Schiltz Kolja, Witzel Joachim, Northoff Georg, Zierhut Kathrin, Gubka Udo, Fellmann Hermann, Kaufmann Jörn, Tempelmann Claus, Wiebking Christine, Bogerts Bernhard
Department of Psychiatry, Otto von Guericke University, Magdeburg, Saxony-Anhalt 39120, Germany.
Arch Gen Psychiatry. 2007 Jun;64(6):737-46. doi: 10.1001/archpsyc.64.6.737.
Pedophilic crime causes considerable public concern, but no causative factor of pedophilia has yet been pinpointed. In the past, etiological theories postulated a major impact of the environment, but recent studies increasingly emphasize the role of neurobiological factors, as well. However, the role of alterations in brain structures that are crucial in the development of sexual behavior has not yet been systematically studied in pedophilic subjects.
To examine whether pedophilic perpetrators show structural neuronal deficits in brain regions that are critical for sexual behavior and how these deficits relate to criminological characteristics.
Amygdalar volume and gray matter of related structures that are critical for sexual development were compared in 15 nonviolent male pedophilic perpetrators (forensic inpatients) and 15 controls using complementary morphometric analyses (voxel-based morphometry and volumetry). Psychosocial adjustment and sexual offenses were also assessed.
Pedophilic perpetrators showed a significant decrease of right amygdalar volume, compared with healthy controls (P = .001). We observed reduced gray matter in the right amygdala, hypothalamus (bilaterally), septal regions, substantia innominata, and bed nucleus of the striae terminalis. In 8 of the 15 perpetrators, enlargement of the anterior temporal horn of the right lateral ventricle that adjoins the amygdala could be recognized by routine qualitative clinical assessment. Smaller right amygdalar volumes were correlated with the propensity to commit uniform pedophilic sexual offenses exclusively (P = .006) but not with age (P = .89).
Pedophilic perpetrators show structural impairments of brain regions critical for sexual development. These impairments are not related to age, and their extent predicts how focused the scope of sexual offenses is on uniform pedophilic activity. Subtle defects of the right amygdala and closely related structures might be implicated in the pathogenesis of pedophilia and might possibly reflect developmental disturbances or environmental insults at critical periods.
恋童癖犯罪引起了公众的广泛关注，但恋童癖的致病因素尚未明确。过去，病因理论假定环境有重大影响，但最近的研究也越来越强调神经生物学因素的作用。然而，在恋童癖患者中，对性行为发展至关重要的脑结构改变的作用尚未得到系统研究。
研究恋童癖犯罪者在对性行为至关重要的脑区是否存在结构性神经元缺陷，以及这些缺陷与犯罪学特征的关系。
使用互补形态学分析（基于体素的形态学测量和体积测量），比较15名非暴力男性恋童癖犯罪者（法医住院患者）和15名对照者中对性发育至关重要的杏仁核体积和相关结构的灰质。还评估了心理社会适应情况和性犯罪情况。
与健康对照组相比，恋童癖犯罪者右侧杏仁核体积显著减小（P = 0.001）。我们观察到右侧杏仁核、下丘脑（双侧）、隔区、无名质和终纹床核的灰质减少。在15名犯罪者中的8名中，通过常规定性临床评估可识别出与杏仁核相邻的右侧侧脑室前角扩大。较小的右侧杏仁核体积仅与单纯实施统一恋童癖性犯罪的倾向相关（P = 0.006），与年龄无关（P = 0.89）。
恋童癖犯罪者在对性发育至关重要的脑区存在结构损伤。这些损伤与年龄无关，其程度可预测性犯罪的范围集中在统一恋童癖活动上的程度。右侧杏仁核和密切相关结构的细微缺陷可能与恋童癖的发病机制有关，可能反映关键时期的发育障碍或环境损伤。
