olume Reduction in Prefrontal Gray Matter in nsuccessful Criminal Psychopaths

ackground: Although studies of neurologic patients have suggested that prefrontal structural impairments may predispose to ociopathy, it is unknown whether there is a relationship between psychopathy and prefrontal volume in individuals from the ommunity and whether any prefrontal structural impairment is specific to “unsuccessful” (caught) psychopaths as opposed to successful” (uncaught) psychopaths. This study tests the hypothesis that psychopathy is associated with a reduction in prefrontal gray olume but that this abnormality is specific to unsuccessful psychopaths. ethod: Prefrontal gray and white matter volumes were assessed using structural magnetic resonance imaging (MRI) in 16 nsuccessful psychopaths, 13 successful psychopaths, and 23 control subjects. esults: Higher total as well as subfactor psychopathy scores (arrogant/deceptive, affective, and impulsive/unstable) were all ssociated with low prefrontal gray volume. Unsuccessful psychopaths, but not successful psychopaths, had a 22.3% reduction in refrontal gray matter volume compared with control subjects. onclusions: These results demonstrating for the first time a prefrontal structural deficit in community psychopaths provide partial upport for a prefrontal theory of psychopathy but highlight an important difference between successful and unsuccessful psychopaths.