Aberrant brain activity in pedophilia links to receptor distribution, gene expression, and behavior

Despite an estimated lifetime prevalence of 0.5–1.0% in men and high public concern, no effective treatment is known for pedophilic disorder. Here, we provide robust meta-analytic evidence that brain activity is not generally altered in pedophilia but deviates specifically in response to sexual stimuli. We show how this meta-analysis-derived functional brain alteration pattern in pedophiles maps onto underlying neurophysiology in terms of specific neurotransmitter systems and their corresponding gene expression as well as to behavioral aspects. We report robust and specific associations between functional brain alterations in pedophiles and the distribution of the serotonergic 5-HT 1B receptor as derived from in vivo positron emission tomography data as well as gene expression analyses. At the functional level, the alterations related to cognitive processes including self-regulation and goal-directed behavior. These findings warrant further investigation into the molecular mechanisms underlying pedophilia and point toward the development of specific pharmacological interventions.