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Abstract. Tema 1 Prefrontal Control of the Amygdala during Real-Time fMRI Neurofeedback Training of Emotion Regulation Vadim Zotev'*, Raquel Phillips', Kymberly D. Young', Wayne C. Drevets'”, Jerzy Bodurka'** 1 lawreate Institute for Brain Research, Tulsa, Oklahoma, United States of America, 2 Janssen Pharmaceutials, LLC, df Johnson £ Johnson, Inc. Ttusvile, New Jersey, United States of America, 3 College of Engineering, Univenity of Oklahoma, Norman, Oklahoma, United States of America Abstract We observed in a previous (PLoS ONE 6:e24522) that the of amygdala activity via real-time fMRI euraeedback FUMAEnD e induction was. in healthy participants, with an enhancement in the functional ] the left rostral anterior cingulate cortex (rACC), bilateral dorsomedial prefrontal cortex (DMPFC), bilateral superior A O a neuroanatomical network engaged during the rtfMRinf procedure. Here we perform a structural vector autoregression (SVAR) analysis of the effective connectivity for this network. The SVAR analysis demonstrates that the left ACC plays an important role during the ríMRI-nf training, modulating the LA and the other network regions. According to a la RO O e ec RA O ER potentially consistent with the ipsilateral distribution of the monosynaptic projections between these regions, The training 1s also accompanied by significant increases in the instantaneous (contemporaneous) effects of the left rACC on four other regions - the bilateral DMPFC, the right MFPC, and the left SFG. The instantaneous effects of the LA on the bilateral DMPFC ll o ete tos [qero yo nro po brian lod podido orcas that the rACC constitute a promising target! A ea cos la aran la Plz a DON dla [al posttraumatic stress disorder (PTSD). TEMA 4. Differentiating psychopathy from antisocial personality disorder: A triarchic model perspective Venables, N. C. Hall, J. R. Patrick, C. J. ; Psychological Medicine, Vol 44(5), Apr, 2014. pp. 1005-1013 + Background: The triarchic model of psychopathy characterizes the disorder in terms of three distinguishable phenotypic facets: disinhibition, meanness and boldness. The present study sought to (1) inform current debates regarding the role of boldness in the definition of psychopathy and (2) clarify boundaries between psychopathy and antisocial personality disorder (ASPD). Method: This study evaluated the degree to which facets of the triarchic model are represented in the most widely used clinical inventory for psychopathy, the Psychopathy Checklist —Revised (PCL-R), in comparison with ASPD as defined by DSM-IV criteria. Adult male offenders from two distinct correctional settings (n = 157 and 169) were investigated to ensure replicability of findings across samples exhibiting high base rates of psychopathy and antisocial behavior. Results: We found evidence for convergent and discriminant validity of the three triarchic facets in predicting symptomatic components of psychopathy as assessed by the PCL-R. Additionally, and crucially vis-a-vis current debates in the field, we found that boldness contributed incrementally (over and above disinhibition and meanness) to prediction of PCL-R psychopathy, in particular its interpersonal style component, but not ASPD. Conclusions: The three distinct facets of the triarchic model of psychopathy are represented clearly and distinctly in the PCL-R, with boldness through its interpersonal facet, but not in DSM-defined ASPD. Our findings suggest that boldness is central to diagnostic conceptions of psychopathy and distinguishes psychopathy from the more prevalent diagnosis of ASPD. Antisocial Personality Disorder in DSM-5: Missteps and Missed Opportunities Donald R. Lynam and David D. Vachon Purdue University This paper evaluates the proposal for antisocial personality disorder (ASPD) in the Diagnostic and Statistical Manual of Mental Disorders—fifih edition (DSM-5). Some aspects of the proposal are appealing: personality disorders will be assessed using trait criteria, and these criteria are similar to trait descriptions of DSM-IV ASPD. Other aspects of the proposal are less appealing. First, the DSM-5 will depend on a newly constructed personality trait system rather than relying on a well validated, widely studied one. Second, the trait profile of ASPD is incomplete; although this profile reflects the traits included in DSM-IV, it maps poorly onto the full personality profile of ASPD. Third, the DSM Workgroup missed an opportunity to finally unify ASPD and psychopathy; history and research suggest that these disorders have diverged mistak- enly. Fourth, the newly proposed criteria of impairments in self- and interpersonal functioning are of questionable derivation and utility. Sex Differences in Antisocial Personality Disorder: Results From the National Epidemiological Survey on Alcohol and Related Conditions Analucia A. Alegria Carlos Blanco Mew Vet Sto Pybletds lead, MOS York, Mew Ves aná New York State Paychiatric Institute, New York, New York and King's College London Columbia University Nancy M. Petry Andrew E. Skodol University of Consecticut School of Medicine: Columbia University and University of Arizona College of Min Liu Bri Grant New York State Paychistric Institute, New York, New York National lastítute of Abuse and Alcobolism, National lastitutes of Health, Bethesda, Maryland Deborah Hasin New York State Psychiatric Institute, New York, New York and Columbia University espe te 3-1 prevalence ratio of een versus womes with Antsocial Personality Disorder (ASPD), search on sex differences cn cometes cl ASPD in the general population ísacarco, The purpose cl is stmdy was lo exam ser dfloronces in chalco and adult adverse events. Het: prchaatse cometa. and lied cormelatos cf DSM-IV ASPD. The sample inciadod 819 men amd 407 women with SM /V ASPD. dagas. Data we den frces te Nañonal Epademiologí: Survey on Alcotut and Related Congo (NESARO) 4 — 43.083, Comparado men, women wi ASPD repone more frequent chldbond emotonal meglect (AOR — 225. 95% Cl 12-330) and sermal abuse (AOR — 420, 95% CL 278-635), any pase selatod advorse event duriag chica ly - parental substance une disorder) LAOR = 247, 95% Cl 160-382), and adverse events during mtulbood (AOR — 4.20, 99% CL 278-615) Although womes with ASP presera less vice antisocial hetamors and hegher ratos cf aggresarveness and amaba) (OR — 0.46; 95% CL 031-067), ey have high años of victimazadion, presto impairmert, amd lower social support. Our findargs suggest incre mental heal ads in econo a ASPD, moriting development al Soren catre progra for acen and en. TEMA 5. Inverse association between dopaminergic neurotransmission and lowdlk Gambling Task performance in pathological gamblers and healthy controls JAKOB LINNET,!* ARNE MOLLER,!” ERICKA PETERSON,** ALBERT GJEDDE”* and DORIS DOUDET'"" ¡Conte of FuncionallyIntegrative Aarhus University. Árhus University !L Denmark 3Pathophysiology and Experimental Tomography Center, Arhus Universi Hospal Denmark of Neurology. University of British Columbia, Canada “Department of Neuroscience and Pharmacology. University of Copenhagen, Denmark Linnet, J., Moller, A., Peterson, E., Gjedde, A £ Doudet,D. (2011). Inverse association between dopaminergic neurotransmission and lowa Gambling Task performance in parhological gamblers and healthy controls. Scandina vian Journal of Paycholo gy 52, 28-34. The dopamine system is believed to affect gambling behavior in pathological gambling. Particularly, dopamine release in the ventral striatum appears to. afec decision-making in the disorder. This study investigated dopamine release in the ventral striatum in relation 10 gambling performance on the lowa. Gambling Task (IGT) in 16 Pahologica! Gamblers (PG) and 14 Healthy Controls (HC). We used Positron Emission Tomography (PET) to measure the binding potential of |''C] raclopride to dopamine DZ3 receptoss during a baseline and gambling condition. We hypothesized that decreased raclopride binding potentials in the ventral striatum during gambling (indicating dopamine release) would be associated with higher IGT performance in MealIhy Con- trols, but lower IGT performance in Pathological Gamblers. The results showed that Pathological Gambiers with dopamine release in the ventral striatum. had significantly lower IGT performance than Healthy Controls. Furthermore, dopamine release was associated with significan y higher IGT performance in Mealthy Controls and significanty lower IGT performance in Pathological Gamblera. The results suggest that dopamine release is involved both in adap- ive and maladaptive decisson-making. These findings may contnbute to a better understanding of dopaminergic dysfunctions in pathological gambling and substance related addictions. Haloperidol modifies instrumental aspects of slot machine gambling in pathological gamblers and healthy controls Anne-Marie Tremblay, Renée C. Desmond, Constantine X. Poulos 4 Martin Zack Oercal Ne Section, Corera tor ad Metal Heat Carata ABSTRACT Instrumental cvoditioning has been implicated in persistence at lot machine gambling, but its specific role remains uncicar. Dopamine (DA) mediates aspects of instrumental responding, and D2 antagonists reliably alter this process. This study investigatod the elocts ol the preferential 1)2 antagonist, haloperidol (3 mg) on reward-eclated betting. behavior in 20 subjects with pathological gambling (PG) and 18 healthy Controls. Hicrarchical regression assessed the. prospective relationship between Payod and Bet Size on consecutive trials. along with potential moderating effects ol Cumulutivo Winnings and Phase of game (carly/late) under drug and placebo. Payof pradictod Bot Size on the next trial regardless of other factors, consistent with un instrumental view ol slot machine gambling, Under placebo. this verelation varicd as 4 función of Winsungs and Phase in PG subjects but was strong and invartant in Controls. Under haloperidol, the Payoll-Bct Size correlation in PG subjects resembled the invaríant pattern of Controls under placebo. In contrust. the Payo(l-Bet Size correlation rose then fell sharply over trials under haloperidol in controls, The corre- lation of Puyol with Het Size ts remarkable given that there is no actual contingency between winning and betting and suggests that reward expectancies largely drive slot machine gambling. By blocking inhíbitory 1)2 receptors. haloperi- dol may huve reversed 'tolerance” to monetary rewani mediated by increased tonic DA in PG subjects. Disturbance ol the Payoff-Bet Size correlation in Controls muy reflect indiscriminate rewand signaling under haloperidol in subjects with normal DA function. indirect enhancement of DA transmision may reduce undue reward -related responding in PG subjects. Shared genetic contributions to anxiety disorders and pathological gambling in a male population Giddens, Justine L. Xian, Hong Scherrer, Jeffrey F. Eisen, Seth A. Potenza, Marc N. ; Journal of Affective Disorders, Vol 132(3), Aug, 2011. pp. 406-412 Background: Pathological gambling (PG) frequently co-occurs with anxiety disorders. However, the extent to which the co-occurrence is related to genetic or environmental factors across PG and anxiety disorders is not known. Method: Data from the Vietnam Era Twin Registry (n = 7869, male twins) were examined in bivariate models to estimate genetic and shared and unique environmental contributions to PG and generalized anxiety disorder (GAD) and PG and panic disorder (PD). Results: While both genetic and unique environmental factors contributed individually to PG, GAD, and PD, the best fitting model indicated that the relationship between PG and GAD was attributabl predominantly to shared genetic contributions (r[sub]A[/sub] = 0.53). In contrast, substantial correlations were observed between both the genetic (r[sub]A[/sub] = 0.34) and unique environmental (r[sub]E[/sub] = 0.31) contributions to PG and PD. Limitations: Results may be limited to middle aged males. Conclusions: The existence of shared genetic contributions between PG and both GAD and PD suggests that specific genes, perhaps those involved in affect regulation or stress responsiveness, contribute to PG and anxiety disorders. Overlapping environmental contributions to the co-occurrence of PG and PD suggest that common life experiences (e.g., early life trauma) contribute to both PG and PD. Conversely, the data suggest that distinct environmental factors contribute to PG and GAD (e.g., early onset of gambling in PG). Future studies should examine the relationship between PG and anxiety disorders amongst other populations (women and adolescents) to identify specific genetic and environmental influences that account for the manifestation of these disorders and their co-occurrences. Gambling pathology is associated with dampened cortisol response among men and women JJ. Paris?, C. Franco?, R. Sodano?, CA. Frye?>“4, E, Wulfert2* * Department of Psychology, The Universi a Albany-SUNTY, Social Sciences 369, 400 Weshington Avenue, Albany, NY 12222, USA * Department of Bology, he Universiy at Albany-SUNY, Albany, NY 12222, USA * Center for Neuroscience Research, The Universty at Albany-SUNY, Albany NY 12222, USA 4 Center for Lfe Sciences Research, The University at Albany -SUNY, Albany, NY 12222, USA ARTICLE INFO ABSTRACT Arc histo Pathological gambling has many similaries to pharmacological addiction. Notably, both pathological Received 6 January 2009 gambling and drug addiction are characterized by aberrations in hypothalamic-pituktary-adrenal (HPA) axis Received in revised form 27 March 2009 responding, As well there are indications that gender differences may play arole in these processes. Whether ica gender and/or HPA response are associated with pathological gambling was of interes. Recreational and — ee pathological gamblers (15 men and 6 women per group) had the HPA factor, cortisol, assessed in saliva pri before and after watching a video of their preferred mode of gambling (slot machines, horse race betting, Gender úllerences scratch-off tickets, blackjack, video poker, craps, sports betting, online casino games, or lottery tickets), and a Hypothalamic-piuitary-adrenal as video of neutral súmuli (a rollercoaster ride). Basal levels of salivary cortisol did not significantly difler Patbologica gambling among recreational and pathological gamblers, However, recreational gamblers demonstrated significanty Problem gamblng increased salivay cortisol levels alter the gambling and rollercoaster videos, whereas pathological gamblers Recreation gambling demonstrated no salary cortisol increase in response to either video stimulus. There was also a non- significant trend or women to have a greater cortisol response to video stimuli compared to men. These data suggest that pathological gambling is associated with hypoactive HPA response to gambling stimul, similar to chronic drug exposure, and gender may contribute to this effect. Clinical Gender Diflerences Among Adult Pathological Gamblers Seeking Treatment Enrique Echeburúa + ltxaso González-Ortega + Paz de Corral + Rocio Polo-López Published online: 9 June 2010 O Springa Science+Husiness Media, LLC 2010 Abstract This study aimed to examine the gender-related differences in demographics, gambling measures, psychological functioning, and motivation for therapy in an outpatient sample of pathological gamblers secking treatment. Participants in this multisite study includad 103 adult cutpatients ($1 women and 52 men) meeting current DSM-IV-TR eriteria for PG. Logistic regression was used to examine if gender was related together to categorical and continuous independent variables. Female gamblers were older than men and more likely to be divorced or widowed and to have a lower annual income. Women became more dependent on bingo and men on slot machines. Gambling motivation and the course of illness for both sexes were also different. Female gamblers were more anxious and with a poorer selfesteem than male gamblers and more affected by depressive symptoms; in tum, men were more impulsive and higher sensation sockers than women and more affected by drug/alcohol abuse. The 68.6% of female gamblers reportad being victims of intimate parmer violence. There were no gender differences about the moti- vation for treatment. Future research should examine gambling behaviors and psycho- logical functioning and suggest treatment approaches to address specific goals according to these gender-related differences. Elevated Functional Connectivity in a Striatal-Amygdala Circuit in Pathological Gamblers Jan Peters'”*?, Stephan Franz Miedl?”, Christian Biichel' 1 Department of Systems Neuroscience, University Medical Center Hamburg Eppendorf, Hamburg, Germany, 2 Helen Wils Neuroscience Institute, University of California, Berkeley, California, United States of America, 3 Department of Psychology, University of Salzburg, Salzburg, Austria Abstract Both substance-based addiction and behavioural impulse control disorders (ICDs) have been associated with observed reliable increases in functional coupling between striatum and bilateral amygdala in gamblers vs. controls. A A = Citation: Peters J, Miedl SF, Búchel C (2013) Elevated Functional Connectivity in a Striatal-Amygdala Circuit in Pathological Gamblers. PLOS ONE 819): 74353. dol:10.1371/joumnal.pone.0074353 The Role of Personality in the Prediction of Treatment Outcome in Pathological Gamblers: A Follow-Up Study Irene Ramos-Grille Montserrat Gomá-i-Freixanet Consorci Sanitari de Terrassa and Universitat Autónoma de. Universitat Autónoma de Barcelona Barcelona Nor Sergi Valero Connor Sanitas de Te Universitari Val ¿Hebron and Ul Autónoma de Barcelona Vicens Valles ¡Consorci Samitari de Terrassa The aim of the present study was to determine which domains in NEO Personality Inventory-Revised would predict relapse and dropout in treatment-secking slot-machine pathological gamblers after 1-year follow-up. The NEO PER was completed by 73 consecutive treatment-seeking outpatients before they began an open program of individual cognitive—behavioral therapy. Twelve months after starting treatment, patients were categorized in groups as abstinent versus relapsed or completers versus dropouts. At 1-year follow-up, 29% of patients were abstinent, and 48% had completed treatment. Those who had relapsed showed higher significant scores on Neuroticism and lower scores on Conscientiousness. The dropout group scored significantly higher on Neuroticism and lower on Agrecableness and Conscien- tiousness than the completer group. Low scores on Conscientiousness emerged as a significant predictor of relapse; while low scores on Conscientiousness and Agrecableness were significant predictors of dropout. It seems as if low Conscientiousness could be considered as a predictor of treatment failure measured by either relapses or dropouts, whereas, low Agrecableness seems to be a prognostic domain specifically for dropouts. Pathological gamblers with lower Conscientiousness and lower Agrecableness seem to be at risk of prematurely dropping out of treatment. Our findings support the importance of individual differences in personality on therapy outcomes. The NEO PER may constitute an important tool to identify treatment-sceking pathological gamblers who may be at risk of relapsing or dropping out of treatment. TEMA 6. Using Perceptual Signatures to Define and Dissociate Condition-Specific Neural Etiology: Autism and Fragile X Syndrome as Model Conditions Armando Bertone + Julie Hanck + Cary Kogan + Avi Chaudhuri + Kim Cornish Abstract The functional link between genetic alteration — present paper, we discuss how such signatures can be used 'arely straightforward and never — to (1) define and Jus aspects of neural ind subsequently, (2) to ¡sms based on such signatures (see companion paper, this issue). and its companion paper. ihod for assessing the functional link Keywords Autism - Fragile X syndrome - Vision - between genotype and neural alteration across these target — Perception - Perceptual signatures - Neural networks conditions by comparing their perceptual signatures. In the Novel Autism Subtype-Dependent Genetic Variants Are Revealed by Quantitative Trait and Subphenotype Association Analyses of Published GWAS Data Valerie W. Hu'*, Anjene Addington”, Alexander Hyman' 1 Department of Biochemistry and Molecular Biology, The George Washington University Medical Center, Washington, D.C, United States of America, 2 Child Psychiatry Branch, National Institute of Mental Health, National Insttutes of Health, Bethesda, Maryland, United States of America Abstract The heterogeneity of symptoms associated with autism spectrum disorders (ASDs) has presented a significant challenge to genetic analyses. Even when associations with genetic variants have been identified, it has been difficult to associate them with a specific trait or characteristic of autism. Here, we report that quantitative trait analyses of ASD symptoms combined with case-control association analyses using distinct ASD subphenotypes identified on the basis of symptomatic profiles result in the identification of highly significant associations with 18 novel single nudeotide polymorphisms (SNPs). The symptom categories included deficits in language usage, non-verbal communication, social development, and play skills, as well as insistence on sameness or ritualistic behaviors. Ten of the trait-associated SNPs, or quantitative trait loci (QTL), were associated with more than one subtype, providing partial replication of the identified QTL. Notably, none of the novel SNPs is located within an exonic region, suggesting that these hereditary components of ASDs are more likely related to gene regulatory processes (or gene expression) than to structural or functional changes in gene products. Seven of the QTL reside within intergenic chromosomal regions associated with rare copy number variants that have been previously reported in autistic samples. Pathway analyses of the genes associated with the QTL identified in this study implicate neurological functions and disorders associated with autism pathophysiology. This study underscores the advantage of incorporating both quantitative traits as well as subphenotypes into large-scale genome-wide analyses of complex disorders. Presence of GAD6S5 autoantibodies in the serum of children with autism or ADHD Ujjwal K. Rout + Nils Abstract Antibodies against glutamic acid decarboxylase 65 (GAD6S) have been detected in the serum of patients with several neurological disorders. The presence of antibodies against GAD6S has not yet been examined in the serum of patients with neurodevelopmental disorders such as autism or attention-deficiUhyperactivity disorder (ADHD). In this study, GADÓS antibodies and total 12G were assayed in the serum of normal subjects and patients diagnosed with autism or ADHD. GAD6S antibodies were detected in the serum of 15% of children with autism (N = 20). 27% of children with ADHD (N= 15) and of none of the controls (N= 14). The serum of 60% of autistic and 53% of ADHD patients reacted with Purkinje úneurons in mouse cercbellum. Serum from 20% of ADHD patients reacted also with the cells in the molecular and granule cell layers and cells in the vicinity of the Purkinje neurons. No association was found between the titer of GAD6S antibodies and total IgG levels, and presence of seizures or mental retardation. None of the ADHD patients were diagnosed with mental retardation. Serum anti- GAD6S antibodies may be a common marker of subgroups A Common Suscepti K. Mungan + Dirk M. Dhossche of patients with autism and ADHD. Reactions of serum antibodies with the cells in the cerebellum in these patients suggest direct effects on brain function. The subgroup of children with autism and ADHD that tests positive for GAD6S antibodies needs further characterization in a lar- ger study. Keywords — Autoantibodies - Autism - ADHD + GAD - Serum - Brain and development y Factor of Both Autism and Epilepsy: Functional Deficiency of GABA, Receptors Jing-Qiong Kang + Gregory Barnes Abstract Autism and epilepsy are common childhood neurological disorders with a great heterogeneity of clinical phenotypes as well as risk factors. There is a high co-morbidity of autism and epilepsy. The neuropatholog y of autism and epilepsy has similar histology implicating the processes of neurogenesis, neural migration, programmed cell death, and neurite outgrowth. Genetic advances have identified multiple molecules that participate in neural development, brain network connectivity, and synaptic function which are involved in the pathogenesis of autism and epilepsy. Mutations in GABAA receptor subunit have been frequently associated with epilepsy, autism, and other neuropsychiatric disorders. In this paper, we address the hypothesis that functional deficiency of GABAergic sig- naling is a potential common molecular mechanism underpinning the co-morbidity of autism and epilepsy. Keywords Autism - Epilepsy - Co-morbidity - GABAA receptor - Brain development - Synaptogenesis scMRI Reveals Large-Scale Brain Network Abnormalities in Autism Brandon A. Zielinski'*, Jeffrey S. Anderson?””, Alyson L. Froehlich*, Molly B. D. Prigge”, Jared A. Nielsen”*, Jason R. Cooperrider”*, Annahir N. Cariello”, P. Thomas Fletcher*”, Andrew L. Alexander””, Nicholas Lange'?”'', Erin D. Bigler**?*”, Janet E. Lainhart?*? Abstract Autism is a complex neurological condition characterized by childhood onset of dysfunction in multiple cognitive domains A A pi Although gross brain anatomic differences in autism are well established, recent studies investigating regional differences in brain structure and function have yielded divergent and seemingly contradictory results. How regional abnormalities relate to the autistic phenotype remains undear. We hypothesized that autism exhibits distinct perturbations in network-level brain architecture, and that cognitive dysfunction may be reflected by abnormal network structure. Network-level anatomic abnormalities in autism have not been previously described. We used structural covariance MR! to investigate network-level differences in gray matter structure within two large-scale networks strongly implicated in autism, the salience network and the default mode network, in autistic subjects and age-, gender-, and IQ-matched controls. We report specific perturbations in brain network architecture in the salience and default-mode networks consistent with clinical manifestations of autism. Extent and distribution of the salience network, involved in social-emotional regulation of environmental stimuli, is restricted in autism. In contrast, posterior elements of the default mode network have increased spatial distribution, suggesting a “posteriorization' of this network. These findings are consistent with a network-based model of autism, and suggest a unifying interpretation of previous work Moreover, we provide evidence of specific abnormalities in brain network architecture underlying autism that are quantifiable using standard clinical MRI. Acquired personality traits of autism following damage to the medial prefrontal cortex Satoshi Umeda Keio Univenity, Tokyo, Japan Masaru Mimura Showo Universo; Tokyo, Japan Motoichiro Kato. Kcio Univenity, Tokyo, Japan Recent neuroimaging studies on “theory of mind” have demonstrated that the medial prefrontal cortex (PFC) is involved when subjects are engaged in various kinds of mentalising tasks. Although a large number of neuroimaging studies have been published, a relatively small amount of neuropsychological evidence supports involvement of the medial PFC in theory of mind reasoning. We recruited two neurological cases with damage to the medial PFC and initially performed the standard neuropsycho- logical assessments for intelligence, memory, and executive functions. To examine theory of mind performance in these two cases, four kinds of standard and advanced tests for theory of mind were used, including first- and second-order false belief tests, the strange stories test, and the faux pas recognition test. Both patients were also requested to complete the questionnaire for the autism-spectrum quotient. Neither case showed impairment on standard theory of mind tests and only mild impairments were seen on advanced theory of mind tests. This pattern of results is basically consistent with previous studies. The most interesting finding was that both cases showed personality changes after surgical operations, leading to characteristics of autism showing a lack of social interaction in everyday life. We discuss herein the possible roles of the medial PFC and emphasize the importance of using multiple approaches to understand the mechanisms of theory of mind and medial prefrontal functions.
