Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Department of Forensic Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland.
Mol Psychiatry. 2019 Mar;24(3):463-470. doi: 10.1038/s41380-018-0122-5. Epub 2018 Jul 23.
Psychopathy is a disorder of high public concern because it predicts violence and offense recidivism. Recent brain imaging studies suggest abnormal brain activity underlying psychopathic behavior. No reliable pattern of altered neural activity has been disclosed so far. This study sought to identify consistent changes of brain activity in psychopaths and to investigate whether these could explain known psychopathology. First, we used activation likelihood estimation (p < 0.05, corrected) to meta-analyze brain activation changes associated with psychopathy across 28 functional magnetic resonance imaging studies reporting 753 foci from 155 experiments. Second, we characterized the ensuing regions functionally by employing metadata of a large-scale neuroimaging database (p < 0.05, corrected). Psychopathy was consistently associated with decreased brain activity in the right laterobasal amygdala, the dorsomedial prefrontal cortex, and bilaterally in the lateral prefrontal cortex. A robust increase of activity was observed in the fronto-insular cortex on both hemispheres. Data-driven functional characterization revealed associations with semantic language processing (left lateral prefrontal and fronto-insular cortex), action execution and pain processing (right lateral prefrontal and left fronto-insular), social cognition (dorsomedial prefrontal cortex), and emotional as well as cognitive reward processing (right amygdala and fronto-insular cortex). Aberrant brain activity related to psychopathy is located in prefrontal, insular, and limbic regions. Physiological mental functions fulfilled by these brain regions correspond to disturbed behavioral patterns pathognomonic for psychopathy. Hence, aberrant brain activity may not just be an epiphenomenon of psychopathy but directly related to the psychopathology of this disorder.
精神变态是一种公众高度关注的疾病，因为它预示着暴力和犯罪复发。最近的脑成像研究表明，精神变态行为的基础是大脑活动异常。到目前为止，还没有揭示出可靠的神经活动改变模式。这项研究旨在确定精神变态者大脑活动的一致变化，并研究这些变化是否可以解释已知的精神病理学。首先，我们使用激活似然估计（p < 0.05，校正）对 28 项功能磁共振成像研究进行荟萃分析，这些研究报告了 155 项实验中的 753 个焦点，与精神变态相关的大脑激活变化。其次，我们通过使用大型神经影像学数据库的元数据来描述随后的功能区域（p < 0.05，校正）。精神变态与右侧基底外侧杏仁核、背内侧前额叶皮质和双侧外侧前额叶皮质的大脑活动减少一致相关。在两个半球的额岛皮质观察到活性的显著增加。数据驱动的功能特征显示与语义语言处理（左侧外侧前额叶和额岛皮质）、动作执行和疼痛处理（右侧外侧前额叶和左侧额岛皮质）、社会认知（背内侧前额叶皮质）以及情感和认知奖励处理（右侧杏仁核和额岛皮质）有关。与精神变态相关的大脑活动异常位于前额叶、岛叶和边缘区域。这些脑区所实现的生理心理功能与精神变态的典型行为障碍模式相吻合。因此，异常的大脑活动可能不仅仅是精神变态的一个表象，而是与这种疾病的精神病理学直接相关。
