The Functional Role of the Prefrontal Cortex in Antisocial Personality Disorder

Sammanfattning: Patients with antisocial personality disorder (ASPD) are deceptive, apathetic, and impulsive. Their social behavior is often inappropriate, and they fail to follow social norms, leading to frequent criminal behavior. Understanding the neural correlates of ASPD could alleviate issues for the patients, such as unstable living conditions, as well as financial costs for the justice system and society. Due to previous research and theoretical implications of the prefrontal cortex (PFC) and its role in emotion-regulation and decision-making, it is likely that ASPD patients would show differences in the PFC relative to healthy individuals. Therefore, emphasis is placed on this region. By systematically reviewing articles which used fMRI to examine ASPD patients, this paper aims to understand if the brain activity in the PFC or functional connectivity within these regions differs between ASPD patients and healthy controls. Decreased activity was found in the anterior cingulate cortex (ACC) and dorsolateral PFC (dlPFC) in ASPD patients compared to healthy controls. Further, decreased functional connectivity was found in the frontoparietal control network, default modenetwork, and attentional network. Other prefrontal regions implicated include the medial frontal cortex, orbitofrontal cortex, and medial prefrontal cortex. Most of these regions are important for cognitive control, enabling integration of information regarding, e.g., errors and conflict. Abnormal processing of such information can lead to the impulsive or inappropriate actions often seen in ASPD patients. The PFC seems to play an important functional role in ASPD, mainly the regions responsible for cognitive control, such as the ACC and dlPFC.