Brain processing of pictures of children in men with pedophilic disorder: A positron emission tomography study.

Although structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, the differences in the processing of child sexual stimuli between men attracted to children and those attracted to adults remain unclear. Here, our purpose was to identify through positron emission tomography the brain responses of 15 male outpatients with pedophilic disorder to validated visual sexual stimuli depicting children (VSSc) and to compare them with 15 male healthy controls matched for sexual orientation (to female or male adults), age, and handedness. The patients' sample comprised both offenders and non-offenders. In response to VSSc, the between-groups analysis showed that activation in the right inferior temporal cortex [Brodmann area (BA) 20] was lower in patients than in controls. Moreover, in patients but not in controls, the presentation of VSSc induced an activation in a more caudal region of the right inferior temporal gyrus (BA 37) and in the left middle occipital gyrus (BA 19). In addition, in patients the level of activation in the caudal right inferior temporal gyrus was positively correlated with ratings of sexual arousal elicited by VSSc, whereas this correlation was negative in BA 20. These results implicate the right inferior temporal gyrus as a possible candidate area mediating sexual arousal in patients with pedophilic disorder and suggest that two of its areas play opposite, i.e., activating and inhibitory, roles.

[Homosexual pedophilia and functional networks - An fMRI case report and literature review]. / Homosexuelle Pädophilie und funktionelle Netzwerke - fMRI-Fallstudie.

Pedophilia is a complex bio-psycho-social disorder often associated with serious offending. Knowledge about neurobiological correlates that could serve as diagnostic and maybe even as prognostic markers is limited. FMRI examination, which shows neuronal activation in vivo and therefore represents a neurobiological correlate, was not done in pedophilia so far. We report on results of an fMRI examination in a homosexual pedophilic sex offender who differed significantly in neuronal activation during exposure to arousing visual material (young boys in underwear) from normal controls. In self assessment on a visual analogous scale the pedophilic offender scored the pictures of the boys as not being interesting and sexually not stimulating. Nevertheless presentation of the pictures of the boys resulted in the pedophilic offender in a significant activation of the attention network and the right orbitofrontal cortex. In contrast to the controls there was no activation of left hemispheric areas relevant for speech. The study design will be continued in a larger sample to examine whether there is a possible neurobiological correlate of pedophilia which can be changed by therapeutic interventions.