Reduced regional cerebral blood flow in non-psychotic violent offenders

The present study was designed to replicate previously reported findings of abnormal frontal and/or temporal cerebral blood flow in violent offenders and to control for the influence of major mental disorder (MMD), substance abuse, and current medication. HMPAO-SPECT-CBF and MRI scans from pretrial forensic psychiatric investigations of 21 subjects convicted of impulsive v iolent crimes were retrospectively re-evaluated. In 16/21 subjects, visual assessment of SPECT scans showed some hypoperfusion in the temporal and/or frontal lobes. MRI showed no corresponding structural damage. Quantified re gional cerebral blood flow (rCBF) in defined regions of interest was compar ed between index cases and 11 healthy control subjects. Index subjects had significant reductions in the right angular gyrus and the right medial temp oral gyrus, bilaterally in the hippocampus, and in the left white frontal m atter, but they had significantly increased rCBF in the parietal associatio n cortex bilaterally. The aberrations were as frequent and severe among the subjects without MMD, substance abuse, and current medication (n = 7) as i n the entire group of index subjects. (C) 2000 Elsevier Science Ireland Ltd . All rights reserved.