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Grey Matter Heterotopia and Criminal Responsibility in a Case of Personal Injury Defense.

ABSTRACT: The abnormal allocation of nodules of grey matter in areas of the brain or spinal cord that should physiologically be occupied by white matter characterizes a neural defect called Grey Matter Heterotopia (GMH). The improvement of MRI techniques has enabled a deeper understanding of the neuropathological bases and epidemiology of such a condition. Among its major manifestations, there is the onset of epileptic seizures, mild intellectual disability, impairments in executive functioning, neurodevelopmental disorders; less frequently GMH has been found associated with depression, anxiety, and schizophrenia. Despite the clinical interest in GMH, no studies have considered the possible forensic and criminological implications of this condition. In the current study, we present a case of GMH in a young male defendant accused of having seriously injured a schoolmate as a reaction to bullying behavior. Neuropsychological and instrumental evidence converge in showing prevalence for the defendant's adoption of repressive responses to stressors, and difficulties to inhibit undesirable behavior at the long run. In the case at hand, the massive stress induced by the exposition to bullying behavior undermined inhibitory control, hence an impulsive and disproportionate reaction took place. Without appropriate therapeutic control, this reactive behavior might take place again. As a consequence, the forensic assessment recommended that the defendant was held partially liable only but that there was likelihood of recidivism. We discuss this single-case evidence for a possible role of GMH in the adoption of dyscontrolled responses to stressors, and the relevance of GMH diagnosis in forensic proceedings.

SUBMITTER: Curci A

PROVIDER: S-EPMC7139628 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Grey Matter Heterotopia and Criminal Responsibility in a Case of Personal Injury Defense.

Curci Antonietta A Rampino Antonio A

Frontiers in psychiatry 20200401

The abnormal allocation of nodules of grey matter in areas of the brain or spinal cord that should physiologically be occupied by white matter characterizes a neural defect called Grey Matter Heterotopia (GMH). The improvement of MRI techniques has enabled a deeper understanding of the neuropathological bases and epidemiology of such a condition. Among its major manifestations, there is the onset of epileptic seizures, mild intellectual disability, impairments in executive functioning, neurodeve ...[more]

PMID: 32296357

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Project description:Increasing evidence indicates heterogeneity in functional and molecular properties of oligodendrocyte lineage cells both during development and under pathologic conditions. In multiple sclerosis, remyelination of grey matter lesions exceeds that in white matter. Here we used cells derived from grey matter versus white matter regions of surgically resected human brain tissue samples, to compare the capacities of human A2B5-positive progenitor cells and mature oligodendrocytes to ensheath synthetic nanofibers, and relate differences to the molecular profiles of these cells. For both cell types, the percentage of ensheathing cells was greater for grey matter versus white matter cells. For both grey matter and white matter samples, the percentage of cells ensheathing nanofibers was greater for A2B5-positive cells versus mature oligodendrocytes. Grey matter A2B5-positive cells were more susceptible than white matter A2B5-positive cells to injury induced by metabolic insults. Bulk RNA sequencing indicated that separation by cell type (A2B5-positive vs mature oligodendrocytes) is more significant than by region but segregation for each cell type by region is apparent. Molecular features of grey matter versus white matter derived A2B5-positive and mature oligodendrocytes were lower expression of mature oligodendrocyte genes and increased expression of early oligodendrocyte lineage genes. Genes and pathways with increased expression in grey matter derived cells with relevance for myelination included those related to responses to external environment, cell-cell communication, cell migration, and cell adhesion. Immune and cell death related genes were up-regulated in grey matter derived cells. We observed a significant number of up-regulated genes shared between the stress/injury and myelination processes, providing a basis for these features. In contrast to oligodendrocyte lineage cells, no functional or molecular heterogeneity was detected in microglia maintained in vitro, likely reflecting the plasticity of these cells ex vivo. The combined functional and molecular data indicate that grey matter human oligodendrocytes have increased intrinsic capacity to myelinate but also increased injury susceptibility, in part reflecting their being at a stage earlier in the oligodendrocyte lineage.

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Grey Matter Heterotopia and Criminal Responsibility in a Case of Personal Injury Defense.

Publications

Grey Matter Heterotopia and Criminal Responsibility in a Case of Personal Injury Defense.

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