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3 Ohio St. J. Crim. L. 341 (2005-2006)
Neuroanatomical Backgrown to Understanding the Brain of the Young Psychopath

handle is hein.journals/osjcl3 and id is 347 raw text is: Neuroanatomical Background to Understanding the Brain of the Young Psychopath James H. Fallon* The objective of this paper is to describe the basis of violent psychopathology from a neuroanatomical point of view. Although there is no universally accepted neurological cause of psychopathology, there are some basic patterns of brain malfunction that are present in a majority of cases. Most notably is the compromised functioning of the orbital prefrontal cortex and associated neural circuitry. Beyond this fundamental finding are considerations of how many types of psychopaths there are, how they are characterized, and what may be the potential contributing causes. These questions are approached from multiple levels of neuroanatomical analysis, including genetic, molecular, neurotransmitter, neuronal, cell cluster, and brain area levels, to entire circuit systems. These levels are then considered in light of prenatal, perinatal, and postnatal development and the timing of neuronal system damage in the life of the psychopathic individual. The mechanistic neuroscience approaches are discussed in terms of the relative contributions of nature (genetic/epigenetic/brain damage) and nurture (environmental). The following conclusions are offered. First, violent psychopathology in youth is associated with structural and functional damage to the orbital cortex and strongly interconnected ventral prefrontal system structures such as the ventromedial prefrontal cortex, ventral anterior cingulate, amygdala, and associated basal ganglia and cortico-subcortical loop circuits. Second, the timing of the injury or malfunctioning of this circuit determines the type of psychopathology manifested later in development, with a) prenatal (e.g., faulty neuronal migration, in utero endocrine toxicity) and perinatal damage occurring prior to two to three years of life associated with a psychopathology where the eventual child/adolescent/adult carries out inappropriately violent acts without knowing what they are doing is wrong, b) damage occurring after the second or third year of life up to about puberty associated with a psychopathology where the eventual childadolescent/adult carries out violent acts and knows what they are doing is wrong, but they cannot control the impulse to act, and c) damage occurring later in life where severe antisocial acts are carried out with full knowledge of the morality and consequences involved, but with a highly variable ability to inhibit the impulses at some point in time and circumstance. Third, there * Professor of Anatomy and Neurobiology, College of Medicine, University of California, Irvine, B.A., St. Michael's College, 1969, M.S. Psychology, Rensselaer Polytechnic Institute, 1972, Ph.D. Anatomy, University of Illinois, 1975, Postdoctoral, Neurosciences, University of California, San Diego, 1978.

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