Functional frontalisation with age: mapping neurodevelopmental trajectories with fMRI

Adolescents at risk for alcohol abuse demonstrate altered frontal lobe activation during Stroop performance

BACKGROUND

Children and adolescents, family history positive (FH+) for alcoholism, exhibit differences in brain structure and functional activation when compared to family history negative (FH-) counterparts. Given that frontal brain regions, and associated reciprocal connections with limbic structures, undergo the most dramatic maturational changes during adolescence, the objective of this study was to compare functional brain activation during a frontally mediated test of response inhibition in 32 adolescents separated into low-risk (FH-) and high-risk (FH+) groups.

METHODS

Functional magnetic resonance (fMRI) blood oxygen level-dependent data were acquired at 1.5 Tesla during performance of Stroop Color Naming, Word Reading, and Interference. Preprocessing and statistical analyses, covaried for age, were conducted in SPM99 using a search territory that included superior, middle, and inferior frontal gyri (trigone region), anterior cingulate gyrus (CG), and left and right amygdala.

RESULTS

Significantly greater activation in the fronto-limbic search territory was observed in FH+ relative to FH- subjects during Stroop Interference. In addition, a significant regression between brain activation and family history density was observed, with a greater density being associated with increased activation in regions including middle frontal gyrus (BA9) and CG (BA24).

CONCLUSIONS

These data demonstrate a significant influence of FH status on brain activation during the performance of a response inhibition task, perhaps reflecting a neurobiological vulnerability associated with FH status that may include reduced neuronal efficiency and/or recruitment of additional neuronal resources. These findings are important given that the adolescent developmental period is already associated with reduced inhibitory capacity, even prior to the onset of alcohol use.

Adolescent development and risk of injury: using developmental science to improve interventions

In adolescence, there is a complex interaction among physical, cognitive, and psychosocial developmental processes, culminating in greater risk-taking and novelty-seeking. Concurrently, adolescents face an increasingly demanding environment, which results in heightened vulnerability to injury. In this paper, we provide an overview of developmental considerations for adolescent injury interventions based on developmental science, including findings from behavioural neuroscience and psychology. We examine the role that typical developmental processes play in the way adolescents perceive and respond to risk and how this integrated body of developmental research adds to our understanding of how to do injury prevention with adolescents. We then highlight strategies to improve the translation of developmental research into adolescent injury prevention practice, calling on examples of existing interventions including graduated driver licensing.

Understanding higher level gait disturbances in mild dementia in order to improve rehabilitation: 'last in-first out'

Predicting and anticipating disturbances in higher level gait is particularly relevant for patients with dementia as higher level gait appears to be closely related to higher level cognitive functioning. A phenomenon that could contribute to the understanding and prediction of disturbances in higher level gait and gait-related motor activity in the various subtypes of dementia is paraphrased as 'last in-first out'. 'Last in-first out' refers to the principle that neural circuits that mature late in development are the most vulnerable to neurodegeneration. The strength of relating symptoms to the 'last in-first out' principle is that a future symptom can be predicted and anticipated in a therapeutic way, even if the disease process has not already started. Therefore, the aim of this review is to provide new strategies for rehabilitation of higher level gait disturbances in dementia based upon the 'last in-first out' principle. These new strategies emerge from five neural networks: the superior longitudinal fasciculus, the uncinate fasciculus, the fronto-cerebellar and fronto-striatal connections, and the cingulum.

Neural substrates of impaired sensorimotor timing in adult attention-deficit/hyperactivity disorder

BACKGROUND

Timing abilities are critical to the successful management of everyday activities and personal safety, and timing abnormalities have been argued to be fundamental to impulsiveness, a core symptom of attention-deficit/hyperactivity disorder (ADHD). Despite substantial evidence of timing deficits in ADHD youth, only two studies have explicitly examined timing in ADHD adults and only at the suprasecond time scale. Also, the neural substrates of these deficits are largely unknown for both youth and adults with ADHD. The present study examined subsecond sensorimotor timing and its neural substrates in ADHD adults.

METHODS

Using functional magnetic resonance imaging, we examined paced and unpaced finger tapping in a sample of 20 unmedicated adults with ADHD and 19 control subjects comparable on age, sex, and estimated IQ. The blood oxygenation level-dependent contrast response was used to estimate task-related neural activity.

RESULTS

Behavioral data showed no between-group differences in mean tapping rates but greater within-subject variability in tap-to-tap intervals for ADHD adults relative to control subjects. Importantly, ADHD adults had greater clock rather than motor variability, consistent with a central timing locus for the atypical movements. The imaging results demonstrated that, relative to control subjects, ADHD adults showed less activity in a number of regions associated with sensorimotor timing, including prefrontal and precentral gyri, basal ganglia, cerebellum, inferior parietal lobule, superior temporal gyri, and insula.

CONCLUSIONS

Our findings show that subsecond timing abnormalities in ADHD youth persist into adulthood and suggest that abnormalities in the temporal structure of behavior observed in ADHD adults result from atypical function of corticocerebellar and corticostriatal timing systems.

Serotonergic modulation of response inhibition and re-engagement? Results of a study in healthy human volunteers

OBJECTIVE

Cognitive functions dependent on the prefrontal cortex, such as the ability to suppress behavior (response inhibition) and initiate a new one (response re-engagement) is important in the activities of daily life. Central serotonin (5-HT) function is thought to be a critical component of these cognitive functions. In recent studies, 5-HT failed to affect stop-signal reaction time (SSRT), a fundamental process in behavioral inhibition. We were interested if response inhibition and re-engagement are influenced through central 5-HT activity as mediated via the 5-HT transporter.

METHODS

Here, using a stop-change task, we investigated the effects of acute and repeated treatment with 10 mg escitalopram, a selective 5-HT reuptake inhibitor, in 36 healthy human volunteers on response inhibition and re-engagement in a randomized, double-blind, placebo-controlled study with cross-over design.

RESULTS

Results do not show an influence of escitalopram on response inhibition or response re-engagement as we did not find differences in SSRT or change reaction time (CRT).

CONCLUSIONS

These findings support the results of previous studies suggesting that 5-HT is not critical in inhibition of already initiated responses and response re-engagement. We hypothesize that results are due to different forms of behavioral inhibition and 5-HT may critical to other forms.

Adolescent brain maturation, the endogenous cannabinoid system and the neurobiology of cannabis-induced schizophrenia

Cannabis use during adolescence increases the risk of developing psychotic disorders later in life. However, the neurobiological processes underlying this relationship are unknown. This review reports the results of a literature search comprising various neurobiological disciplines, ultimately converging into a model that might explain the neurobiology of cannabis-induced schizophrenia. The article briefly reviews current insights into brain development during adolescence. In particular, the role of the excitatory neurotransmitter glutamate in experience-dependent maturation of specific cortical circuitries is examined. The review also covers recent hypotheses regarding disturbances in strengthening and pruning of synaptic connections in the prefrontal cortex, and the link with latent psychotic disorders. In the present model, cannabis-induced schizophrenia is considered to be a distortion of normal late postnatal brain maturation. Distortion of glutamatergic transmission during critical periods may disturb prefrontal neurocircuitry in specific brain areas. Our model postulates that adolescent exposure to Δ9-tetrahydrocannabinol (THC), the primary psychoactive substance in cannabis, transiently disturbs physiological control of the endogenous cannabinoid system over glutamate and GABA release. As a result, THC may adversely affect adolescent experience-dependent maturation of neural circuitries within prefrontal cortical areas. Depending on dose, exact time window and duration of exposure, this may ultimately lead to the development of psychosis or schizophrenia. The proposed model provides testable hypotheses which can be addressed in future studies, including animal experiments, reanalysis of existing epidemiological data, and prospective epidemiological studies in which the role of the dose-time-effect relationship should be central.

Adolescent development of the neural circuitry for thinking about intentions

In this fMRI study, we investigated the development during adolescence of the neural network underlying thinking about intentions. A total of 19 adolescent participants (aged 12.1–18.1 years), and 11 adults (aged 22.4–37.8 years), were scanned using fMRI. A factorial design was employed with between-subjects factor age group and within-subjects factor causality (intentional or physical). In both adults and adolescents, answering questions about intentional causality vs physical causality activated the medial prefrontal cortex (PFC), superior temporal sulcus (STS), temporal poles and precuneus bordering with posterior cingulate cortex. In addition, there was a significant interaction between group and task in the medial PFC. During intentional relative to physical causality, adolescents activated part of the medial PFC more than did adults and adults activated part of the right STS more than did adolescents. These results suggest that the neural strategy for thinking about intentions changes between adolescence and adulthood. Although the same neural network is active, the relative roles of the different areas change, with activity moving from anterior (medial prefrontal) regions to posterior (temporal) regions with age.

Invited commentary: understanding brain mechanisms of pain processing in adolescents' non-suicidal self-injury

Whereas non-suicidal self injury (NSSI) is reported in 13-23% of adolescents and is an increasingly studied topic, there has been little investigation into the pathophysiology behind self-injury. This commentary examines recent research into pain and emotional distress to discuss implications for the manner we should understand, research, and treat NSSI in the future. Research indicates that adolescents may be particularly vulnerable to NSSI behaviors due to neurodevelopmental changes in the processing of distress and pain. Additionally, emotional distress and physical pain neural pathways may have been altered in these individuals, leading to the development of NSSI behaviors during adolescence when changes in ongoing brain development may lead to further emotional dysregulation and poor impulse control. Further studies that directly characterize the relationship between emotional distress and physical pain in adolescence, as well as the neural differences between self-injurers and non-self-injurers, are needed.

The storm and stress of adolescence: insights from human imaging and mouse genetics

The characterization of adolescence as a time of "storm and stress" remains an open debate. Intense and frequent negative affect during this period has been hypothesized to explain the increased rates of affective disorders, suicide, and accidental death during this time of life. Yet some teens emerge from adolescence with minimal turmoil. We provide a neurobiological model of adolescence that proposes an imbalance in the development of subcortical limbic (e.g., amygdala) relative to prefrontal cortical regions as a potential mechanism for heightened emotionality during this period. Empirical support for this model is provided from recent behavioral and human imaging studies on the development of emotion regulation. We then provide examples of environmental factors that may exacerbate imbalances in amygdala-ventrofrontal function increasing risk for anxiety related behaviors. Finally we present data from human and mouse studies to illustrate how genetic factors may enhance or diminish this risk. Together, these studies provide a converging methods approach for understanding the highly variable stress and turmoil experienced in adolescence.

Mapping attention-deficit/hyperactivity disorder from childhood to adolescence--no neurophysiologic evidence for a developmental lag of attention but some for inhibition

BACKGROUND

The role of a developmental lag for deficits of higher brain functions in attention-deficit/hyperactivity disorder (ADHD) has not yet been tested in longitudinal studies. We examined the development of neurophysiological markers of attention (Cue P300; contingent negative variation [CNV]) and inhibition (NoGo P300) in ADHD and control groups from childhood to adolescence for support of the developmental lag hypothesis of ADHD.

METHODS

ADHD (n = 28/3 girls) and control (n = 22/5 girls) subjects were assessed at baseline (Time 1; ADHD age 10.8 +/- 1.8 years, controls 10.4 +/- 1.1 years) and at two follow-up examinations (Time 2 after 1.2 years, Time 3 after 2.5 years). Event-related potential maps were recorded during a cued Continuous Performance Test (CPT) at all assessments and analyzed using scalp and source (sLORETA) measures.

RESULTS

CPT performance showed common effects of ADHD and younger age, consistent with (but not specific to) developmental lag. The NoGo P300 developed earlier and became stronger in control subjects than in the ADHD group, again consistent with an initial developmental lag. In contrast, the attenuation of the Cue P300 and the CNV with ADHD at all assessments was opposite to the enhancement with younger age and thus inconsistent with developmental lag. The sLORETA source localization also differed between ADHD and developmental effects.

CONCLUSIONS

These results provide strong evidence for multiple and persistent neural processing deficits in ADHD. They do not support the developmental lag hypothesis for attentional dysfunction in ADHD despite partial evidence that developmental lag contributes to inhibitory brain dysfunction during early adolescence.

Clinical and therapeutic aspects of Klinefelter's syndrome: sexual function

Klinefelter's syndrome (KS) is the most common sex chromosomal aberration among men, with estimated prevalence of about 1 in 500 newborn males. The classical phenotype of KS is widely recognized, but many affected subjects present only very mild signs. While the association between KS and infertility has been well documented, few studies have investigated sexual function in the KS patients. In the present paper we reviewed studies addressed to emotional processing and sexual function in KS. We searched the following databases Medline, Pubmed, Embase, for Klinefelter's syndrome, sexuality. We focus on the peculiar contribution of genetic and hormonal background, which characterizes sexual dysfunction in KS. Abnormal structure and function of the emotional brain circuits have been described in KS. These alterations were less pronounced when the patients underwent to testosterone replacement therapy suggesting that they were mediated by testosterone deficiency. Accordingly, clinical studies indicate that sexual dysfunctions, eventually present in KS, are not specifically associated with the syndrome but are related to the underlying hypogonadism. In conclusion, androgen deficiency more than chromosomal abnormality is the major pathogenic factor of sexual dysfunction in KS.

A preliminary study of the neural mechanisms of frustration in pediatric bipolar disorder using magnetoencephalography

BACKGROUND

Irritability is prevalent and impairing in pediatric bipolar disorder (BD) but has been minimally studied using neuroimaging techniques. We used magnetoencephalography (MEG) to study theta band oscillations in the anterior cingulate cortex (ACC) during frustration in BD youth. ACC theta power is associated with attention to emotional stimuli, and the ACC may mediate responses to frustrating stimuli.

METHODS

We used the affective Posner task, an attention paradigm that uses rigged feedback to induce frustration, to compare 20 medicated BD youth (14.9+/-2.0 years; 45% male) and 20 healthy controls (14.7+/-1.7 years; 45% male). MEG measured neuronal activity after negative and positive feedback; we also compared groups on reaction time, response accuracy, and self-reported affect. Patients met strict DSM-IV BD criteria and were euthymic. Controls had no psychiatric history.

RESULTS

BD youth reported more negative affective responses than controls. After negative feedback, BD subjects, relative to controls, displayed greater theta power in the right ACC and bilateral parietal lobe. After positive feedback, BD subjects displayed lower theta power in the left ACC than did controls. Correlations between MEG, behavior, and affect were nonsignificant.

CONCLUSION

In this first MEG study of BD youth, BD youth displayed patterns of theta oscillations in the ACC and parietal lobe in response to frustration-inducing negative feedback that differed from healthy controls. These data suggest that BD youth may display heightened processing of negative feedback and exaggerated self-monitoring after frustrating emotional stimuli. Future studies are needed with unmedicated bipolar youth, and comparison ADHD and anxiety groups.

Effects of age and sex on developmental neural networks of visual-spatial attention allocation

Compared to our understanding of the functional maturation of brain networks underlying complex cognitive abilities, hardly anything is known of the neurofunctional development of simpler cognitive abilities such as visuo-spatial attention allocation. Furthermore, nothing is known on the effect of gender on the functional development of attention allocation. This study employed event related functional magnetic resonance imaging to investigate effects of age, sex, and sex by age interactions on the brain activation of 63 males and females, between 13 to 38years, during a visual-spatial oddball task. Behaviourally, with increasing age, speed was traded for accuracy, indicative of a less impulsive performance style in older subjects. Increasing age was associated with progressively increased activation in typical areas of selective attention of lateral fronto-striatal and temporo-parietal brain regions. Sex difference analysis showed enhanced activation in right-hemispheric inferior frontal and superior temporal regions in females, and in left-hemispheric inferior temporo-parietal regions in males. Importantly, the age by sex interaction findings showed that these sex-dimorphic patterns of brain activation may be the result of underlying sex differences in the functional maturation of these brain regions, as females had sex-specific progressive age-correlations in the same right inferior fronto-striato-temporal areas, while male-specific age-correlations were in left medial temporal and parietal areas. The findings demonstrate progressive functional maturation of fronto-striato-parieto-temporal networks of the relatively simple function of attention allocation between early adolescence and mid-adulthood. They furthermore show that sex-dimorphic patterns of enhanced reliance on right inferior frontal, striatal and superior temporal regions in females and of left temporo-parietal regions in males during attention allocation may be the result of underlying sex differences in the functional maturation of these brain regions.

What has fMRI told us about the development of cognitive control through adolescence?

Cognitive control, the ability to voluntarily guide our behavior, continues to improve throughout adolescence. Below we review the literature on age-related changes in brain function related to response inhibition and working memory, which support cognitive control. Findings from studies using functional magnetic resonance imaging (fMRI) indicate that processing errors, sustaining a cognitive control state, and reaching adult levels of precision, persist through adolescence. Developmental changes in patterns of brain function suggest that core regions of the circuitry underlying cognitive control are on-line early in development. However, age-related changes in localized processes across the brain, and in establishing long range connections that support top-down modulation of behavior, more effective neural processing for optimal mature executive function. While great progress has been made in understanding the age-related changes in brain processes underlying cognitive development, there are still important challenges in developmental neuroimaging methods and the interpretation of data that need to be addressed.

Neural correlates of response inhibition in pediatric bipolar disorder and attention deficit hyperactivity disorder

Impulsivity, inattention and poor behavioral inhibition are common deficits in pediatric bipolar disorder (PBD) and attention deficit hyperactivity disorder (ADHD). This study aimed to identify similarities and differences in the neural substrate of response inhibition deficits that are associated with these disorders. A functional magnetic resonance imaging (fMRI) study was conducted on 15 unmedicated PBD patients (Type I, manic/mixed), 11 unmedicated ADHD patients, and 15 healthy controls (HC) (mean age = 13.5 years; S.D. = 3.5). A response inhibition task examined the ability to inhibit a motor response to a target when a stop cue appeared shortly after. The PBD and ADHD groups did not differ on behavioral performance, although both groups were less accurate than the HC group. fMRI findings showed that for trials requiring response inhibition, the ADHD group, relative to the PBD and HC groups, demonstrated reduced activation in both ventrolateral (VLPFC) and dorsolateral (DLPFC) prefrontal cortex, and increased bilateral caudate activation compared with HC. The PBD group, relative to HC, showed decreased activation in the left VLPFC, at the junction of the inferior and middle frontal gyri, and in the right anterior cingulate cortex (ACC). Prefrontal dysfunction was observed in both the ADHD and PBD groups relative to HC, although it was more extensive and accompanied by subcortical overactivity in ADHD.

White matter development in adolescence: a DTI study

Adolescence is a unique period of physical and cognitive development that includes concurrent pubertal changes and sex-based vulnerabilities. While diffusion tensor imaging (DTI) studies show white matter maturation throughout the lifespan, the state of white matter integrity specific to adolescence is not well understood as are the contributions of puberty and sex. We performed whole-brain DTI studies of 114 children, adolescents, and adults to identify age-related changes in white matter integrity that characterize adolescence. A distinct set of regions across the brain were found to have decreasing radial diffusivity across age groups. Region of interest analyses revealed that maturation was attained by adolescence in broadly distributed association and projection fibers, including those supporting cortical and brain stem integration that may underlie known enhancements in reaction time during this period. Maturation after adolescence included association and projection tracts, including prefrontal-striatal connections, known to support top-down executive control of behavior and interhemispheric connectivity. Maturation proceeded in parallel with pubertal changes to the postpubertal stage, suggesting hormonal influences on white matter development. Females showed earlier maturation of white matter integrity compared with males. Together, these findings suggest that white matter connectivity supporting executive control of behavior is still immature in adolescence.

A group independent component analysis of covert verb generation in children: a functional magnetic resonance imaging study

Semantic language skills are an integral part of early childhood language development. The semantic association between verbs and nouns constitutes an important building block for the construction of sentences. In this large-scale functional magnetic resonance imaging (fMRI) study, involving 336 subjects between the ages of 5 and 18 years, we investigated the neural correlates of covert verb generation in children. Using group independent component analysis (ICA), seven task-related components were identified including the mid-superior temporal gyrus, the most posterior aspect of the superior temporal gyrus, the parahippocampal gyrus, the inferior frontal gyrus, the angular gyrus, and medial aspect of the parietal lobule (precuneus/posterior cingulate). A highly left-lateralized component was found including the medial temporal gyrus, the frontal gyrus, the inferior frontal gyrus, and the angular gyrus. The associated independent component (IC) time courses were analyzed to investigate developmental changes in the neural elements supporting covert verb generation. Observed age effects may either reflect specific local neuroplastic changes in the neural substrates supporting language or a more global transformation of neuroplasticity in the developing brain. The results are analyzed and presented in the framework of two theoretical models for neurocognitive brain development. In this context, group ICA of fMRI data from our large sample of children aged 5-18 years provides strong evidence in support of the regionally weighted model for cognitive neurodevelopment of language networks.

Normal development of brain circuits

Spanning functions from the simplest reflex arc to complex cognitive processes, neural circuits have diverse functional roles. In the cerebral cortex, functional domains such as visual processing, attention, memory, and cognitive control rely on the development of distinct yet interconnected sets of anatomically distributed cortical and subcortical regions. The developmental organization of these circuits is a remarkably complex process that is influenced by genetic predispositions, environmental events, and neuroplastic responses to experiential demand that modulates connectivity and communication among neurons, within individual brain regions and circuits, and across neural pathways. Recent advances in neuroimaging and computational neurobiology, together with traditional investigational approaches such as histological studies and cellular and molecular biology, have been invaluable in improving our understanding of these developmental processes in humans in both health and illness. To contextualize the developmental origins of a wide array of neuropsychiatric illnesses, this review describes the development and maturation of neural circuits from the first synapse through critical periods of vulnerability and opportunity to the emergent capacity for cognitive and behavioral regulation, and finally the dynamic interplay across levels of circuit organization and developmental epochs.

Cognitive-behavioral flexibility in anorexia nervosa

Anorexia nervosa (AN) patients are characterized by perfectionism and obsessional personality traits. This anorectic personality type is associated with an exaggerated cognitive control and impaired cognitive-behavioral flexibility. Neuropsychological studies addressing flexibility have supported an impaired cognitive set-shifting (i.e., concrete and rigid behaviors to changing rules) as well as an impaired behavioral response shifting (i.e., stereotyped or perseverative behaviors) in AN patients independent of nutritional status and body weight. Furthermore, impaired set-shifting was found in healthy sisters of AN patients suggesting that cognitive inflexibility is a trait marker in AN patients. Brain imaging studies have provided new insights in striatocortical circuit dysfunctions that may underlie both the clinical symptoms of obsessive-compulsive personality traits and the neuropsychological observations of impaired cognitive-behavioral flexibility. The conceptualization of AN as a neurodevelopmental striatocortical disorder may help to develop new promising treatment approaches for this severe disorder.

Neuromaturation and Adolescent Risk Taking: Why Development Is Not Determinism

In the January 2009 issue of this journal, Males argues that adolescent brain science perpetuates the “myth of adolescent risk taking.” He contends that those who study adolescent neuromaturation are biological determinists who ignore the profound social and environmental forces that influence adolescent behavior to further their own agendas. Males mischaracterizes developmental research and misinterprets public health data. This article analyzes his argument and provides a response based on the evidence. There is significant cross-species evidence that adolescence serves an important developmental function on the road to full maturation and is not merely an oppressive social construction. Research on neuromaturation can help elucidate both the vulnerabilities and tremendous potential of the adolescent brain. It also provides the opportunity to examine the role of social environments in shaping developmental processes and to explore how reasoned understandings of adolescent brain and biological development are being used to inform interventions that scaffold adolescent vulnerabilities.

The development of performance-monitoring function in the posterior medial frontal cortex

BACKGROUND

Despite its critical role in performance-monitoring, the development of posterior medial prefrontal cortex (pMFC) in goal-directed behaviors remains poorly understood. Performance monitoring depends on distinct, but related functions that may differentially activate the pMFC, such as monitoring response conflict and detecting errors. Developmental differences in conflict- and error-related activations, coupled with age-related changes in behavioral performance, may confound attempts to map the maturation of pMFC functions. To characterize the development of pMFC-based performance monitoring functions, we segregated interference and error-processing, while statistically controlling for performance.

METHODS

Twenty-one adults and 23 youth performed an event-related version of the Multi-Source Interference Task during functional magnetic resonance imaging (fMRI). Linear modeling of interference and error contrast estimates derived from the pMFC were regressed on age, while covarying for performance.

RESULTS

Interference- and error-processing were associated with robust activation of the pMFC in both youth and adults. Among youth, interference- and error-related activation of the pMFC increased with age, independent of performance. Greater accuracy associated with greater pMFC activity during error commission in both groups.

DISCUSSION

Increasing pMFC response to interference and errors occurs with age, likely contributing to the improvement of performance monitoring capacity during development.

Differential relationships between personal and community stressors and children's neurocognitive functioning

Early adversity can alter development of neurocognition, including executive cognitive and emotional regulatory functions. This is the first study to explore differential relationships between personal (physical and emotional abuse and neglect, school and parental stressors) and community (neighborhood problems and witnessing neighborhood violence) stressors and neurocognition. Predominantly Latino children (n = 553) aged 10 to 12 years completed tasks measuring intelligence, impulsivity, problem solving, cognitive flexibility, decision making, and emotion attributions. Adjusting for age and parent education, bivariate regression analyses found exposure to personal stressors to be associated with relative deficits in at least one neurocognitive function. Community stressors were related to relative deficits in emotion attributions and problem solving. In multivariate analyses, neglect was related to misattributions of emotion and IQ deficits, and physical abuse was related to problem solving. Community stressors were not correlated with neurocognition when viewed relative to personal stressors. Stressor types were differentially associated with performance on specific neurocognitive tasks.

Immaturities in reward processing and its influence on inhibitory control in adolescence

The nature of immature reward processing and the influence of rewards on basic elements of cognitive control during adolescence are currently not well understood. Here, during functional magnetic resonance imaging, healthy adolescents and adults performed a modified antisaccade task in which trial-by-trial reward contingencies were manipulated. The use of a novel fast, event-related design enabled developmental differences in brain function underlying temporally distinct stages of reward processing and response inhibition to be assessed. Reward trials compared with neutral trials resulted in faster correct inhibitory responses across ages and in fewer inhibitory errors in adolescents. During reward trials, the blood oxygen level-dependent signal was attenuated in the ventral striatum in adolescents during cue assessment, then overactive during response preparation, suggesting limitations during adolescence in reward assessment and heightened reactivity in anticipation of reward compared with adults. Importantly, heightened activity in the frontal cortex along the precentral sulcus was also observed in adolescents during reward-trial response preparation, suggesting reward modulation of oculomotor control regions supporting correct inhibitory responding. Collectively, this work characterizes specific immaturities in adolescent brain systems that support reward processing and describes the influence of reward on inhibitory control. In sum, our findings suggest mechanisms that may underlie adolescents' vulnerability to poor decision-making and risk-taking behavior.

Comorbidity study of ADHD: applying association rule mining (ARM) to National Health Insurance Database of Taiwan

OBJECTIVE

This paper intends to apply association rule mining (ARM) to explore the labyrinthian network of ADHD comorbidity, and to examine the practicality of ARM in comorbidity studies using clinic databases.

METHODS

From clinic records of enrollees of Taiwan National Health Insurance (NHI), 18,321 youngsters aged 18 or less with diagnosis of ADHD in 2001 were recruited as case group in this study. And all their clinic diagnoses made from 2000 to 2002, as comorbidity, were categorized according to "The International Classification of Disease, 9th Revision, Clinical Modification" (ICD-9-CM) diagnosis system. For comparison, fourfold non-ADHD controls were recruited from 2001s NHI enrollees on a random base but matched gender and age of cases. ARM was done with Apriori algorithm to examine the strengths of associations among those diagnoses. The support and confidence values of ARM results were examined. Comorbidity rates and relative risk (RR) ratios of both groups of each diagnosis were compared one another.

RESULTS

ADHD case group has apparently higher risk of comorbidity with psychiatric comorbidity than with other physical illnesses. From results of ARM, developmental delay (DD) appears as an important node between ADHD and anxiety disorder (support: 5.12%, confidence: 97.42%), mild mental retardation (support: 4.42%, confidence: 92.09%) and autism (support: 6.49%, confidence: 94.93%).

CONCLUSIONS

The finding of this study, an important role of DD between ADHD and other psychiatric comorbidity, supports neurological findings in developmental delay of ADHD children's front cortex, as well as some epidemiology findings. This study also demonstrated the practicality of ARM in comorbidity studies using enormous clinic databases like NHIRD.

Invited commentary: understanding brain mechanisms of pain processing in adolescents' non-suicidal self-injury

Whereas non-suicidal self injury (NSSI) is reported in 13-23% of adolescents and is an increasingly studied topic, there has been little investigation into the pathophysiology behind self-injury. This commentary examines recent research into pain and emotional distress to discuss implications for the manner we should understand, research, and treat NSSI in the future. Research indicates that adolescents may be particularly vulnerable to NSSI behaviors due to neurodevelopmental changes in the processing of distress and pain. Additionally, emotional distress and physical pain neural pathways may have been altered in these individuals, leading to the development of NSSI behaviors during adolescence when changes in ongoing brain development may lead to further emotional dysregulation and poor impulse control. Further studies that directly characterize the relationship between emotional distress and physical pain in adolescence, as well as the neural differences between self-injurers and non-self-injurers, are needed.

The maturation of incentive processing and cognitive control

Understanding how immaturities in the reward system affect decision-making can inform us on adolescent vulnerabilities to risk-taking, which is a primary contributor to mortality and substance abuse in this age group. In this paper, we review the literature characterizing the neurodevelopment of reward and cognitive control and propose a model for adolescent reward processing. While the functional neuroanatomy of the mature reward system has been well-delineated, adolescent reward processing is just beginning to be understood. Results indicate that adolescents relative to adults demonstrate decreased anticipatory processing and assessment of risk, but an increased consummatory response. Such differences could result in suboptimal representations of reward valence and value and bias adolescent decision-making. These functional differences in reward processing occur in parallel with on-going structural and pharmacological maturation in the adolescent brain. In addition to limitations in incentive processing, basic cognitive control abilities, including working memory and inhibitory control, continue to mature during adolescence. Consequently, adolescents may be limited, relative to adults, in their abilities to inhibit impulsive behaviors and reliably hold 'on-line' comparisons of potential rewards/punishments during decision-making.

Adolescent maturity and the brain: the promise and pitfalls of neuroscience research in adolescent health policy

Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-to-policy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being.

Development of cortical asymmetry in typically developing children and its disruption in attention-deficit/hyperactivity disorder

CONTEXT

Just as typical development of anatomical asymmetries in the human brain has been linked with normal lateralization of motor and cognitive functions, disruption of asymmetry has been implicated in the pathogenesis of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD). No study has examined the development of cortical asymmetry using longitudinal neuroanatomical data.

OBJECTIVE

To delineate the development of cortical asymmetry in children with and without ADHD.

DESIGN

Longitudinal study.

SETTING

Government Clinical Research Institute.

PARTICIPANTS

A total of 218 children with ADHD and 358 typically developing children, from whom 1133 neuroanatomical magnetic resonance images were acquired prospectively.

MAIN OUTCOME MEASURES

Cortical thickness was estimated at 40 962 homologous points in the left and right hemispheres, and the trajectory of change in asymmetry was defined using mixed-model regression.

RESULTS

In right-handed typically developing individuals, a mean (SE) increase in the relative thickness of the right orbitofrontal and inferior frontal cortex with age of 0.011 (0.0018) mm per year (t(337) = 6.2, P < .001) was balanced against a relative left-hemispheric increase in the occipital cortical regions of 0.013 (0.0015) mm per year (t(337) = 8.1, P < .001). Age-related change in asymmetry in non-right-handed typically developing individuals was less extensive and was localized to different cortical regions. In ADHD, the posterior component of this evolving asymmetry was intact, but the prefrontal component was lost.

CONCLUSIONS

These findings explain the way that, in typical development, the increased dimensions of the right frontal and left occipital cortical regions emerge in adulthood from the reversed pattern of childhood cortical asymmetries. Loss of the prefrontal component of this evolving asymmetry in ADHD is compatible with disruption of prefrontal function in the disorder and demonstrates the way that disruption of typical processes of asymmetry can inform our understanding of neurodevelopmental disorders.

The neural basis of sustained and transient attentional control in young adults with ADHD

Differences in neural activation during performance on an attentionally demanding Stroop task were examined between 23 young adults with ADHD carefully selected to not be co-morbid for other psychiatric disorders and 23 matched controls. A hybrid blocked/single-trial design allowed for examination of more sustained vs. more transient aspects of attentional control. Our results indicated neural dysregulation across a wide range of brain regions including those involved in overall arousal, top-down attentional control, response selection, and inhibition. Furthermore, this dysregulation was most notable in lateral regions of DLPFC for sustained attentional control and in medial areas for transient aspects of attentional control. Because of the careful selection and matching of our two groups, these results provide strong evidence that the neural systems of attentional control are dysregulated in young adults with ADHD and are similar to dysregulations seen in children and adolescents with ADHD.

SELF-RATED EXECUTIVE FUNCTION: DEVELOPMENT OF THE EXECUTIVE FUNCTION INDEX

There are several self-rating executive function (SREF) measures in existence that were developed solely in clinical populations or which sample a limited range of executive functions. The Executive Function Index (EFI) was developed here in a normal population with five subscales derived through factor analysis: Motivational Drive, Strategic Planning, Organization, Impulse Control, and Empathy. The content of three second order factors is consistent with the functions mediated by dorsolateral, orbitofrontal, and medial prefrontal circuits. Intrascale reliability and demographic relationships are reported as well as strong correlations with other SREF measures validated in clinical and neuroimaging studies. This brief measure provides a quick and efficient means of collecting data in large samples in order to test hypotheses regarding the role of prefrontal systems in various aspects of behavior and to corroborate findings of other methods, such as objective tests and functional neuroimaging.

Sex-dependent age modulation of frontostriatal and temporo-parietal activation during cognitive control

Developmental functional imaging studies of cognitive control show progressive age-related increase in task-relevant fronto-striatal activation in male development from childhood to adulthood. Little is known, however, about how gender affects this functional development. In this study, we used event related functional magnetic resonance imaging to examine effects of sex, age, and their interaction on brain activation during attentional switching and interference inhibition, in 63 male and female adolescents and adults, aged 13 to 38. Linear age correlations were observed across all subjects in task-specific frontal, striatal and temporo-parietal activation. Gender analysis revealed increased activation in females relative to males in fronto-striatal areas during the Switch task, and laterality effects in the Simon task, with females showing increased left inferior prefrontal and temporal activation, and males showing increased right inferior prefrontal and parietal activation. Increased prefrontal activation clusters in females and increased parietal activation clusters in males furthermore overlapped with clusters that were age-correlated across the whole group, potentially reflecting more mature prefrontal brain activation patterns for females, and more mature parietal activation patterns for males. Gender by age interactions further supported this dissociation, revealing exclusive female-specific age correlations in inferior and medial prefrontal brain regions during both tasks, and exclusive male-specific age correlations in superior parietal (Switch task) and temporal regions (Simon task). These findings show increased recruitment of age-correlated prefrontal activation in females, and of age-correlated parietal activation in males, during tasks of cognitive control. Gender differences in frontal and parietal recruitment may thus be related to gender differences in the neurofunctional maturation of these brain regions.

Oculomotor anomalies in attention-deficit/hyperactivity disorder: evidence for deficits in response preparation and inhibition

OBJECTIVE

To examine patterns of executive and oculomotor control in a group of both boys and girls with attention-deficit/hyperactivity disorder (ADHD).

METHOD

Cross-sectional study of 120 children aged 8 to 12 years, including 60 with ADHD (24 girls) and 60 typically developing controls (29 girls). Oculomotor paradigms included visually guided saccades (VGS), antisaccades, memory-guided saccades, and a go/no-go test, with variables of interest emphasizing response preparation, response inhibition, and working memory.

RESULTS

As a group, children with ADHD demonstrated significant deficits in oculomotor response preparation (VGS latency and variability) and response inhibition but not working memory. Girls, but not boys with ADHD, had significantly longer VGS latencies, even after controlling for differences in ADHD symptom severity. The ADHD subtypes did not differ on response preparation or inhibition measures; however, children with the Inattentive subtype were less accurate on the working memory task than those with the Combined subtype.

CONCLUSIONS

Sex differences in children with ADHD extend beyond symptom presentation to the development of oculomotor control. Saccade latency may represent a specific deficit among girls with ADHD.

Divided attention capacity in adults with autism spectrum disorders and without intellectual disability

Earlier research showed that divided attention, an aspect of executive function, is limited in both children and adults with autism spectrum disorders (ASDs). The current study explored divided attention capacity in adults with ASD and without intellectual disability (n = 36). Divided attention was tested using a computerized variant of a well-known memory recognition test, with two levels of cognitive load. The effect of cognitive load on reaction time performance is considered to be inversely proportional to divided attention capacity. The study failed to provide a relationship between divided attention and ASD, contrary to earlier research. Findings indicated that only the adults with ASD who used medication had a divided attention deficit, and that this group had specific difficulty reaching a binary decision in a memory search task. An additional finding was that the participants with ASD were overall slow. Possible causes and implications of these findings are discussed.

Functional disturbances within frontostriatal circuits across multiple childhood psychopathologies

OBJECTIVE

Neuroimaging studies of healthy individuals inform us about the normative maturation of the frontostriatal circuits that subserve self-regulatory control processes. Findings from these studies can be used as a reference frame against which to compare the aberrant development of these processes in individuals across a wide range of childhood psychopathologies.

METHOD

The authors reviewed extensive neuroimaging evidence for the presence of abnormalities in frontostriatal circuits in children and adults with Tourette's syndrome and obsessive-compulsive disorder (OCD) as well as a more limited number of imaging studies of adolescents and adults with anorexia nervosa or bulimia nervosa that, together, implicate dysregulation of frontostriatal control systems in the pathogenesis of these eating disorders.

RESULTS

The presence of an impaired capacity for self-regulatory control that derives from abnormal development of frontostriatal circuits likely interacts in similar ways with normally occurring somatic sensations and motor urges, intrusive thoughts, sensations of hunger, and preoccupation with body shape and weight to contribute, respectively, to the development of the tics of Tourette's syndrome, the obsessions of OCD, the binge eating behaviors of bulimia, and the self-starvation of anorexia.

CONCLUSIONS

Analogous brain mechanisms in parallel frontostriatal circuits, or even in differing portions of the same frontostriatal circuit, may underlie the differing behavioral disturbances in these multiple disorders, although further research is needed to confirm this hypothesis.

The neural substrates of cognitive control deficits in autism spectrum disorders

Executive function deficits are among the most frequently reported symptoms of autism spectrum disorders (ASDs), however, there have been few functional magnetic resonance imaging (fMRI) studies that investigate the neural substrates of executive function deficits in ASDs, and only one in adolescents. The current study examined cognitive control - the ability to maintain task context online to support adaptive functioning in the face of response competition - in 22 adolescents aged 12-18 with autism spectrum disorders and 23 age, gender, and IQ matched typically developing subjects. During the cue phase of the task, where subjects must maintain information online to overcome a prepotent response tendency, typically developing subjects recruited significantly more anterior frontal (BA 10), parietal (BA 7 and BA 40), and occipital regions (BA 18) for high control trials (25% of trials) versus low control trials (75% of trials). Both groups showed similar activation for low control cues, however the ASD group exhibited significantly less activation for high control cues. Functional connectivity analysis using time series correlation, factor analysis, and beta series correlation methods provided convergent evidence that the ASD group exhibited lower levels of functional connectivity and less network integration between frontal, parietal, and occipital regions. In the typically developing group, fronto-parietal connectivity was related to lower error rates on high control trials. In the autism group, reduced fronto-parietal connectivity was related to attention deficit hyperactivity disorder symptoms.

The neural basis of response inhibition and attention allocation as mediated by gestational age

Children and adolescents born before 33 weeks of gestation, that is very preterm, may experience problems with the inhibitory control of behaviour and the allocation of attention. Previous functional magnetic resonance imaging (fMRI) studies have found preterm-born adolescents to display altered brain activation in tasks measuring inhibitory control. However, adolescence is a period during which dynamic changes are occurring in the brain, and it is not yet known whether these functional alterations will persist into adulthood, or instead reflect developmental delay. This study used an event-related fMRI Go/No-Go motor response inhibition paradigm, which included an oddball task measuring attention allocation to infrequent stimuli, to compare blood-oxygen-level-dependent (BOLD) signal between 26 preterm-born adults and 21 controls. Group differences in brain activation were observed in inhibition and attention networks during both conditions. During motor response inhibition, preterm-born participants compared to controls showed increased BOLD signal in medial and right lateral posterior brain regions, including middle temporal/occipital gyrus, posterior cingulate gyrus and precuneus. During oddball trials, preterm-born young adults displayed attenuated brain activation in a fronto-parietal-cerebellar network which is involved in mediating attention allocation. This pattern of reduced brain activation in task-relevant regions of attention allocation, and increased activation in posterior brain regions during inhibitory control, suggests adult alteration of inhibition and attention processing following very preterm birth, which may reflect a developmental delay.

Dysfunctional response preparation and inhibition during a visual Go/No-go task in children with two subtypes of attention-deficit hyperactivity disorder

While a response inhibition problem is well-established in children with attention-deficit/hyperactivity disorder of the combined subtype (AD/HDcom), the predominantly inattentive subtype (AD/HDin) has not been investigated previously. This study examined control versus subtype differences in visually evoked response inhibition using task performance and event-related potential (ERP) measures. Children with AD/HDcom (n=15) and AD/HDin (n=15) and age-matched controls (n=15) performed a cued visual Go/Nogo task requiring either activation or inhibition (30%) of a button-press response to the S2 (Go or Nogo stimulus) following the S1 (warning stimulus), presented 1380 ms earlier. Task performance and ERP indices of Warning, Go and Nogo stimulus processing, as well as preparation during the S1-S2 interval, were examined for group differences. Behavioural results indicated a response inhibition deficit in children with AD/HDcom and AD/HDin, with additional response activation problems in AD/HDcom. Topographic ERP differences between controls and both clinical groups suggested atypical (a) preparation for S2 as indexed by the late CNV, (b) early sensory/attentional processing of both S1 and S2, and (c) response inhibition as indexed by N2 and P3. In addition to replicating previous AD/HDcom findings, these results indicate that children with AD/HDin differ from controls in response preparation and inhibition during a cued visual Go/Nogo task.

Diffusion tensor imaging study of white matter fiber tracts in pediatric bipolar disorder and attention-deficit/hyperactivity disorder

BACKGROUND

To investigate microstructure of white matter fiber tracts in pediatric bipolar disorder (PBD) and attention-deficit/hyperactivity disorder (ADHD).

METHODS

A diffusion tensor imaging (DTI) study was conducted at 3 Tesla on age- and IQ-matched children and adolescents with PBD (n = 13), ADHD (n = 13), and healthy control subjects (HC) (n = 15). Three DTI parameters, fractional anisotropy (FA), apparent diffusion coefficient (ADC), and regional fiber coherence index (r-FCI), were examined in eight fiber tracts: anterior corona radiata (ACR), anterior limb of the internal capsule (ALIC), superior region of the internal capsule (SRI), posterior limb of the internal capsule (PLIC), superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), cingulum (CG), and splenium (SP).

RESULTS

Significantly lower FA was observed in ACR in both PBD and ADHD relative to HC. In addition, FA and r-FCI values were significantly lower in ADHD relative to PBD and HC in both the ALIC and the SRI. Further, ADC was significantly greater in ADHD relative to both the PBD and HC in ACR, ALIC, PLIC, SRI, CG, ILF, and SLF.

CONCLUSIONS

Decreased FA in ACR implies an impaired fiber density or reduced myelination in both PBD and ADHD in this prefrontal tract. These abnormalities, together with the reduced fiber coherence, extended to corticobulbar tracts in ADHD. Increased ADC across multiple white matter tracts in ADHD indicates extensive cellular abnormalities with less diffusion restriction in ADHD relative to PBD.

Atomoxetine modulates right inferior frontal activation during inhibitory control: a pharmacological functional magnetic resonance imaging study

BACKGROUND

Atomoxetine, a selective noradrenaline reuptake inhibitor (SNRI) licensed for the treatment of attention-deficit/hyperactivity disorder (ADHD), has been shown to improve response inhibition in animals, healthy volunteers, and adult patients. However, the mechanisms by which atomoxetine improves inhibitory control have yet to be determined.

METHODS

The effects of atomoxetine (40 mg) were measured with a stop-signal functional magnetic resonance imaging (fMRI) paradigm in 19 healthy volunteers, in a within-subject, double-blind, placebo-controlled design.

RESULTS

Atomoxetine improved inhibitory control and increased activation in the right inferior frontal gyrus when volunteers attempted to inhibit their responses (irrespective of success). Plasma levels of drug correlated significantly with right inferior frontal gyrus activation only during successful inhibition.

CONCLUSIONS

These results show that atomoxetine exerts its beneficial effects on inhibitory control via modulation of right inferior frontal function, with implications for understanding and treating inhibitory dysfunction of ADHD and other disorders.

Brain network dynamics during error commission

Previous studies suggest that the anterior cingulate and other prefrontal brain regions might form a functionally-integrated error detection network in the human brain. This study examined whole brain functional connectivity to both correct and incorrect button presses using independent component analysis (ICA) of functional magnetic resonance imaging (fMRI) data collected from 25 adolescent and 25 adult healthy participants (ages 11-37) performing a visual Go/No-Go task. Correct responses engaged a network comprising left lateral prefrontal cortex, left postcentral gyrus/inferior parietal lobule, striatum, and left cerebellum. In contrast, a similar network was uniquely engaged during errors, but this network was not integrated with activity in regions believed to be engaged for higher-order cognitive control over behavior. A medial/dorsolateral prefrontal-parietal neural network responded to all No-Go stimuli, but with significantly greater activity to errors. ICA analyses also identified a third error-related circuit comprised of anterior temporal lobe, limbic, and pregenual cingulate cortices, possibly representing an affective response to errors. There were developmental differences in error-processing activity within many of these neural circuits, typically reflecting greater hemodynamic activation in adults. These findings characterize the spatial structure of neural networks underlying error commission and identify neurobiological differences between adolescents and adults.

A neurogenetic approach to impulsivity

Impulsivity is a complex and multidimensional trait that is of interest to both personality psychologists and to clinicians. For investigators seeking the biological basis of personality traits, the use of neuroimaging techniques such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) revolutionized personality psychology in less than a decade. Now, another revolution is under way, and it originates from molecular biology. Specifically, new findings in molecular genetics, the detailed mapping and the study of the function of genes, have shown that individual differences in personality traits can be related to individual differences within specific genes. In this article, we will review the current state of the field with respect to the neural and genetic basis of trait impulsivity.

Neural basis of Delta-9-tetrahydrocannabinol and cannabidiol: effects during response inhibition

BACKGROUND

This study examined the effect of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on brain activation during a motor inhibition task.

METHODS

Functional magnetic resonance imaging and behavioural measures were recorded while 15 healthy volunteers performed a Go/No-Go task following administration of either THC or CBD or placebo in a double-blind, pseudo-randomized, placebo-controlled repeated measures within-subject design.

RESULTS

Relative to placebo, THC attenuated activation in the right inferior frontal and the anterior cingulate gyrus. In contrast, CBD deactivated the left temporal cortex and insula. These effects were not related to changes in anxiety, intoxication, sedation, and psychotic symptoms.

CONCLUSIONS

These data suggest that THC attenuates the engagement of brain regions that mediate response inhibition. CBD modulated function in regions not usually implicated in response inhibition.

Why do many psychiatric disorders emerge during adolescence?

The peak age of onset for many psychiatric disorders is adolescence, a time of remarkable physical and behavioural changes. The processes in the brain that underlie these behavioural changes have been the subject of recent investigations. What do we know about the maturation of the human brain during adolescence? Do structural changes in the cerebral cortex reflect synaptic pruning? Are increases in white-matter volume driven by myelination? Is the adolescent brain more or less sensitive to reward? Finding answers to these questions might enable us to further our understanding of mental health during adolescence.

Neuroimaging studies of normal brain development and their relevance for understanding childhood neuropsychiatric disorders

OBJECTIVE

To review the maturational events that occur during prenatal and postnatal brain development and to present neuroimaging findings from studies of healthy individuals that identify the trajectories of normal brain development.

METHOD

Histological and postmortem findings of early brain development are presented, followed by a discussion of anatomical, diffusion tensor, proton spectroscopy, and functional imaging findings from studies of healthy individuals, with special emphasis on longitudinal data.

RESULTS

Early brain development occurs through a sequence of major events, beginning with the formation of the neural tube and ending with myelination. Brain development at a macroscopic level typically proceeds first in sensorimotor areas, spreading subsequently and progressively into dorsal and parietal, superior temporal, and dorsolateral prefrontal cortices throughout later childhood and adolescence. These patterns of anatomical development parallel increasing activity in frontal cortices that subserves the development of higher-order cognitive functions during late childhood and adolescence. Disturbances in these developmental patterns seem to be involved centrally in the pathogenesis of various childhood psychiatric disorders including childhood-onset schizophrenia, attention-deficit/hyperactivity disorder, developmental dyslexia, Tourette's syndrome, and bipolar disorder.

CONCLUSIONS

Advances in imaging techniques have enhanced our understanding of normal developmental trajectories in the brain, which may improve insight into the abnormal patterns of development in various childhood psychiatric disorders.

Neurodevelopment and executive function in autism

Autism is a neurodevelopmental disorder characterized by social and communication deficits, and repetitive behavior. Studies investigating the integrity of brain systems in autism suggest a wide range of gray and white matter abnormalities that are present early in life and change with development. These abnormalities predominantly affect association areas and undermine functional integration. Executive function, which has a protracted development into adolescence and reflects the integration of complex widely distributed brain function, is also affected in autism. Evidence from studies probing response inhibition and working memory indicate impairments in these core components of executive function, as well as compensatory mechanisms that permit normative function in autism. Studies also demonstrate age-related improvements in executive function from childhood to adolescence in autism, indicating the presence of plasticity and suggesting a prolonged window for effective treatment. Despite developmental gains, mature executive functioning is limited in autism, reflecting abnormalities in wide-spread brain networks that may lead to impaired processing of complex information across all domains.

Desperately driven and no brakes: developmental stress exposure and subsequent risk for substance abuse

Adverse life events are associated with a wide range of psychopathology, including an increased risk for substance abuse. In this review, we focus on the inter-relationship between exposure to adversity and brain development, and relate this to enhanced windows of vulnerability. This review encompasses clinical and preclinical data, drawing evidence from epidemiological studies, morphometric and functional imaging studies, and molecular biology and genetics. The interaction of exposure during a sensitive period and maturational events produces a cascade that leads to the initiation of substance use at younger ages, and increases the likelihood of addiction by adolescence or early adulthood. A stress-incubation/corticolimbic dysfunction model is proposed based on the interplay of stress exposure, development stage, and neuromaturational events that may explain the seeking of specific classes of drugs later in life. Three main factors contribute to this age-based progression of increased drug use: (1) a sensitized stress response system; (2) sensitive periods of vulnerability; and (3) maturational processes during adolescence. Together, these factors may explain why exposure to early adversity increases risk to abuse substances during adolescence.