Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232;
Berenson-Allen Center for Non-Invasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.
Proc Natl Acad Sci U S A. 2018 Jan 16;115(3):601-606. doi: 10.1073/pnas.1706587115. Epub 2017 Dec 18.
Following brain lesions, previously normal patients sometimes exhibit criminal behavior. Although rare, these cases can lend unique insight into the neurobiological substrate of criminality. Here we present a systematic mapping of lesions with known temporal association to criminal behavior, identifying 17 lesion cases. The lesion sites were spatially heterogeneous, including the medial prefrontal cortex, orbitofrontal cortex, and different locations within the bilateral temporal lobes. No single brain region was damaged in all cases. Because lesion-induced symptoms can come from sites connected to the lesion location and not just the lesion location itself, we also identified brain regions functionally connected to each lesion location. This technique, termed lesion network mapping, has recently identified regions involved in symptom generation across a variety of lesion-induced disorders. All lesions were functionally connected to the same network of brain regions. This criminality-associated connectivity pattern was unique compared with lesions causing four other neuropsychiatric syndromes. This network includes regions involved in morality, value-based decision making, and theory of mind, but not regions involved in cognitive control or empathy. Finally, we replicated our results in a separate cohort of 23 cases in which a temporal relationship between brain lesions and criminal behavior was implied but not definitive. Our results suggest that lesions in criminals occur in different brain locations but localize to a unique resting state network, providing insight into the neurobiology of criminal behavior.
脑损伤后，先前正常的患者有时会表现出犯罪行为。虽然罕见，但这些病例可以为犯罪行为的神经生物学基础提供独特的见解。在这里，我们系统地绘制了与犯罪行为有明确时间关联的病变位置，确定了 17 个病变病例。病变部位的空间分布不均，包括内侧前额叶皮层、眶额皮层和双侧颞叶的不同位置。并非所有病例都有单一的脑区受损。由于病变引起的症状可能来自与病变部位相连的部位，而不仅仅是病变部位本身，我们还确定了与每个病变部位功能相连的脑区。这种技术称为病变网络映射，最近已经确定了涉及各种病变引起的疾病症状产生的区域。所有病变都与相同的大脑区域网络功能相连。与导致其他四种神经精神综合征的病变相比，这种与犯罪行为相关的连接模式是独特的。该网络包括涉及道德、基于价值的决策和心理理论的区域，但不包括涉及认知控制或同理心的区域。最后，我们在一个单独的包含 23 例病例的队列中复制了我们的结果，这些病例暗示了脑损伤与犯罪行为之间存在时间关系，但并非明确。我们的结果表明，罪犯的病变发生在不同的脑区，但定位于一个独特的静息状态网络，为犯罪行为的神经生物学提供了见解。
