An orbitofrontostriatopallidal pathway for morality: evidence from postlesion antisocial and obsessive-compulsive disorder.

ABSTRACT

INTRODUCTION: A detailed proposal is made to the effect that nonlesional antisocial personality disorder (APD) is, among other things, a dysfunctional hypomoralism and that nonlesional obsessive-compulsive disorder (OCD) is, among other things, a dysfunctional hypermoralism. METHOD: To provide an empirical test of this proposal, 25 previously published cases of acquired (post lesion) APD and 39 cases of acquired OCD are reviewed and compared with multivariate inference tests. RESULTS: The acquired APD patients most often present putamenal or pallidal lesions. CONCLUSION: The ensemble of neurobiological, endocrine, and behavioural traits in APD and OCD, as well as the distinct lesion sites in the acquired variants, support the notion of an orbitofrontostriatopallidal brain system underlying morality.