Can brain stimulation treat psychopathy?

Scientists exploring new ways to address psychopathic traits have found that gentle electrical or magnetic stimulation of the brain may slightly improve empathy and prosocial behavior. A new study published in Progress in Neuro-Psychopharmacology and Biological Psychiatry suggests the technology shows promise—but there is currently no direct evidence it works in people with psychopathy.

Psychopathy is often associated with persistent antisocial behavior and emotional differences, such as reduced empathy, guilt, and concern for others. Traditional treatments, including therapy programs and anger-management courses, have had limited success in changing these core emotional traits.

This has led researchers to explore whether differences in brain activity might help explain psychopathy, and whether targeting the brain directly could offer new treatment possibilities.

Brain imaging studies have shown that people with psychopathic traits often have unusual activity in regions linked to emotion and decision-making. These include areas involved in recognizing fear, responding to others’ pain, and regulating behavior.

Scientists have therefore begun testing non-invasive brain stimulation, which utilizes magnets or weak electrical currents applied to the scalp, to see whether altering brain activity can influence emotional responses.

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Led by Célia F. Camara from the University of Essex in the U.K., the research team behind the new study wanted to know whether these brain-stimulation techniques could change traits related to psychopathy.

Camara and colleagues conducted a large review and statistical analysis of 64 experiments involving 122 measured effects. The studies examined several forms of stimulation, including transcranial magnetic stimulation and transcranial direct current stimulation, and compared them with sham (placebo-like) conditions.

Most experiments were conducted with healthy adult volunteers rather than people diagnosed with psychopathy. Participants completed tasks or questionnaires measuring empathy, emotional reactions, or prosocial behavior before and after brain stimulation. The researchers then combined results across studies to see whether any consistent patterns emerged.

The findings demonstrated that certain types of “excitatory” brain stimulation—designed to increase activity in targeted brain regions—produced small to moderate improvements in social and emotional responses. In some cases, participants reported greater empathy, increased willingness to help others, or increased feelings of guilt. Other types of stimulation that dampen brain activity sometimes reduced these responses.

Overall, the analysis suggests that non-invasive brain stimulation can influence emotional and social processing in ways that are relevant to psychopathic traits. However, the results were mixed and varied widely depending on the type of stimulation, the brain area targeted, and how many sessions participants received.

The researchers noted that while the findings provide early proof that emotional traits can be influenced by brain stimulation, the technology is far from being a practical treatment. Notably, the review found that the only available study conducted specifically on psychopathic individuals reported null effects.

“The generalizability of our findings is limited by insufficient research on psychopathy-relevant samples. Responses to non-invasive brain stimulation in individuals with psychopathy may differ from those of non-psychopathic populations, as evidence indicates that individuals with psychopathy exhibit distinct neurobiological profiles compared with non-psychopathic cohorts,” Camara and colleagues cautioned.

Nevertheless, the results open the door to new ways of understanding and potentially addressing the emotional aspects of psychopathy.

The study, “On the possibility to modulate psychopathic traits via non-invasive brain stimulation: A systematic review and meta-analysis,” was authored by Célia F. Camara, Carmen S. Sergiou, Andrés Molero Chamizo, Alejandra Sel, Nathzidy G. Rivera Urbina, Michael A. Nitsche, and Paul H.P. Hanel.