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The contribution of brain imaging to the understanding of psychopathy

Published online by Cambridge University Press:  12 September 2018

Jesus Pujol*
MRI Research Unit, Department of Radiology, Hospital del Mar, CIBERSAM G21, Barcelona, Spain
Ben J. Harrison
Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia
Oren Contreras-Rodriguez
Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, CIBERSAM G17, Barcelona, Spain
Narcis Cardoner
Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
Author for correspondence: Jesus Pujol, E-mail:


Psychopathy is a personality type characterized by both callous emotional dysfunction and deviant behavior that affects society in the form of actions that harm others. Historically, researchers have been concerned with seeking data and arguments to support a neurobiological foundation of psychopathy. In the past few years, increasing research has begun to reveal brain alterations putatively underlying the enigmatic psychopathic personality. In this review, we describe the brain anatomical and functional features that characterize psychopathy from a synthesis of available neuroimaging research and discuss how such brain anomalies may account for psychopathic behavior. The results are consistent in showing anatomical alterations involving primarily a ventral system connecting the anterior temporal lobe to anterior and ventral frontal areas, and a dorsal system connecting the medial frontal lobe to the posterior cingulate cortex/precuneus complex and, in turn, to medial structures of the temporal lobe. Functional imaging data indicate that relevant emotional flow breakdown may occur in both these brain systems and suggest specific mechanisms via which emotion is anomalously integrated into cognition in psychopathic individuals during moral challenge. Directions for future research are delineated emphasizing, for instance, the relevance of further establishing the contribution of early life stress to a learned blockage of emotional self-exposure, and the potential role of androgenic hormones in the development of cortical anomalies.

Review Article
Copyright © Cambridge University Press 2018 

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