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A view behind the mask of sanity: meta-analysis of aberrant brain activity in psychopaths

Molecular Psychiatry volume 24, pages 463–470 (2019)Cite this article

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Abstract

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.

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Acknowledgements

PTF is supported by the National Institute of Mental Health (R01-MH074457). DB is funded by the Deutsche Forschungsgemeinschaft (DFG, BZ2/2-1, BZ2/3-1, and BZ2/4-1; International Research Training Group IRTG2150), Amazon AWS Research Grant, the German National Academic Foundation, and the START-Program of the Faculty of Medicine, RWTH Aachen. SBE is supported by the Deutsche Forschungsgemeinschaft (DFG, EI 816/4-1, EI 816/6-1), the National Institute of Mental Health (R01-MH074457), the Helmholtz Portfolio Theme “Supercomputing and Modeling for the Human Brain,” and the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement No. 7202070 (HBP SGA1).

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany

    Timm B. Poeppl, Maximilian R. Donges, Rainer Rupprecht & Berthold Langguth

  2. Department of Forensic Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland

    Andreas Mokros

  3. Department of Psychology, FernUniversität in Hagen (University of Hagen), Hagen, Germany

    Andreas Mokros

  4. Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA

    Peter T. Fox

  5. South Texas Veterans Healthcare System, San Antonio, TX, USA

    Peter T. Fox

  6. Department of Physics, Florida International University, Miami, FL, USA

    Angela R. Laird

  7. Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany

    Danilo Bzdok

  8. JARA Brain, Jülich Aachen Research Alliance, Jülich, Germany

    Danilo Bzdok

  9. Parietal team, INRIA, Neurospin, Gif-sur-Yvette, France

    Danilo Bzdok

  10. Research Centre Jülich, Institute of Neuroscience and Medicine (INM-7), Jülich, Germany

    Simon B. Eickhoff

  11. Institute for Systems Neuroscience, Heinrich Heine University, Düsseldorf, Germany

    Simon B. Eickhoff

Authors
  1. Timm B. Poeppl
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Correspondence to Timm B. Poeppl.

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Poeppl, T.B., Donges, M.R., Mokros, A. et al. A view behind the mask of sanity: meta-analysis of aberrant brain activity in psychopaths. Mol Psychiatry 24, 463–470 (2019). https://doi.org/10.1038/s41380-018-0122-5

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