Department of General Psychology, University of Padova, Via Venezia 8, 25131, Padova, PD, Italy.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Brain Imaging Behav. 2021 Oct;15(5):2681-2692. doi: 10.1007/s11682-020-00442-z. Epub 2021 Jan 28.
Pedophilia is a disorder of public concern because of its association with child sexual offense and recidivism. Previous neuroimaging studies of potential brain abnormalities underlying pedophilic behavior, either in idiopathic or acquired (i.e., emerging following brain damages) pedophilia, led to inconsistent results. This study sought to explore the neural underpinnings of pedophilic behavior and to determine the extent to which brain alterations may be related to distinct psychopathological features in pedophilia. To this aim, we run a coordinate based meta-analysis on previously published papers reporting whole brain analysis and a lesion network analysis, using brain lesions as seeds in a resting state connectivity analysis. The behavioral profiling approach was applied to link identified regions with the corresponding psychological processes. While no consistent neuroanatomical alterations were identified in idiopathic pedophilia, the current results support that all the lesions causing acquired pedophilia are localized within a shared resting state network that included posterior midlines structures, right inferior temporal gyrus and bilateral orbitofrontal cortex. These regions are associated with action inhibition and social cognition, abilities that are consistently and severely impaired in acquired pedophiles. This study suggests that idiopathic and acquired pedophilia may be two distinct disorders, in line with their distinctive clinical features, including age of onset, reversibility and modus operandi. Understanding the neurobiological underpinnings of pedophilic behavior may contribute to a more comprehensive characterization of these individuals on a clinical ground, a pivotal step forward for the development of more efficient therapeutic rehabilitation strategies.
恋童癖是一个公众关注的问题，因为它与儿童性犯罪和累犯有关。以前对潜在的恋童癖行为的神经影像学研究，无论是特发性的还是获得性的（即脑损伤后出现的），都得出了不一致的结果。这项研究旨在探索恋童癖行为的神经基础，并确定大脑改变与恋童癖的不同心理病理特征之间的关系程度。为此，我们对以前发表的报告全脑分析和病变网络分析的论文进行了基于坐标的荟萃分析，使用病变作为静息状态连接分析的种子。行为分析方法被用来将确定的区域与相应的心理过程联系起来。虽然在特发性恋童癖中没有发现一致的神经解剖学改变，但目前的结果支持所有导致获得性恋童癖的病变都位于一个共享的静息状态网络内，该网络包括后中线结构、右侧下颞叶和双侧眶额皮层。这些区域与动作抑制和社会认知有关，而获得性恋童癖者的这些能力一直受到严重损害。这项研究表明，特发性和获得性恋童癖可能是两种不同的障碍，与它们独特的临床特征一致，包括发病年龄、可逆性和作用方式。了解恋童癖行为的神经生物学基础可能有助于更全面地描述这些个体的临床特征，这是开发更有效的治疗康复策略的关键一步。
