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Cazala F, Fonteille V, Moulier V, Pélégrini-Issac M, De Beaurepaire C, Abondo M, Bodon-Bruzel M, Cano J, Cochez F, Fouli T, Thevenon C, Dauba B, Pugeat M, Stoléru S. Brain responses to pictures of children in men with pedophilic disorder: a functional magnetic resonance imaging study. Eur Arch Psychiatry Clin Neurosci 2019; 269:713-729. [PMID: 30094544 DOI: 10.1007/s00406-018-0933-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
Structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, and have reported many contradictory or non-replicated findings. Here, our purpose was to identify through functional magnetic resonance imaging the brain responses of 25 male outpatients with pedophilic disorder to visual stimuli depicting children (VSc) and to compare them with 24 male healthy controls matched on sexual orientation (to female or male adults), age, and handedness. No region was differentially activated across the two groups in response to VSc. However, as shown by a random-effects statistical analysis (cluster-level pFWE-corrected < 0.05), in patients with pedophilia, but not in controls, the presentation of VSc induced a bilateral activation in the lateral occipital and temporal cortices, in particular in the right inferior temporal gyrus, as well as an activation in the declive of the cerebellar vermis. In addition, in patients the level of bilateral activation in the above-mentioned regions was positively correlated with ratings of perceived sexual arousal elicited by VSc. These results implicate these regions as possible candidate areas mediating sexual arousal in patients with pedophilic disorder.
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Affiliation(s)
- Fadwa Cazala
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France
| | - Véronique Fonteille
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Centre Hospitalo-Universitaire et Université de Saint-Etienne, Saint-Etienne, France
| | - Virginie Moulier
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Mélanie Pélégrini-Issac
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB) Paris, Paris, France
| | | | - Marlène Abondo
- Antenne Rennaise du Centre de Ressources Régional sur les Auteurs de Violences Sexuelles de Bretagne, CHU Pontchaillou, Rennes, France
| | | | - Jean Cano
- CHRU de Tours, Hôpital Trousseau, Tours, France.,ERIOS-CRIAVS Aquitaine, Centre Hospitalier Charles-Perrens, Bordeaux, France
| | | | - Taoufik Fouli
- Département Santé-Justice du Centre Hospitalier Esquirol, Limoges, France
| | | | - Bernard Dauba
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France.,AP-HP, Centre d'Investigation Clinique-1421, Pitié-Salpêtrière University Hospital, Paris, France
| | - Michel Pugeat
- Université Claude Bernard Lyon 1, INSERM U1060 and Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, France
| | - Serge Stoléru
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France. .,Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France. .,Institut du Cerveau et de la Moelle épinière, Sorbonne Université, CNRS, INSERM, Centre de neuroimagerie de recherche (CENIR), Paris, France.
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Abstract
Psychologists and a psychiatrist testify to the clinical condition of people sentenced to socio-judicial supervision with court-ordered therapy. Despite the extension of the indication of the programme, this complex supervision often concerns the perpetrators of intra and/or extra familial sexual abuse. Preventing reoffending through the global treatment of the patient is a major concern both for the doctor-coordinators as well as the doctor and psychologists delivering the therapy.
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Affiliation(s)
- Florent Cochez
- Centre de ressources pour les intervenants auprès des auteurs de violences sexuelles d'Aquitaine, Erios, centre hospitalier Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux Cedex, France; Institut psycho-judiciaire, centre hospitalier de Cadillac, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France
| | - Mélanie Lesueur
- Institut psycho-judiciaire, centre hospitalier de Cadillac, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France; Unité hospitalière spécialement aménagée, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France
| | - Marie Fayet
- Institut psycho-judiciaire, centre hospitalier de Cadillac, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France; CRIAVS Rhône-Alpes Grenoble, protection judiciaire de la jeunesse, unité éducative d'accueil de jour, 9, place Victor-Hugo, 38026 Grenoble, France
| | - Jean-Pierre Bouchard
- Unité pour malades difficiles, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France; Unité de soins intensifs psychiatriques, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France; Institut psycho-judiciaire, centre hospitalier de Cadillac, 89, rue Cazeaux-Cazalet, 33410 Cadillac-sur-Garonne, France.
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