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EV0906

Neurobiological changes in pedophilic disorder: a scoping review of neuroimaging and neurochemical evidence and differences between offending and non-offending individuals

NEUROBIOLOGICAL ALTERATIONS IN PEDOPHILIC DISORDER: A SCOPING REVIEW OF NEUROIMAGING, NEUROCHEMICAL EVIDENCE, AND DIFFERENCES BETWEEN OFFENDERS AND NON-OFFENDERS

While pedophilic disorder is associated with neural changes related to emotion, sexual salience, and cognitive control, offending behavior is additionally characterized by more pronounced inhibitory and frontolimbic dysfunction.

The aim is to distinguish pedophilic disorder at the level of sexual orientation from offending behavior as an act, and to identify brain changes by comparing offending and non-offending individuals. The method is a scoping review in which 21 specialized studies were analyzed after eligibility criteria were applied to 53 studies identified through the search strategy; the included studies used functional magnetic resonance imaging (fMRI), positron emission tomography (PET), electroencephalography (EEG), and voxel-based morphometry (VBM). Original neuroimaging or neuroassessment studies involving individuals with pedophilic disorder were included, while reviews, editorials, and studies without a neurobiological assessment were excluded. Findings include prefrontal hypoactivation in the form of reduced activity in the dorsal anterior prefrontal cortex, amygdala and hypothalamic hypersensitivity to child-related stimuli, and GABA deficiency in the form of lower chemical concentrations in the dorsal anterior cingulate cortex. Unlike the non-offending group, the offending group shows deficient top-down control in prefrontal–limbic connectivity, bilateral reductions in hypothalamic volume, and reduced gray matter in the right temporal pole. In contrast, preserved neural networks and greater affective empathy emerge as protective factors in individuals with the disorder who do not offend. The authors conclude that pedophilic disorder is associated with neural changes involving emotion, sexual salience, and cognitive control, whereas offending behavior is characterized by more pronounced inhibitory and frontolimbic dysfunction.

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