Expectation of sexual images of adults and children elicits differential dorsal anterior cingulate cortex activation in pedophilic sexual offenders and healthy controls

Inka Ristow; Jens Foell; Christian Kärgel; Viola Borchardt; Shijia Li; Dominik Denzel; Joachim Witzel; Krasimira Drumkova; Klaus Beier; Tillmann H.C. Kruger; Jorge Ponseti; Boris Schiffer; Kolja Schiltz; Henrik Walter; Martin Walter

NeuroImage: Clinical (Jan 2019)

Expectation of sexual images of adults and children elicits differential dorsal anterior cingulate cortex activation in pedophilic sexual offenders and healthy controls

Inka Ristow,
Jens Foell,
Christian Kärgel,
Viola Borchardt,
Shijia Li,
Dominik Denzel,
Joachim Witzel,
Krasimira Drumkova,
Klaus Beier,
Tillmann H.C. Kruger,
Jorge Ponseti,
Boris Schiffer,
Kolja Schiltz,
Henrik Walter,
Martin Walter

Affiliations

Inka Ristow: Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany
Jens Foell: Department of Psychology, Florida State University, Tallahassee, FL, USA
Christian Kärgel: Division of Forensic Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
Viola Borchardt: Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany
Shijia Li: Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
Dominik Denzel: Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany
Joachim Witzel: Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
Krasimira Drumkova: Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
Klaus Beier: Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
Tillmann H.C. Kruger: Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
Jorge Ponseti: Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Kiel University, Medical School, Kiel, Germany
Boris Schiffer: Division of Forensic Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
Kolja Schiltz: Section of Forensic Psychiatry, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany; Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany
Henrik Walter: Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Univesität zu Berlin and Berlin Institute of Health, Berlin, Germany
Martin Walter: Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany; Department of Psychiatry, Eberhard Karls University, Tübingen, Germany; Max Planck Institute for Biological Cybernetics Tübingen, Germany; Corresponding author at: Head Section for Translational Psychiatry, Dept. of Psychiatry, University of Tuebingen, Osianderstr. 24, 72076 Tübingen, Germany.

Journal volume & issue: Vol. 23

Abstract

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Background: Pedophilic disorder is characterized by increased sexual interest towards children, with comparatively lesser interest towards adults. In real life, the behavior of subjects with pedophilic disorder is shaped by evaluative processes in response to sexually relevant cues. Therefore, brain activation during anticipation of sexually relevant cues is of potential interest. Whereas previous research demonstrated reduced activation when viewing adult (non-preferred) sexual stimuli in pedophilic sex offenders (PSOs), it is not known if anticipation of preferred versus unpreferred stimuli will elicit differential brain activation. Methods: Two fMRI studies (1.5 and 7 Tesla) were conducted in separate samples, each with 26 subjects (13/13 PSOs/controls) to assess brain activity during expectancy of subsequent adult (non-preferred) sexual stimuli. In the second study (7 Tesla) additionally child (preferred) cues were presented. Results: As predicted, expectancy of adult sexual stimuli generated smaller dorsal anterior cingulate cortex (dACC) activation in PSOs in both studies, driven by stronger activation during expectancy of adult erotic stimuli in non-pedophilic controls (HCs). In the second study, PSOs showed significantly increased activations in dACC during expectancy of child stimuli compared with expectancy of adult stimuli. This difference was significantly greater compared to the same contrast in HCs, thus demonstrating preference specificity of dACC activation. Conclusion: Our findings support the notion of decreased brain activation to adult cues in PSOs and preference specificity in neural response during expectancy of erotic stimuli. The localization of these cue reactivity differences in the salience network supports the interpretation that PSOs show abnormally increased preparatory activation even before relevant sexual stimuli are actually presented. Keywords: Dorsal anterior cingulate cortex (dACC), Expectancy, fMRI, Pedophilic sex offenders, Pedophilic disorder, Sexual processing

Published in NeuroImage: Clinical

ISSN: 2213-1582 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General): Computer applications to medicine. Medical informatics; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: http://www.journals.elsevier.com/neuroimage-clinical/

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