Psychopathy is one of the greatest risk factors for serious and persistent violence. In order to detect its neurobiological substrates, we examined 39 male psychopathic subjects and matched controls using structural MR imaging and the Psychopathy Check-List (PCL-R). Individual brain region volumes were calculated using the Julich-Brain and AAL3 atlases. Associations of region volumes with the PCL-R dimensions among psychopathic subjects and differences between both groups were analysed. PCL-R factor 2 assessing lifestyle and antisocial behaviour showed in the psychopathic sample negative associations with volumes of several regions, including pons, nuclei of basal ganglia, thalamus, basal forebrain (CH-4), cerebellar regions and areas in orbitofrontal, dorsolateral-frontal and insular cortices. These findings suggest dysfunctions in specific frontal-subcortical circuits, which are known to be relevant for behavioral control. In contrast, the interpersonal-affective PCL-R factor 1 showed only weak positive and negative associations with orbitofrontal, dorsolateral-frontal and left hippocampal areas (CA1, subiculum), among others, indicating that involved brain regions might be affected to a variable degree in different individuals. The group comparison yielded a significantly reduced total brain volume in psychopathic subjects relative to controls, while pronounced regional focuses of volume differences were found only in the right subiculum, suggesting an interindividually variable pattern of structural deviations in the brains of psychopathic subjects. In conclusion, these findings are compatible with the dimensionality of the PCL-R construct, and suggest a particulary strong association of antisocial behavior to smaller volumes in widespread subcortical-cortical brain regions.
