Psychiatry Research Neuroimaging 114 (2002) 95–102 0925-4927/02/$ - see front matter  2002 Elsevier Science Ireland Ltd. All rights reserved. PII: S0925-4927 Ž 02 . 00005-7 Prefrontal volumes in habitually violent subjects with antisocial personality disorder and type 2 alcoholism Mikko P. Laakso *, Faith Gunning-Dixon , Olli Vaurio , Eila Repo-Tiihonen , a,b, c d d Hilkka Soininen , Jari Tiihonen a d,e,f Department of Neurology, Kuopio University Hospital, 70211 Kuopio, Finland a Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland b Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA c Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Kuopio, Kuopio, Finland d Department of Clinical Physiology, Kuopio University Hospital, Kuopio, Finland e Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland f Received 18 September 2001; received in revised form 7 February 2002; accepted 11 February 2002 Abstract Pathology of the prefrontal cortices has been suggested to be a part of neural networks underlying deviant behavioral patterns. Recently, reduced overall prefrontal cortical volumes have been proposed in subjects with antisocial personality disorder (ASP). It is not known whether there are specific patterns of volume loss within the prefrontal regions. Nor is it known if there are correlations between the prefrontal volumes and degree of psychopathology. In this study, total prefrontal, prefrontal white, and cortical (dorsolateral, orbitofrontal, medial frontal) prefrontal volumes were measured from magnetic resonance images in 24 non-psychotic, violent male subjects who had a diagnosis of ASP in combination with type 2 alcoholism, and 33 age-matched control males. The degree of psychopathy in the ASP subjects was assessed using the Psychopathy Checklist-Revised (PCL-R). Compared with the controls, the ASP subjects had significantly smaller volumes of all three cortical regions on the left, but this significance disappeared after controlling for differences in education and duration of alcoholism. For the dorsolateral and orbitofrontal cortices, only duration of alcoholism was significantly associated with the observed volume deficit, and for the medial frontal cortex it was the difference in education. Thus, the observed volume deficits in this sample were related more to alcoholism or differences in education rather than to the diagnosis of ASP. Moreover, no significant correlations between any of the volumes and the degree of psychopathy were found.  2002 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Alcohol; Antisocial personality; Homicide; Imaging; MRI; Prefrontal; Sociopathy; Violence *Corresponding author. Department of Neurology, Building 5, Kuopio University Hospital, POB 1777, 70211 Kuopio, Finland. Tel.: q358-17-173738; fax: q358-17-173019. http:yywww.uku.fiyneuroy. E-mail address: mikko.laakso@uku.fi (M.P. Laakso).