This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this preliminary study is to begin to examine the neuropathological basis of non-paraphilic compulsive sexual behavior (NCSB) and one type of paraphilic CSB, pedophilia. Paraphilic compulsive sexual behavior involves preoccupation with culturally deviant arousal patterns. Non-paraphilic CSB involves excessive preoccupation with culturally sanctioned aspects of normative sexual urges and behaviors or engaging in such behaviors with an intensity and/or frequency that the behavior leads to impairment of social or occupational function. Based on a review of the literature, we have reason to believe that frontal lobe dysfunction can lead to disinhibition of sexual behavior and hypersexual behavior in CSB. Temporal lobe abnormalities have also been associated with hypersexuality but also seems to be uniquely involved in development of various fetishes, paraphilias and pedophilia. We plan to compare baseline structural and functional magnetic resonance imaging (MRI) scans of the orbital frontal and the temporal lobes. Additionally, we will be performing two types of neurophysiologic tests designed to assess impulsivity and attentional bias. If these tests discriminate between controls and the study groups then the procedures will be repeated during the fMRI scan. We hypothesize that the CSB group will show decreased perfusion of the orbital frontal region of the frontal lobes at baseline and will show smaller orbital frontal lobes on structural imaging. Further we hypothesize that there will be an inverse correlation between degree of behavior impulsivity (as assessed by rating scales and neurophysiological testing) and orbital frontal lobe activity as assessed by fMRI. With regard to the neurophysiological task that assesses impulsive behavior, we hypothesize that the NCSB group will exhibit significantly more impulsivity as assessed by errors of commission when compared to the control and the pedophilic groups. Additionally we hypothesize that there will be decreased temporal lobe activity (and temporal lobes size) in the pedophile group compared to the CSB and control groups. Finally, we hypothesize that the pedophilic group will show an attentional bias toward pictures of children over adults when compared to the control group.
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