Abnormal Ventromedial Prefrontal Cortex Function in Children With Psychopathic Traits During Reversal Learning

Abstract

To our knowledge, this study provides the first evidence of abnormal ventromedial prefrontal cortex responsiveness in children with psychopathic traits and demonstrates this dysfunction was not attributable to comorbid attention-deficit/hyperactivity disorder. These findings suggest that reversal learning impairments in patients with developmental psychopathic traits relate to abnormal processing of reinforcement information.

Punishment and psychopathy: a case-control functional MRI investigation of reinforcement learning in violent antisocial personality disordered men

“…32 The fi ndings from this study support the proposition that the representation of reinforcement value is profoundly disturbed in adult men with psychopathy (panel). 33 Thus, in adolescents 21 and adults, rather than psychpathic traits being associated with decreases in activity within reinforcement-sensitive regions after unexpected punish ment, signifi cantly greater activation within these regions was seen in response to punished trials. This result challenges the notion that individuals with psychopathy are simply insensitive to subjective value, prediction errors, or both.…”

“…12,24 In this study, however, we noted no behavioural defi cits, which is consistent with results of the fMRI investigation with the same task in adolescents with conduct disorder and callous unemotional traits. 21 In these two fMRI studies, abnormal activations were seen in brain regions signalling prediction errors. Adolescents with conduct disorder and callous unemotional traits showed greater activity within the ventromedial prefrontal cortex to punished reversal errors than did healthy adolescent controls.…”

“…Adolescents with conduct disorder and callous unemotional traits showed greater activity within the ventromedial prefrontal cortex to punished reversal errors than did healthy adolescent controls. 21 Off enders with antisocial personality disorder and psychopathy, unlike those without psychopathy and non-off enders, showed signifi cantly greater activation within the posterior cingulate cortex to punished reversal errors. Consistent with previous fi ndings in healthy adults, reduced BOLD responses within the posterior cingulate to punished reversal errors compared with those for rewarded correct responses were seen in the off enders with antisocial personality disorder but not psycho pathy and in the non-off enders.…”

“…The ventromedial prefrontal cortex, posterior cingulate cortex, and dorsal caudate track changes in reinforcement information, reducing activation in response to punishment, thus signalling behavioural error, change in reinforcement contingency (when reward is expected but punishment received), and the need to adapt behaviour. 20,21 Little is known about the neural systems serving reinforcement learning anomalies in off enders with antisocial personality disorder with and without psychopathy. Offl ine versions of probabilistic response reversal tasks are self-paced, which means that intervals between the stimulus presentation, response, and feedback vary across trials.…”

“…This change lessens task diffi culty and the likelihood of confounding introduced by large diff erences in performance, such as diff erential contamination by error events. 22 The scanner version of the task has been used to assess adolescents with conduct disorder and callous unemotional traits, 21 which are the childhood antecedents of antisocial personality disorder with psychopathy. 5 Compared with healthy teenagers, adolescents who have conduct disorder with callous unemotional traits showed intact recruitment of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, and inferior frontal cortices when changing their behaviour in response to punishment signals, but did not appropriately reduce activation of the ventromedial prefrontal cortex.…”