Often typified as cunning social predators, psychopathic offenders show a persistent pattern of impulsive and reckless behavior, the pathophysiology of which has been related to dysfunction in the dorsolateral prefrontal cortex (DLPFC). That is, the DLPFC is important for the regulatory control of impulses and emotion as well as working memory and psychopathic offenders show impairments in all three dimensions. In the present study, we used combined transcranial magnetic stimulation and electroencephalography to compare the physiology of the DLPFC in 13 psychopathic offenders and 15 healthy subjects vis à vis excitability and inhibition. In addition, working memory performance was measured through the letter-number sequencing test. Results showed that compared to healthy subjects, psychopathic offenders had inhibition not excitability deficits in the DLPFC that was accompanied by deficits in working memory performance. In healthy controls and psychopathic offenders working memory performance correlated with the extent of inhibition over the DLPFC. Taken together, these findings suggest that psychopathic offenders suffer from dysfunctional inhibitory neurotransmission in the DLPFC and impaired working memory which may account for the behavioral impairments associated with this disorder.
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