Structural Deficits in the Frontotemporal Network Associated With Psychopathic Traits in Violent Offenders With Schizophrenia

Abstract

People with schizophrenia (SZ) are at increased risk of violence compared to the general population. However, the neural mechanisms of violent behavior in patients with SZ are still unclear due to the heterogeneity of the diseased population. In this study, we aimed to examine the neural correlates of violent behavior in SZ and to determine whether the structural deficits were related to psychopathic traits. A total of 113 participants, including 31 SZ patients with violent behavior (vSZ), 39 SZ patients without violent behavior (nvSZ), and 43 healthy controls (HC), completed the T1-weighted magnetic resonance imaging (MRI) scan and were analyzed using voxel-based morphometry approach. The psychopathic traits were assessed using the Psychopathy Checklist: Screening Version (PCL:SV). The results showed decreased gray matter volume (GMV) in the vSZ group in the right temporal lobe and bilateral inferior frontal gyri compared to HCs; while reduced GMV in the inferior parietal lobe, parahippocampal and orbital frontal gyri was found in the nvSZ group compared with HCs. Correlation analyses showed that psychopathic traits were negatively associated with the GMV in the right superior temporal and left fusiform gyri in the vSZ group, indicating that psychopathic traits, as reflected by the score of antisocial factor, might be related to structural deficits in the temporal lobe, which led to a propensity to violent behavior in patients with SZ. Our findings suggest that violent behavior in patients with SZ might have a personality background associated with the frontotemporal network aberrance. In future studies, we need to take a closer look at psychopathic traits for better understanding of the mechanism of interpersonal violence in patients with SZ and to explore whether the imaging findings from this study can serve as a biomarker to predict future violent behaviors and community living.

Prediction of violence in male schizophrenia using sMRI, based on machine learning algorithms

“…Structural magnetic resonance imaging (sMRI) as an easy access, high resolution, and non-invasive imaging technique has been widely used to understand the neurobiology of violence in SCZ. Recent sMRI studies have confirmed significant alterations in multiple cerebral regions, in particular frontal and temporal lobes, in SCZ patients with violence [ 14 – 17 ]. For example, a study of cortical morphology showed reduced cortical thickness within the precentral, parietal, temporal, and fusiform cortex in SCZ patients with a history of violence [ 18 ].…”

Brain structural alterations associated with impulsiveness in male violent patients with schizophrenia

“…The volume alteration in regions of VSC appeared to be associated with impulsiveness, indicating that poor impulse control might play an important role in the neurobiological basis of violence in SCZ. Compared to prior studies, the whole-brain approach was superior to the analysis of specific isolated regions in the identification of regions associated with violence, as the analysis of isolated regions could be insufficient to reveal the neurobiological underpinnings due to the complex phenotypes of violence [ 7 , 41 ]. In addition, all the participants with VSC in the present study were free of substance abuse and personality disorder, thus, it is reasonable to infer that the brain structural alterations of these participants might be related to violence [ 13 ].…”

“…Some other researchers found that patients with VSC had reduced GMV in the bilateral cerebellum, BA 39/40 [ 11 ], putamen, left cuneus/precuneus and parietal cortex [ 18 ], as well as decreased cortical thickness in sensorimotor regions [ 19 ], compared to those with NSC. However, some neuroimaging studies did not find any significant difference in the brain structure between the VSC and NSC [ 7 , 15 , 20 , 21 ]. Due to the disparities in current findings, the structural changes associated with violence in SCZ are still unclear, nor is its association with clinical risk factors in SCZ, which indicated the necessity to explore the neurobiological underpinning of violent behavior in individuals with SCZ.…”

Dr. Jekyll und Mr. Hyde – Ein Case Report?

“…Patienten, die an Schizophrenie leiden, haben ein erhöhtes Risiko, Gewalt gegen andere auszuüben und sind für etwa 10 % aller Tötungsdelikte verantwortlich 5 .…”