographics coexist. Although age, TLE side, semantic abilities, and psychoticism cooperate to determine SMCR, impairment of such domain is not a distinctive feature of TLE.

Static and Temporal Dynamic Alteration of Intrinsic Brain Activity in MRI-negative Temporal Lobe Epilepsy

PURPOSE

To comprehensively explore the potential brain activity abnormalities affected by MRI-negative temporal lobe epilepsy (TLE) and to detect whether the changes were associated with cognition and help in the diagnosis or lateralization.

METHOD

Six static intrinsic brain activity (IBA) indicators (ALFF, fALFF, ReHo, DC, GSCorr, VMHC) and their corresponding six temporal dynamic indicators in 39 unilateral MRI-negative TLE patients and 42 healthy volunteers were compared. Correlation analyses were performed between these indicators in areas displaying group differences, cognitive function, and epilepsy duration. ROC analyses were performed to test the diagnostic and lateralization ability of the IBA parameters.

RESULTS

Considerable overlap was present among the abnormal brain regions detected by different static and dynamic indicators, including (1) alteration of fALFF, Reho, DC, VMHC, dfALFF, dReHo, and dDC in the temporal neocortex (predominately ipsilateral to the epileptogenic foci); (2) decreased dGSCorr and dVMHC in the occipital lobe. Meanwhile, the ReHo and VMHC values in the temporal neocortex correlated with the cognition scores or epilepsy duration (P < 0.01). The ROC analysis results revealed moderate diagnosis or lateralization efficiency of several IBA indicators (fALFF, dfALFF, ReHo, DC, dDC, and VMHC).

CONCLUSION

The abnormal condition of neuronal activity in the temporal neocortex, predominately lateralized to the epileptic side, was a crucial feature in patients with MRI-negative TLE and might offer diagnosis or lateralization information. The application of dynamic intrinsic brain activity indicators played a complementary role, further revealing the temporal variability decline of the occipital lobe in MRI-negative TLE patients.

How reliable are amygdala findings in psychopathy? A systematic review of MRI studies

The amygdala is a key component in predominant neural circuitry models of psychopathy. Yet, after two decades of neuroimaging research on psychopathy, the reproducibility of amygdala findings is questionable. We systematically reviewed MRI studies (81 of adults, 53 of juveniles) to determine the consistency of amygdala findings across studies, as well as within specific types of experimental tasks, community versus forensic populations, and the lowest- versus highest-powered studies. Three primary findings emerged. First, the majority of studies found null relationships between psychopathy and amygdala structure and function, even in the context of theoretically relevant tasks. Second, findings of reduced amygdala activity were more common in studies with low compared to high statistical power. Third, the majority of peak coordinates of reduced amygdala activity did not fall primarily within the anatomical bounds of the amygdala. Collectively, these findings demonstrate significant gaps in the empirical support for the theorized role of the amygdala in psychopathy and indicate the need for novel research perspectives and approaches in this field.

More than just statics: Static and temporal dynamic changes in intrinsic brain activity in unilateral temporal lobe epilepsy

Background

Temporal lobe epilepsy (TLE) is the most prevalent refractory focal epilepsy and is more likely accompanied by cognitive impairment. The fully understanding of the neuronal activity underlying TLE is of great significance.

Objective

This study aimed to comprehensively explore the potential brain activity abnormalities affected by TLE and detect whether the changes were associated with cognition.

Methods

Six static intrinsic brain activity (IBA) indicators [amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), degree centrality (DC), global signal correlation (GSCorr), and voxel-mirrored homotopic connectivity (VMHC)] and their corresponding dynamic indicators, such as dynamic ALFF (dALFF), dynamic fALFF (dfALFF), dynamic ReHo (dReHo), dynamic DC (dDC), dynamic VMHC (dVMHC), and dynamic GSCorr (dGSCorr), in 57 patients with unilateral TLE and 42 healthy volunteers were compared. Correlation analyses were also performed between these indicators in areas displaying group differences and cognitive function, epilepsy duration, and severity.

Results

Marked overlap was present among the abnormal brain regions detected using various static and dynamic indicators, primarily including increased ALFF/dALFF/fALFF in the bilateral medial temporal lobe and thalamus, decreased ALFF/dALFF/fALFF in the frontal lobe contralateral to the epileptogenic side, decreased fALFF, ReHo, dReHo, DC, dDC, GSCorr, dGSCorr, and VMHC in the temporal neocortex ipsilateral to the epileptogenic foci, decreased dReHo, dDC, dGSCorr, and dVMHC in the occipital lobe, and increased ALFF, fALFF, dfALFF, ReHo, and DC in the supplementary motor area ipsilateral to the epileptogenic foci. Furthermore, most IBA indicators in the abnormal brain region significantly correlated with the duration of epilepsy and several cognitive scale scores (P < 0.05).

Conclusion

The combined application of static and dynamic IBA indicators could comprehensively reveal more real abnormal neuronal activity and the impairment and compensatory mechanisms of cognitive function in TLE. Moreover, it might help in the lateralization of epileptogenic foci and exploration of the transmission and inhibition pathways of epileptic activity.

The Bilateral Precuneus as a Potential Neuroimaging Biomarker for Right Temporal Lobe Epilepsy: A Support Vector Machine Analysis

Background and Objective

While evidence has demonstrated that the default-mode network (DMN) plays a key role in the broad-scale cognitive problems that occur in right temporal lobe epilepsy (rTLE), little is known about alterations in the network homogeneity (NH) of the DMN in TLE. In this study, we used the NH method to investigate the NH of the DMN in TLE at rest, and an support vector machine (SVM) method for the diagnosis of rTLE.

Methods

A total of 43 rTLE cases and 42 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Imaging data were analyzed with the NH and SVM methods.

Results

rTLE patients have a decreased NH in the right inferior temporal gyrus (ITG) and left middle temporal gyrus (MTG), but increased NH in the bilateral precuneus (PCu) and right inferior parietal lobe (IPL), compared with HCs. We found that rTLE had a longer performance reaction time (RT). No significant correlation was found between abnormal NH values and clinical variables of the patients. The SVM results showed that increased NH in the bilateral PCu as a diagnostic biomarker distinguished rTLE from HCs with an accuracy of 74.12% (63/85), a sensitivity 72.01% (31/43), and a specificity 72.81% (31/42).

Conclusion

These findings suggest that abnormal NH of the DMN exists in rTLE, and highlights the significance of the DMN in the pathophysiology of cognitive problems occurring in rTLE, and the bilateral PCu as a neuroimaging diagnostic biomarker for rTLE.

Distinct neural signatures of schizotypy and psychopathy during visual word-nonword recognition

Previous behavioural data indicate lower word-nonword recognition accuracy in association with a high level of positive schizotypy, psychopathy, or motor impulsivity traits, each with some unique contribution, in the general population. This study aimed to examine the neural underpinnings of these associations using functional magnetic resonance imaging (fMRI) in a volunteer sample. Twenty-two healthy English-speaking adults completed self-report measures of schizotypy (Oxford-Liverpool Inventory of Feelings and Experiences [O-LIFE]), psychopathy (Triarchic Psychopathy Measure [TriPM]), and impulsivity (Barratt Impulsiveness Scale [BIS-11]) and underwent whole-brain fMRI while performing a lexical decision task (LDT) featuring high and low-frequency words, real nonwords, and pseudohomophones. Higher positive schizotypy (Unusual Experiences) was associated with lower cerebellum activity during identification of low-frequency words (over real nonwords). Higher Boldness (fearless dominance) and Meanness (callous aggression) facets of psychopathy were associated with lower striatal and posterior cingulate activity when identifying nonwords over words. Higher Motor Impulsivity was associated with lower activity in the fusiform (bilaterally), inferior frontal (right-sided), and temporal gyri (bilaterally) across all stimuli-types over resting baseline. Positive schizotypy, psychopathy, and impulsivity traits influence word-nonword recognition through distinct neurocognitive mechanisms. Positive schizotypy and psychopathy appear to influence LDT performance through brain areas that play only a supportive (cerebellum) or indirect role in reading-related skills. The negative association between Motor Impulsivity and activations typically found for phonological processing and automatic word identification indicates a reduced bilateral integration of the meaning and sound of mental word representations, and inability to select the appropriate outputs, in impulsive individuals.

Clarifying the roles of schizotypy and psychopathic traits in lexical decision performance

INTRODUCTION

Some studies suggest that lexical recognition is impaired in people with schizophrenia, psychopathy and/or antisocial personality disorders, but not affective disorders. We examined the extent to which various traits dimensionally linked to one or more of these disorders are associated with lexical recognition performance in the general population.

METHODS

Seventy-eight healthy English-speaking participants completed self-report measures of schizotypy, psychopathy, impulsivity, depression, anxiety and stress. All participants were assessed on a one-choice variant of a lexical decision task (LDT).

RESULTS

Meanness and Boldness traits of psychopathy (Triarchic Psychopathy Measure), and positive schizotypy (Unusual Experiences, Oxford-Liverpool Inventory of Feelings and Experiences) were associated with poor word-nonword accuracy, and predicted a significant amount of unique variance (Meanness, 12%; Boldness, 4.8%; Positive Schizotypy, 4.4%; total 21%) in performance. Higher motor impulsivity predicted 30% of the variance in low-frequency words recognition accuracy, but only in non-native English speakers. Affective traits were not associated with LDT performance.

CONCLUSION

Psychopathic traits show stronger negative associations with lexical recognition performance than schizotypal traits, and impulsivity may differently influence lexical decision performance in native and non-native speakers. Further studies are needed to replicate these findings, especially the influence of language familiarity in the impulsivity-performance relationship, and to clarify the influence of corresponding symptom dimensions in lexical recognition abilities, taking language familiarity, migration status, and comorbidity into account, in people with schizophrenia, psychopathy, and/or antisocial personality disorders.

Neural Correlates of Adolescent Irritability and Its Comorbidity With Psychiatric Disorders

OBJECTIVE

Irritable mood, a common and impairing symptom in psychopathology, has been proposed to underlie the developmental link between oppositional problems in youth and depression in adulthood. We examined the neural correlates of adolescent irritability in IMAGEN, a sample of 2,024 14-year-old adolescents from 5 European countries.

METHOD

The Development and Well-Being Assessment (DAWBA) was used to assess attention-deficit/hyperactivity disorder, major depressive disorder, oppositional defiant disorder, and generalized anxiety disorder. Three items from the DAWBA, selected as close matches to the Affective Reactivity Index, were used to assess irritability. Structural magnetic resonance imaging was examined using whole-brain voxel-based morphometry analysis, and functional magnetic resonance imaging was examined during a stop signal task of inhibitory control. Imaging data were included in structural equation models to examine the direct and indirect associations between irritable mood and comorbid DSM diagnoses.

RESULTS

Whole-brain voxelwise analysis showed that adolescent irritable mood was associated with less gray matter volume and less neural activation underlying inhibitory control in frontal and temporal cortical areas (cluster-correction at p < .05). Structural equation models suggested that part of the observed smaller gray matter volume was exclusively driven by irritability separate from direct relationships between generalized anxiety disorder (or attention-deficit/hyperactivity disorder, major depressive disorder, or oppositional defiant disorder) and gray matter volume.

CONCLUSION

This study identifies adolescent irritability as an independent construct and points to a neurobiological correlate to irritability that is an important contributing feature to many psychopathological disorders.

Brain structural correlates of familial risk for mental illness: a meta-analysis of voxel-based morphometry studies in relatives of patients with psychotic or mood disorders

Schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD) are heritable psychiatric disorders with partially overlapping genetic liability. Shared and disorder-specific neurobiological abnormalities associated with familial risk for developing mental illnesses are largely unknown. We performed a meta-analysis of structural brain imaging studies in relatives of patients with SCZ, BD, and MDD to identify overlapping and discrete brain structural correlates of familial risk for mental disorders. Search for voxel-based morphometry studies in relatives of patients with SCZ, BD, and MDD in PubMed and Embase identified 33 studies with 2292 relatives and 2052 healthy controls (HC). Seed-based d Mapping software was used to investigate global differences in gray matter volumes between relatives as a group versus HC, and between those of each psychiatric disorder and HC. As a group, relatives exhibited gray matter abnormalities in left supramarginal gyrus, right striatum, right inferior frontal gyrus, left thalamus, bilateral insula, right cerebellum, and right superior frontal gyrus, compared with HC. Decreased right cerebellar gray matter was the only abnormality common to relatives of all three conditions. Subgroup analyses showed disorder-specific gray matter abnormalities in left thalamus and bilateral insula associated with risk for SCZ, in left supramarginal gyrus and right frontal regions with risk for BD, and in right striatum with risk for MDD. While decreased gray matter in right cerebellum might be a common brain structural abnormality associated with shared risk for SCZ, BD, and MDD, regional gray matter abnormalities in neocortex, thalamus, and striatum appear to be disorder-specific.

Brain gray matter network organization in psychotic disorders

Abnormal neuroanatomic brain networks have been reported in schizophrenia, but their characterization across patients with psychotic disorders, and their potential alterations in nonpsychotic relatives, remain to be clarified. Participants recruited by the Bipolar and Schizophrenia Network for Intermediate Phenotypes consortium included 326 probands with psychotic disorders (107 with schizophrenia (SZ), 87 with schizoaffective disorder (SAD), 132 with psychotic bipolar disorder (BD)), 315 of their nonpsychotic first-degree relatives and 202 healthy controls. Single-subject gray matter graphs were extracted from structural MRI scans, and whole-brain neuroanatomic organization was compared across the participant groups. Compared with healthy controls, psychotic probands showed decreased nodal efficiency mainly in bilateral superior temporal regions. These regions had altered morphological relationships primarily with frontal lobe regions, and their network-level alterations were associated with positive symptoms of psychosis. Nonpsychotic relatives showed lower nodal centrality metrics in the prefrontal cortex and subcortical regions, and higher nodal centrality metrics in the left cingulate cortex and left thalamus. Diagnosis-specific analysis indicated that individuals with SZ had lower nodal efficiency in bilateral superior temporal regions than controls, probands with SAD only exhibited lower nodal efficiency in the left superior and middle temporal gyrus, and individuals with psychotic BD did not show significant differences from healthy controls. Our findings provide novel evidence of clinically relevant disruptions in the anatomic association of the superior temporal lobe with other regions of whole-brain networks in patients with psychotic disorders, but not in their unaffected relatives, suggesting that it is a disease-related trait. Network disorganization primarily involving frontal lobe and subcortical regions in nonpsychotic relatives may be related to familial illness risk.

Affective and interpersonal psychopathic traits associated with reduced corpus callosum volume among male inmates - RETRACTED

BACKGROUND

Psychopathy is a personality disorder associated with severe emotional and interpersonal consequences and persistent antisocial behavior. Neurobiological models of psychopathy emphasize impairments in emotional processing, attention, and integration of information across large-scale neural networks in the brain. One of the largest integrative hubs in the brain is the corpus callosum (CC) - a large white matter structure that connects the two cerebral hemispheres.

METHOD

The current study examines CC volume, measured via Freesurfer parcellation, in a large sample (n = 495) of incarcerated men who were assessed for psychopathic traits using the Hare Psychopathy Checklist-Revised (PCL-R).

RESULTS

Psychopathy was associated with reduced volume across all five sub-regions of the CC. These relationships were primarily driven by the affective/interpersonal elements of psychopathy (PCL-R Factor 1), as no significant associations were found between the CC and the lifestyle/antisocial traits of psychopathy. The observed effects were not attributable to differences in substance use severity, age, IQ, or total brain volume.

CONCLUSIONS

These findings align with suggestions that core psychopathic traits may be fostered by reduced integrative capacity across large-scale networks in the brain.

Toward neuroimaging-based network biomarkers for transient ischemic attack

Stroke is associated with topological disruptions of large-scale functional brain networks. However, whether these disruptions occur in transient ischemic attack (TIA), an important risk factor for stroke, remains largely unknown. Combining multimodal MRI techniques, we systematically examined TIA-related topological alterations of functional brain networks, and tested their reproducibility, structural, and metabolic substrates, associations with clinical risk factors and abilities as diagnostic and prognostic biomarkers. We found that functional networks in patients with TIA exhibited decreased whole-brain network efficiency, reduced nodal centralities in the bilateral insula and basal ganglia, and impaired connectivity of inter-hemispheric communication. These alterations remained largely unchanged when using different brain parcellation schemes or correcting for micro head motion or for regional gray matter volume, cerebral blood flow or hemodynamic lag of BOLD signals in the patients. Moreover, some alterations correlated with the levels of high-density lipoprotein cholesterol (an index related to ischemic attacks via modulation of atherosclerosis) in the patients, distinguished the patients from healthy individuals, and predicted future ischemic attacks in the patients. Collectively, these findings highlight the emergence of characteristic network dysfunctions in TIA, which may aid in elucidating pathological mechanisms and establishing diagnostic and prognostic biomarkers for the disease.

Abnormal default-mode network homogeneity in patients with temporal lobe epilepsy

Default-mode network (DMN) plays a key role in a broad-scale cognitive problem, which occurs in temporal lobe epilepsy (TLE). However, little is known about the alterations of the network homogeneity (NH) of DMN in TLE. In the present study, we employed NH method to investigate the NH of DMN in TLE at rest.A total of 47 patients with TLE (right TLE [rTLE] 29, and left TLE [lTLE] 18) and 35 healthy controls who underwent resting-state functional magnetic resonance imaging were enrolled. NH approach was used to analyze the data.rTLE exhibited decreased NH in the right middle temporal pole gyrus and increased NH in the bilateral posterior cingulate cortex compared to the control group. In lTLE, decreased NH was observed in left inferior temporal gyrus and left hippocampus. Meanwhile, we found that lTLE had a longer performance reaction time. No significant correlation was found between abnormal NH values and clinical variables in the patients.These findings suggested that abnormal NH of the DMN exists in rTLE and lTLE, and highlighted the significance of DMN in the pathophysiology of cognitive problems occurring in TLE and also found the existence of abnormality of executive function in lTLE.

Hemispheric Specialization within the Superior Anterior Temporal Cortex for Social and Nonsocial Concepts

Studies of semantic dementia, imaging, and repetitive TMS have suggested that the bilateral anterior temporal lobes (ATLs) underpin a modality-invariant representational hub within the semantic system. Questions remain, however, regarding functional specialization across a variety of knowledge domains within the ATL region. We investigated direct evidence for the functional relevance of the superior ATL in processing social concepts. Using converging evidence from noninvasive brain stimulation and neuropsychology, we demonstrate graded differentiation of right and left superior anterior temporal areas in social cognition. Whereas the left superior ATL is necessary for processing both social and nonsocial abstract concepts, social conceptual processing predominates in the right superior ATL. This graded hemispheric specialization is mirrored in the patient results. Our data shed new light on the classic debate about hemispheric differences in semantic and social cognition. These results are considered in the context of models of semantic representation and the emerging data on connectivity for left and right ATL regions.

Error-related processing in adult males with elevated psychopathic traits

Psychopathy is a serious personality disorder characterized by dysfunctional affective and behavioral symptoms. In incarcerated populations, elevated psychopathic traits have been linked to increased rates of violent recidivism. Cognitive processes related to error processing have been shown to differentiate individuals with high and low psychopathic traits and may contribute to poor decision making that increases the risk of recidivism. Error processing abnormalities related to psychopathy may be attributable to error-monitoring (error detection) or posterror processing (error evaluation). A recent 'bottleneck' theory predicts deficiencies in posterror processing in individuals with high psychopathic traits. In the current study, incarcerated males (n = 93) performed a Go/NoGo response inhibition task while event-related potentials (ERPs) were recorded. Classic time-domain windowed component and principal component analyses were used to measure error-monitoring (as measured with the error-related negativity [ERN/Ne]) and posterror processing (as measured with the error positivity [Pe]). Psychopathic traits were assessed using Hare's Psychopathy Checklist-Revised (PCL-R). PCL-R Total score, Factor 1 (interpersonal-affective traits), and Facet 3 (lifestyle traits) scores were positively related to posterror processes (i.e., increased Pe amplitude) but unrelated to error-monitoring processes (i.e., ERN/Ne). These results support the attentional bottleneck theory and further describe deficiencies related to elevated psychopathic traits that could be beneficial for new treatment strategies for psychopathy.

Psychopathy: developmental perspectives and their implications for treatment

Psychopathy is a mental disorder marked by deficient emotional responses, lack of empathy, and poor behavioral controls, commonly resulting in persistent antisocial deviance and criminal behavior. Accumulating research suggests that psychopathy follows a developmental trajectory with strong genetic influences, and which precipitates deleterious effects on widespread functional networks, particularly within paralimbic regions of the brain. While traditional therapeutic interventions commonly administered in prisons and forensic institutions have been notoriously ineffective at combating these outcomes, alternative strategies informed by an understanding of these specific neuropsychological obstacles to healthy development, and which target younger individuals with nascent symptoms of psychopathy are more promising. Here we review recent neurobehavioral and neuroimaging literature that informs our understanding of the brain systems compromised in psychopathy, and apply these data to a broader understanding of its developmental course, ultimately promoting more proactive intervention strategies profiting from adaptive neuroplasticity in youth.

Intrinsic limbic and paralimbic networks are associated with criminal psychopathy

BACKGROUND

Psychopathy is a personality disorder associated with impairments in decision-making, empathy, and impulsivity. Recent brain imaging studies suggest that psychopathy is associated with abnormalities in limbic/paralimbic brain regions. To date, no studies have examined functional brain connectivity measures using independent component analyses (ICA) in adults with psychopathy. Here, we test hypotheses regarding paralimbic connectivity in adult incarcerated individuals stratified by psychopathy scores.

METHODS

One hundred and two prison inmates were rated using the Hare Psychopathy Checklist-Revised (PCL-R). FMRI data were collected while subjects performed an auditory target detection "oddball" task. FMRI data were analyzed using group ICA to identify functional networks responding to the oddball task correlating with psychopathy scores.

RESULTS

Components demonstrating significant correlations with psychopathy included a default mode network, a frontoparietal component, and a visual/posterior cingulate component. Modulation trends correlated strongly with factor 2 (impulsivity) and total PCL-R scores in the frontoparietal and visual/posterior cingulate networks, and with factor 1 (affective) scores within the default mode network. The posterior cingulate region factored significantly in the modulation trends observed.

CONCLUSION

Consistent with the hypothesis of limbic/paralimbic abnormalities associated with psychopathy, modulation trends correlated strongly with PCL-R scores. There is strong evidence to implicate the posterior cingulate in aberrant functional connectivity associated with the manifestation of psychopathic symptoms. Future investigations comparing functional trends associated with the posterior cingulate in psychopathic subjects may provide further insight into the manifestation of this disorder.

Cortex and amygdala morphology in psychopathy

Psychopathy is characterized by abnormal emotional processes, but only recent neuroimaging studies have investigated its cerebral correlates. The study aim was to map local differences of cortical and amygdalar morphology. Cortical pattern matching and radial distance mapping techniques were used to analyze the magnetic resonance images of 26 violent male offenders (age: 32±8) with psychopathy diagnosed using the Psychopathy Checklist-Revised (PCL-R) and no schizophrenia spectrum disorders, and in matched controls (age: 35± sp="0.12"/>11). The cortex displayed up to 20% reduction in the orbitofrontal and midline structures (corrected p<0.001 bilaterally). Up to 30% tissue reduction in the basolateral nucleus, and 10-30% enlargement effects in the central and lateral nuclei indicated abnormal structure of the amygdala (corrected p=0.05 on the right; and symmetrical pattern on the left). Psychopathy features specific morphology of the main cerebral structures involved in cognitive and emotional processing, consistent with clinical and functional data, and with a hypothesis of an alternative evolutionary brain development.

Executive function profiles of pedophilic and nonpedophilic child molesters

There is increasing evidence of neurocognitive dysfunction among child molesters, supporting the notion of brain anomalies among pedophiles. However, approximately half of child molesters are not pedophilic (i.e., are not primarily attracted to children), and neurocognitive differences between pedophilic (PED) and nonpedophilic (NPED) child molesters are not well understood. The purpose of this study was to assess neurocognition, specifically executive functioning (EF), among phallometrically defined PED and NPED child molesters, relative to nonsexual offenders (NSO). Participants (N = 89) were compared on seven EF domains. Results revealed that (a) child molesters exhibited an overall executive profile that was different from that of NSOs, with PEDs differing from NSOs but not from NPEDs; (b) child molesters on the whole performed better than NSOs on abstract reasoning and more poorly on inhibition; and (c) PEDs performed better than NPEDs on planning and exhibited better overall performance accuracy relative to NPEDs. These results suggest that PEDs exhibit a more deliberate, planful response style characterized by greater self-monitoring; whereas NPEDs appear to respond more impulsively. The current report further elucidates neurocognition among child molesters and highlights the need for future research examining subtypes of child molesters.

Aberrant neural processing of moral violations in criminal psychopaths

A defining characteristic of psychopathy is the willingness to intentionally commit moral transgressions against others without guilt or remorse. Despite this "moral insensitivity," the behavioral and neural correlates of moral decision-making in psychopathy have not been well studied. To address this issue, the authors used functional magnetic resonance imaging (fMRI) to record hemodynamic activity in 72 incarcerated male adults, stratified into psychopathic (n = 16) and nonpsychopathic (n = 16) groups based on scores from the Hare Psychopathy Checklist-Revised (R. D. Hare, 2003), while they made decisions regarding the severity of moral violations of pictures that did or did not depict moral situations. Consistent with hypotheses, an analysis of brain activity during the evaluation of pictures depicting moral violations in psychopaths versus nonpsychopaths showed atypical activity in several regions involved in moral decision-making. This included reduced moral/nonmoral picture distinctions in the ventromedial prefrontal cortex and anterior temporal cortex in psychopaths relative to nonpsychopaths. In a separate analysis, the association between severity of moral violation ratings and brain activity across participants was compared in psychopaths versus nonpsychopaths. Results revealed a positive association between amygdala activity and severity ratings that was greater in nonpsychopaths than psychopaths, and a negative association between posterior temporal activity and severity ratings that was greater in psychopaths than nonpsychopaths. These results reveal potential neural underpinnings of moral insensitivity in psychopathy and are discussed with reference to neurobiological models of morality and psychopathy.

Aggression, psychopathy and brain imaging - Review and future recommendations

Violent behavior appears to result from a complex web of interacting genetic as well as environmental factors. Psychopathy is a strong predictor for relapse in violent acts. The current review shed light on rapidly expanding knowledge in brain imaging related to violent behavior and psychopathy. A literature search was performed in PubMed, Cochrane and PsycInfo combining the key words: mentally disordered offender/aggression/violence/ crime/forensic psychiatry/brain imaging neuroimaging/fMRI/MRI/PET/SPECT/lack of empathy/psychopathy and antisocial personality disorder. The reviewed material, which consisted of 48 articles, indicates a rather strong consensus on the connection between dysfunctional parts of the frontal and temporal lobes and violent antisocial behavior and psychopathy. In future studies, it would be useful to focus on the limbic system and to investigate which parts of the frontal lobes and cerebral networks that are of interest in the psychopathic personality. Moreover, the reviewed material highlights some of the methodological difficulties in this area of research such as selection bias in the recruitment of patients, inadequate matching of control subjects, and sometimes incongruous results. In the future we hope that brain imaging can be used to map biological deviations in different offenders in order to try to learn more about the different mechanisms behind violent behaviors.

The neural basis of moral cognition: sentiments, concepts, and values

The human moral nature has perplexed laymen and academics for millennia. Recent developments in cognitive neuroscience are opening new venues for unveiling the complex psychological and neurobiological mechanisms underling human morality and its impairments. Here we review these lines of evidence and key topics of debate and explain why investigating the mechanisms of cognition-emotion interaction and of the neural bases of moral sentiments and values will be critical for our understanding of the human moral mind.

A magnetic resonance spectroscopy study of antisocial behaviour disorder, psychopathy and violent crime among military conscripts

BACKGROUND

Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods.

OBJECTIVES

In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy.

METHODS

All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy.

RESULTS

Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala-hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases.

CONCLUSION

As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

Structural brain abnormalities in psychopaths-a review

The biological basis of psychopathy has not yet been fully elucidated. Few studies deal with structural neuroimaging in psychopaths. The aim of this article is to review these studies in order to contribute to our understanding of the biological basis of psychopathy. Data in the literature report a reduction in prefrontal gray matter volume, gray matter loss in the right superior temporal gyrus, amygdala volume loss, a decrease in posterior hippocampal volume, an exaggerated structural hippocampal asymmetry, and an increase in callosal white matter volume in psychopathic individuals. These findings suggest that psychopathy is associated with brain abnormalities in a prefrontal-temporo-limbic circuit-i.e. regions that are involved, among others, in emotional and learning processes. Additionally, data indicate that psychopathic individuals cannot be seen as a homogeneous group. The associations between structural changes and psychopathic characteristics do not enable causal conclusions to be drawn, but point rather to the important role of biological brain abnormalities in psychopathy. To gain a comprehensive understanding of this, psychopathy must be viewed as a multifactorial process involving neurobiological, genetic, epidemiological and sociobiographical factors.

Psychopathy: theory, measurement, and treatment

The purpose of this article is to link empirical literature to the theoretical background of the concept of psychopathy and the impact that this has had on the development of treatment and intervention procedures for psychopathic offenders. This article begins with a discussion of the different theories of psychopathy, which leads into considerations of different developmental pathways of psychopathy in the individual. The discussion will then lead on to the psychometrics and measurement tools used to assess psychopathy in the individual. The measurement section will primarily be focused on Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The relationship between psychopathy and different types of crime is also discussed. The final section of the article considers the treatment and interventions that are available to psychopathic offenders and the implications this has for future research.

Bimodal distribution of violent assaults

The aim of the present study was to investigate the relationship between the number of injuries inflicted on victim during violent assault and other variables, characterizing the offender and the assault. The study is based on all the cases that were processed at the City Court of Tallinn, Estonia in 1986 and 1996. The number of assault-related injuries caused to the victim in Tallinn, Estonia, for 1986 and 1996 revealed bimodal distribution. About 2/3 of the assaults resulted in 1-5 injuries, in 1/3 of the cases the number of inflicted injuries was 10 or higher, with only a relatively small number of injuries in between. This distribution pattern was stable over the 10-year interval between the observations and was invariant to alcohol intoxication, consequences, and reasons for the assault. Comparison of the offenders' criminal record during the 15-year follow-up period showed that recidivism was more common among those who had committed a multi-injury assault as their first offence. The evident distribution of assaults into few- and multi-injury groups and the fact that the number of injuries caused during the first offence is a more reliable criterion for predicting the further criminal record of the offender than the consequences of the assault suggest that there are two discrete types of behaviour determined by a set of variables characteristic of the offender's psychology.

Neuroimaging in psychopathy

OBJECTIVE

The biological basis of psychopathy remains to be fully elucidated. Evidence suggests a genetic contribution and dysfunction of the serotonin system. The objective of this article is to review the contribution of the neuroimaging of the last decade to our understanding of psychopathy.

METHOD

A literature search was conducted using PubMed and the words psychopath, antisocial personality disorder, dissocial personality disorder, violence, image and imaging. In addition, the reference lists of the identified papers, and recent textbooks, were perused for additional sources.

RESULTS

Five structural and 15 functional neuroimaging studies were selected and examined. Structural studies have reported decreased prefrontal grey matter, decreased posterior hippocampal volume and increased callosal white matter, but to this point, these have not been replicated. Functional studies suggest reduced perfusion and metabolism in the frontal and temporal lobes. Abnormalities of function have been reported, predominantly in frontal and temporal lobe structures during classical conditioning and response inhibition tasks, and in the processing of emotional words and pictures.

CONCLUSION

Functional neuroimaging strongly suggests dysfunction of particular frontal and temporal lobe structures in psychopathy. However, there are difficulties in selecting homogeneous index cases and appropriate control groups. Further studies are necessary. Responses depend on genetic endowment, early life experience, the sociocultural context and the significance of any stimulus to the individual.

Neuroimaging and personality disorders

Within the past several years, neuroimaging research on personality disorders has begun to develop. Personality disorders can be thought of as trait-like dysfunctional patterns in cognitive, affective, impulse control, and interpersonal domains. These domains of dysfunction have been linked to specific neural circuits. Developments in brain imaging techniques have allowed researchers to examine the neural integrity of these circuits in personality-disordered individuals. This article reviews the neuroimaging literature on borderline personality disorder, antisocial personality disorder (including psychopathy) and schizotypal personality disorder. Functional and structural studies provide support for dysfunction in fronto-limbic circuits in borderline and antisocial personality disorder, whereas temporal lobe and basal striatal-thalamic compromise is evident in schizotypal personality disorder.