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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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