title: Gray matter abnormalities in patients with narcissistic personality disorder.
abstract: BACKGROUND
  Despite the relevance of narcissistic personality disorder (NPD) in clinical settings, there is currently no empirical data available regarding the neurobiological correlates of NPD. In the present study, we performed a voxel-based morphometric analysis to provide initial insight into local abnormalities of gray matter (GM) volume.
  
  
  METHODS
  Structural brain images were obtained from patients with NPD (n = 17) and a sample of healthy controls (n = 17) matched regarding age, gender, handedness, and intelligence. Groups were compared with regard to global brain tissue volumes and local abnormalities of GM volume. Regions-of-interest analyses were calculated for the anterior insula.
  
  
  RESULTS
  Relative to the control group, NPD patients had smaller GM volume in the left anterior insula. Independent of group, GM volume in the left anterior insula was positively related to self-reported emotional empathy. Complementary whole-brain analyses yielded smaller GM volume in fronto-paralimbic brain regions comprising the rostral and median cingulate cortex as well as dorsolateral and medial parts of the prefrontal cortex.
  
  
  CONCLUSIONS
  Here we provide the first empirical evidence for structural abnormalities in fronto-paralimbic brain regions of patients with NPD. The results are discussed in the context of NPD patients' restricted ability for emotional empathy.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Schulze
authors.forename: Isabel
authors.initials: I
authors.lastname: Dziobek
authors.forename: Aline
authors.initials: A
authors.lastname: Vater
authors.forename: Hauke R
authors.initials: HR
authors.lastname: Heekeren
authors.forename: Malek
authors.initials: M
authors.lastname: Bajbouj
authors.forename: Babette
authors.initials: B
authors.lastname: Renneberg
authors.forename: Isabella
authors.initials: I
authors.lastname: Heuser
authors.forename: Stefan
authors.initials: S
authors.lastname: Roepke
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000473:pathology*
keywords: Anterior insula; Brain imaging; Empathy; Narcissistic personality disorder; Voxel-based morphometry