title: Brain alterations in paedophilia: a critical review.
abstract: Psychosocial and biological factors have been implicated in paedophilia, such as alterations in brain structure and function. The purpose of this paper is to review the expanding body of literature on this topic including brain abnormality case reports, as well as structural and functional neuroimaging studies. Case studies of men who have committed sexual offences against children implicate frontal and temporal abnormalities that may be associated with impaired impulse inhibition. Structural neuroimaging investigations show volume reductions in paedophilic men. Although the findings have been heterogeneous, smaller amygdala volume has been replicated repeatedly. Functional neuroimaging investigations demonstrate an overlap between paedophiles and teleiophiles during sexual arousal processing. While it is controversial among studies regarding group differences, reliable discrimination between paedophilic and teleiophilic men may be achieved using functional activation patterns. Nevertheless, the heterogeneous findings published so far suggest further research is necessary to disentangle the neurobiological mechanisms of paedophilic preference. A number of methodological confounds have been identified, which may account for the inconsistent results that could prove to be beneficial for future investigations.
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: sebastian.mohnke@charite.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mohnke
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: mueller.sabine@charite.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Müller
authors.affiliation: Charité - Universitätsmedizin Berlin, Institute of Sexology and Sexual Medicine, Luisenstr. 57, 10117 Berlin, Germany. Electronic address: till.amelung@charite.de.
authors.forename: Till
authors.initials: T
authors.lastname: Amelung
authors.affiliation: Hannover Medical School, Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: krueger.tillmann@mh-hannover.de.
authors.forename: Tillmann H C
authors.initials: TH
authors.lastname: Krüger
authors.affiliation: University Medical Center Schleswig-Holstein, Section for Sexual Medicine, Arnold-Heller-Str. 3, 24105 Kiel, Germany. Electronic address: ponseti@sexmed.uni-kiel.de.
authors.forename: Jorge
authors.initials: J
authors.lastname: Ponseti
authors.affiliation: Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Bochum, Germany. Electronic address: boris.schiffer@uni-due.de.
authors.forename: Boris
authors.initials: B
authors.lastname: Schiffer
authors.affiliation: Otto-von-Guericke-University Magdeburg, Department of Psychiatry, Leipziger Str. 44, 39120 Magdeburg, Germany. Electronic address: martin.walter@med.ovgu.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Walter
authors.affiliation: Charité - Universitätsmedizin Berlin, Institute of Sexology and Sexual Medicine, Luisenstr. 57, 10117 Berlin, Germany. Electronic address: klaus.beier@charite.de.
authors.forename: Klaus M
authors.initials: KM
authors.lastname: Beier
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: henrik.walter@charite.de.
authors.forename: Henrik
authors.initials: H
authors.lastname: Walter
mesh_terms: D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D010378:Pedophilia / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*
keywords: Brain pathology; Child sexual abuse; Magnetic resonance imaging; Sexual arousal; Sexual offending