Disrupted Prefrontal Regulation of Striatal Subjective Value Signals in Psychopathy

Psychopathy is a personality disorder with strong links to criminal behavior. While research on psychopathy has focused largely on socio-affective dysfunction, recent data suggest that aberrant decision making may also play an important role. Yet, the circuit-level mechanisms underlying maladaptive decision making in psychopathy remain unclear. Here, we used a multi-modality functional imaging approach to identify these mechanisms in a population of adult male incarcerated offenders. Psychopathy was associated with stronger subjective value-related activity within the nucleus accumbens (NAcc) during inter-temporal choice and with weaker intrinsic functional connectivity between NAcc and ventromedial prefrontal cortex (vmPFC). NAcc-vmPFC connectivity strength was negatively correlated with NAcc subjective value-related activity; however, this putative regulatory pattern was abolished as psychopathy severity increased. Finally, weaker cortico-striatal regulation predicted more frequent criminal convictions. These data suggest that cortico-striatal circuit dysregulation drives maladaptive decision making in psychopathy, supporting the notion that reward system dysfunction comprises an important neurobiological risk factor. •Ventral striatal subjective value signals are amplified in incarcerated psychopaths•Medial cortico-striatal intrinsic connectivity is weak in psychopathic individuals•Cortico-striatal regulation of striatal activation is disrupted in psychopathy•Diminished cortico-striatal regulation is associated with more criminal convictions Psychopaths are notorious for their criminal behavior and poor self-control, but underlying neural mechanisms remain unresolved. Using fMRI in incarcerated offenders, Hosking et al. show that regulatory cortico-striatal connectivity is weakened in psychopathy, driving heightened striatal value encoding during decision making.