Neuroimaging in sexual offenses and paraphilia: A call to harmonize current clinical and imaging assessments in sexual offenses and paraphilia

Introduction: The advent of brain imaging studies has provided a chance to assess behavioral changes in patients with psychiatric disorders and compare the results with healthy individuals. These studies have clinical and research implications especially for forensic clinicians, and psychologists who not only diagnose psychiatric disorders but also need to determine the level of criminal responsibility and assess the level of risk that patients may pose for the safety of the public. However, few studies have reviewed the current literature systematically. The aim of this article is to summarize and categorize available studies. Materials and Methods: We performed a comprehensive search to identify all available articles on neuroimaging findings of paraphilia. Results: Sixty hundred and fifty five papers were reviewed for this study, out of which 56 articles were selected. Papers were classified according to sexual disorder types and were categorized into case reports and case series (n= 25), and case-control studies (n= 31). Important findings of the selected papers were summarized and areas of the brain involvement were highlighted. Conclusion: Structural and functional neuroimaging may elucidate the neuroanatomical network of paraphilia. These findings have research and clinical implications in the field of forensic psychiatry.