ABSTRACT 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-HT1B receptor as derived from in vivo positron

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SIMILAR CONTENT BEING VIEWED BY OTHERS THE IMAGEN STUDY: A DECADE OF IMAGING GENETICS IN ADOLESCENTS Article Open access 29 June 2020 NEURAL CORRELATES OF HARM AVOIDANCE: A MULTIMODAL

META-ANALYSIS OF BRAIN STRUCTURAL AND RESTING-STATE FUNCTIONAL NEUROIMAGING STUDIES Article Open access 20 September 2024 ASSOCIATION BETWEEN BRAIN SEROTONIN 4 RECEPTOR BINDING AND

REACTIVITY TO EMOTIONAL FACES IN DEPRESSED AND HEALTHY INDIVIDUALS Article Open access 11 May 2023 DATA AVAILABILITY Coordinates used in the meta-analyses are available from the included

studies that are referenced in the Supplementary Information. Transmitter and receptor atlases are shipped with the JuSpace Toolbox (https://github.com/juryxy/JuSpace/). Neurosynth data are

available at https://neurosynth.org/. Allen Human Brain Atlas data are available from https://human.brain-map.org/. CODE AVAILABILITY ALE software is available at

https://www.brainmap.org/ale/, the JuBrain Anatomy Toolbox 3.0 at https://github.com/inm7/jubrain-anatomy-toolbox, the JuSpace Toolbox 1.4 at https://github.com/juryxy/JuSpace, Neurosynth

0.3.8 at https://github.com/neurosynth/neurosynth, neuromaps 0.0.3 at https://github.com/netneurolab/neuromaps, and the Talairach Client 2.4.3 at http://www.talairach.org/client.html.

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Article  PubMed  PubMed Central  Google Scholar  Download references ACKNOWLEDGMENTS None. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Psychiatry, Psychotherapy and

Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany Gereon J. Schnellbächer, Viktoria Pietsch, Katrin Sakreida & Timm B. Poeppl * Institute of Neuroscience and

Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany Juergen Dukart & Simon B. Eickhoff * Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine

University Düsseldorf, Düsseldorf, Germany Juergen Dukart & Simon B. Eickhoff * McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, Quebec,

Canada Justine Y. Hansen & Ross D. Markello * Faculty of Psychology, FernUniversität in Hagen (University of Hagen), Hagen, Germany Andreas Mokros * Department of Diagnostic and

Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg–Eppendorf, Hamburg, Germany Inka Ristow * Leibniz Institute of Neurobiology, Magdeburg, Germany Martin Walter

* Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany Martin Walter * Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of

Regensburg, Regensburg, Germany Timm B. Poeppl Authors * Gereon J. Schnellbächer View author publications You can also search for this author inPubMed Google Scholar * Juergen Dukart View

author publications You can also search for this author inPubMed Google Scholar * Justine Y. Hansen View author publications You can also search for this author inPubMed Google Scholar *

Ross D. Markello View author publications You can also search for this author inPubMed Google Scholar * Andreas Mokros View author publications You can also search for this author inPubMed 

Google Scholar * Viktoria Pietsch View author publications You can also search for this author inPubMed Google Scholar * Inka Ristow View author publications You can also search for this

author inPubMed Google Scholar * Katrin Sakreida View author publications You can also search for this author inPubMed Google Scholar * Martin Walter View author publications You can also

search for this author inPubMed Google Scholar * Simon B. Eickhoff View author publications You can also search for this author inPubMed Google Scholar * Timm B. Poeppl View author

publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS T.B.P. designed the study; S.B.E. gave conceptual advice. V.P., K.S. and T.B.P. gathered data for the

meta-analyses. T.B.P. conducted the meta-analyses with advice of S.B.E. J.D. and T.B.P. conducted the neurotransmitter analyses. J.D. performed the gene expression analyses. J.Y.H. and

R.D.M. provided the behavioral profiling. G.S. and T.B.P. wrote the manuscript. A.M., I.R. and M.W. discussed the results and implications. All authors commented on the manuscript at all

stages. CORRESPONDING AUTHOR Correspondence to Timm B. Poeppl. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. PEER REVIEW PEER REVIEW INFORMATION _Nature

Mental Health_ thanks Kirsten Jordan, Cristina Scarpazza and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. ADDITIONAL INFORMATION PUBLISHER’S

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pedophilia links to receptor distribution, gene expression, and behavior. _Nat. Mental Health_ 1, 615–622 (2023). https://doi.org/10.1038/s44220-023-00105-0 Download citation * Received: 06

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