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神经科患者反社会行为的网络定位:证据与影响。

Network localization of antisocial behavior in neurological patients: Evidence and implications.

机构信息

Department of Neurology, Division of Behavioral Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.

出版信息

Handb Clin Neurol. 2023;197:45-54. doi: 10.1016/B978-0-12-821375-9.00009-8.

Abstract

Antisocial behavior may develop in otherwise normal persons as a result of neurological diseases, including patients with focal brain lesions, frontotemporal dementia, and Parkinson Disease patients taking dopamine agonist medications. Evidence from these neurological patients demonstrates that antisocial behaviors relate to dysfunction in several different brain regions that form a specific brain network, rather than any single location alone. This network associated with acquired antisocial behavior is involved in social decision-making (measured using moral decision-making tasks) and value-based decision-making (measured using neuroeconomic and reward-based tasks). Collectively, this work supports the hypothesis that antisocial behavior across different neurological diseases results from dysfunction within a common network of brain regions associated with social valuation and decision-making, providing insight into the neural mechanisms leading to acquired antisocial behavior. These findings have important implications, but also important limitations, for understanding criminal behavior in patients with psychopathy, for rehabilitation in criminals, for ethical discussions regarding moral and legal responsibility, and for forensic neurological evaluations in persons accused of crimes.

摘要

反社会行为可能在其他正常人群中发展,作为一种结果的神经疾病,包括患者与局灶性脑病变,额颞叶痴呆,和帕金森病患者服用多巴胺激动剂药物。来自这些神经患者的证据表明,反社会行为与几个不同的大脑区域的功能障碍相关联,形成了一个特定的脑网络,而不是任何一个单独的位置。这个网络与后天的反社会行为相关联,涉及到社会决策(使用道德决策任务来衡量)和基于价值的决策(使用神经经济学和基于奖励的任务来衡量)。总的来说,这项工作支持了这样一种假设,即不同神经疾病中的反社会行为是由于与社会价值和决策相关的共同脑区网络内的功能障碍所致,为导致后天反社会行为的神经机制提供了深入的了解。这些发现对理解精神病患者的犯罪行为、罪犯的康复、关于道德和法律责任的伦理讨论以及被控犯罪的人的法医神经评估都具有重要意义,但也存在重要的局限性。

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