"Building on this initial structural data, we are currently attempting to use functional imaging (fMRI) to understand better how the brains of patients with narcissistic personality disorder work. "Our data shows that the amount of empathy is directly correlated to the volume of gray brain matter of the corresponding cortical representation in the insular region, and that the patients with narcissism exhibit a structural deficit in exactly this area," states Dr. The regulation of self-esteem is overly dependent on expressions or defences against infantile pleasures, which are discarded in adult life. The ideal ego is dominated by infantile pursuits, values and prohibitions. For patients with narcissism, this region of the cerebral cortex was markedly reduced in thickness compared to the control group. Regression to the regulation of infantile self-esteem. The findings revealed that those subjects suffering from narcissistic personality disorder exhibited structural abnormalities in precisely that region of the brain, which is involved in the processing and generation of compassion. The cerebral cortex forms the external nerve cell layer of the brain. Using magnetic resonance imaging (MRI) methods, the scientists measured the thickness of the patients' cerebral cortex. By means of various tests, the researchers had already revealed in a preliminary study that these patients actually exhibit a deficit of the ability to empathize. They analyzed a total of 34 test subjects, of which 17 suffered from a narcissistic personality disorder. Stefan Röpke from the Charité Department of Psychiatry and Director of the personality disorders working group, have for the first time demonstrated the structural correlate of this deficit. In this study, the team of scientists led by Privatdozent Dr.