Structural and functional MRI- findings in children and adolescents with antisocial behavior

Internalizing and Externalizing Symptoms Are Associated With Different Trajectories of Cortical Development During Late Childhood

OBJECTIVE

Investigation of neurobiological differences between internalizing and externalizing symptoms in children is needed to better understand the unique pathophysiology of each, which may ultimately better target treatments and interventions. Longitudinal studies are critical, given the marked brain development that occurs in childhood; however, few such studies exist, and results are inconsistent. The aim of this study was to longitudinally investigate associations between internalizing and externalizing symptoms, and cortical thinning during late childhood.

METHOD

Participants were 105 children (49 male) from the community, who underwent magnetic resonance imaging (MRI) brain scans, and completed questionnaire measures of depressive and anxiety symptoms at two time points (mean age: 8.4 years at baseline, 10.0 years at follow-up); and, mothers, who reported on child internalizing and externalizing symptoms at both time points. Whole-brain vertex-wise regression analyses were performed to assess associations between change in cortical thickness and symptoms between baseline and follow-up.

RESULTS

Increases in internalizing symptoms over time were associated with reduced thinning in the orbitofrontal cortex, whereas increases in externalizing symptoms were associated with reduced thinning in the postcentral gyrus. The interaction between internalizing and externalizing symptom change was not associated with cortical thinning.

CONCLUSION

Results suggest that the development of internalizing and externalizing symptoms are associated with unique neurodevelopmental patterns in late childhood, potentially implicating differential deficits in affective reactivity, emotion regulation, and social cognition. Further research is required to elucidate the implications of these patterns for ongoing brain development, psychopathology, and behavior.

Reduced gray matter volume in male adolescent violent offenders

Background

Previous studies reported that reduced gray matter volume (GMV) was associated with violent-related behaviors. However, the previous studies were conducted on adults and no study has studied the association between GMV and violent behaviors on adolescents. The purpose of the study was to investigate GMV’s effects in adolescent violent offenders based on a Chinese Han population, which can address the problem of possible confounding factors in adult studies.

Methods

We recruited 30 male adolescent violent offenders and 29 age- and sex-matched healthy controls (HCs). Differences in both whole-brain and GMV were evaluated using voxel-based morphometry (VBM). We assessed the accuracy of VBM using the receiver operating characteristic curve (ROC) and discriminant analysis.

Results

Compared with HCs, the male adolescent offenders showed significantly reduced GMV in five cortical and subcortical brain regions, including the olfactory cortex, amygdala, middle temporal gyrus and inferior parietal lobe in the left hemisphere, as well as the right superior temporal gyrus. Both ROC curve and discriminate analyses showed that these regions had relatively high sensitivities (58.6%–89.7%) and specificities (58.1%–74.2%) with 76.7% classification accuracy.

Conclusions

Our results indicated that reduced volume in the frontal-temporal-parietal-subcortical circuit may be closely related to violent behaviors in male adolescents, which might be an important biomarker for detecting violent behaviors in male adolescents.

Ventral striatum and amygdala activity as convergence sites for early adversity and conduct disorder

Childhood family adversity (CFA) increases the risk for conduct disorder (CD) and has been associated with alterations in regions of affective processing like ventral striatum (VS) and amygdala. However, no study so far has demonstrated neural converging effects of CFA and CD in the same sample. At age 25 years, functional MRI data during two affective tasks, i.e. a reward (N = 171) and a face-matching paradigm (N = 181) and anatomical scans (N = 181) were acquired in right-handed currently healthy participants of an epidemiological study followed since birth. CFA during childhood was determined using a standardized parent interview. Disruptive behaviors and CD diagnoses during childhood and adolescence were obtained by diagnostic interview (2-19 years), temperamental reward dependence was assessed by questionnaire (15 and 19 years).CFA predicted increased CD and amygdala volume. Both exposure to CFA and CD were associated with a decreased VS response during reward anticipation and blunted amygdala activity during face-matching. CD mediated the effect of CFA on brain activity. Temperamental reward dependence was negatively correlated with CFA and CD and positively with VS activity. These findings underline the detrimental effects of CFA on the offspring's affective processing and support the importance of early postnatal intervention programs aiming to reduce childhood adversity factors.

The influence of comorbid oppositional defiant disorder on white matter microstructure in attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are highly comorbid disorders. ADHD has been associated with altered white matter (WM) microstructure, though the literature is inconsistent, which may be due to differences in the in- or exclusion of participants with comorbid ODD. WM abnormalities in ODD are still poorly understood, and it is unclear whether comorbid ODD in ADHD may have confounded the current ADHD literature. Diffusion Tensor Imaging (DTI) was used to compare fractional anisotropy (FA) and mean diffusivity (MD) between ADHD patients with (n = 42) and without (n = 117) comorbid ODD. All participants were between 8-25 years and groups did not differ in mean age or gender. Follow-up analyses were conducted to examine the role of antisocial behaviour (conduct problems) on FA and MD values in both groups. Comorbid ODD in ADHD was associated with lower FA in left frontotemporal WM, which appeared independent of ADHD symptoms. FA was negatively associated with antisocial behaviour in ADHD + ODD, but not in ADHD-only. Comorbid ODD is associated with WM abnormalities in individuals with ADHD, which appears to be independent of ADHD symptoms. Altered WM microstructure in comorbid ODD may play a role in inconsistencies in the current DTI literature in ADHD. Altered development of these tracts may contribute to social-emotional and cognitive problems in children with oppositional and antisocial behaviour.

A Whole-Brain Investigation of White Matter Microstructure in Adolescents with Conduct Disorder

BACKGROUND

The biological basis of severe antisocial behaviour in adolescents is poorly understood. We recently reported that adolescents with conduct disorder (CD) have significantly increased fractional anisotropy (FA) of the uncinate fasciculus (a white matter (WM) tract that connects the amygdala to the frontal lobe) compared to their non-CD peers. However, the extent of WM abnormality in other brain regions is currently unclear.

METHODS

We used tract-based spatial statistics to investigate whole brain WM microstructural organisation in 27 adolescent males with CD, and 21 non-CD controls. We also examined relationships between FA and behavioural measures. Groups did not differ significantly in age, ethnicity, or substance use history.

RESULTS

The CD group, compared to controls, had clusters of significantly greater FA in 7 brain regions corresponding to: 1) the bilateral inferior and superior cerebellar peduncles, corticopontocerebellar tract, posterior limb of internal capsule, and corticospinal tract; 2) right superior longitudinal fasciculus; and 3) left cerebellar WM. Severity of antisocial behavior and callous-unemotional symptoms were significantly correlated with FA in several of these regions across the total sample, but not in the CD or control groups alone.

CONCLUSIONS

Adolescents with CD have significantly greater FA than controls in WM regions corresponding predominantly to the fronto-cerebellar circuit. There is preliminary evidence that variation in WM microstructure may be dimensionally related to behaviour problems in youngsters. These findings are consistent with the hypothesis that antisocial behaviour in some young people is associated with abnormalities in WM 'connectivity'.

Structural and Functional Alterations in Right Dorsomedial Prefrontal and Left Insular Cortex Co-Localize in Adolescents with Aggressive Behaviour: An ALE Meta-Analysis

Recent neuroimaging work has suggested that aggressive behaviour (AB) is associated with structural and functional brain abnormalities in processes subserving emotion processing and regulation. However, most neuroimaging studies on AB to date only contain relatively small sample sizes. To objectively investigate the consistency of previous structural and functional research in adolescent AB, we performed a systematic literature review and two coordinate-based activation likelihood estimation meta-analyses on eight VBM and nine functional neuroimaging studies in a total of 783 participants (408 [224AB/184 controls] and 375 [215 AB/160 controls] for structural and functional analysis respectively). We found 19 structural and eight functional foci of significant alterations in adolescents with AB, mainly located within the emotion processing and regulation network (including orbitofrontal, dorsomedial prefrontal and limbic cortex). A subsequent conjunction analysis revealed that functional and structural alterations co-localize in right dorsomedial prefrontal cortex and left insula. Our results are in line with meta-analytic work as well as structural, functional and connectivity findings to date, all of which make a strong point for the involvement of a network of brain areas responsible for emotion processing and regulation, which is disrupted in AB. Increased knowledge about the behavioural and neuronal underpinnings of AB is crucial for the development of novel and implementation of existing treatment strategies. Longitudinal research studies will have to show whether the observed alterations are a result or primary cause of the phenotypic characteristics in AB.

Reduced cortical surface area in adolescents with conduct disorder

Children with conduct disorder (CD) are at increased risk of developing antisocial personality disorder and psychopathy in adulthood. Neuroimaging research has identified abnormal cortical volume (CV) in CD. However, CV comprises two genetically and developmentally separable components: cortical thickness (CT) and surface area (SA). Aim of this study is to explore the relationship between the cortical constituents of CV in boys with CD. We applied FreeSurfer software to structural MRI data to derive measures of CV, CT, and SA in 21 boys with CD and 19 controls. Relationships between these cortical measures were investigated. Boys with CD had significantly reduced CV and SA compared to non-CD boys in ventromedial and dorsolateral prefrontal cortex. We found no significant between-group differences in CT. Reduced prefrontal CV in boys with CD is associated with significantly reduced SA in the same regions. This finding may help to identify specific neurodevelopmental mechanisms underlying cortical deficits observed in CD.

[Female conduct disorders]

The last few years have seen much research on girls with conduct disorder (CD). This article summarizes the gender-specific data regarding prevalence, differences with respect to symptomatology (e.g., subtypes of aggression, callous-unemotional (cu)-traits), and it presents data on the autonomic and neuroendocrine stress system as well as genetic, neurocognitive, and neuroimaging data. Differences in the impact of environmental factors on boys and girls for the development of CD are discussed. Taken together, the data indicate that there is great overlap in symptomatology, personality traits, and neurobiological aberrations in girls and boys with CD. Since fewer girls than boys exhibit CD symptomatology, further investigations on CD in girls might help to identify resilience factors that could improve future therapeutic interventions.

DTI-measured white matter abnormalities in adolescents with Conduct Disorder

Emerging research suggests that antisocial behavior in youth is linked to abnormal brain white matter microstructure, but the extent of such anatomical connectivity abnormalities remain largely untested because previous Conduct Disorder (CD) studies typically have selectively focused on specific frontotemporal tracts. This study aimed to replicate and extend previous frontotemporal diffusion tensor imaging (DTI) findings to determine whether noncomorbid CD adolescents have white matter microstructural abnormalities in major white matter tracts across the whole brain. Seventeen CD-diagnosed adolescents recruited from the community were compared to a group of 24 non-CD youth which did not differ in average age (12-18) or gender proportion. Tract-based spatial statistics (TBSS) fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) measurements were compared between groups using FSL nonparametric two-sample t test, clusterwise whole-brain corrected, p < .05. CD FA and AD deficits were widespread, but unrelated to gender, verbal ability, or CD age of onset. CD adolescents had significantly lower FA and AD values in frontal lobe and temporal lobe regions, including frontal lobe anterior/superior corona radiata, and inferior longitudinal and fronto-occipital fasciculi passing through the temporal lobe. The magnitude of several CD FA deficits was associated with number of CD symptoms. Because AD, but not RD, differed between study groups, abnormalities of axonal microstructure in CD rather than myelination are suggested. This study provides evidence that adolescent antisocial disorder is linked to abnormal white matter microstructure in more than just the uncinate fasciculus as identified in previous DTI studies, or frontotemporal brain structures as suggested by functional neuroimaging studies. Instead, neurobiological risk specific to antisociality in adolescence is linked to microstructural abnormality in numerous long-range white matter connections among many diverse different brain regions.

Understanding Youth Antisocial Behavior Using Neuroscience through a Developmental Psychopathology Lens: Review, Integration, and Directions for Research

Youth antisocial behavior (AB) is an important public health concern impacting perpetrators, victims, and society. Functional neuroimaging is becoming a more common and useful modality for understanding neural correlates of youth AB. Although there has been a recent increase in neuroimaging studies of youth AB and corresponding theoretical articles on the neurobiology of AB, there has been little work critically examining the strengths and weaknesses of individual studies and using this knowledge to inform the design of future studies. Additionally, research on neuroimaging and youth AB has not been integrated within the broader framework of developmental psychopathology. Thus, this paper provides an in-depth review of the youth AB functional neuroimaging literature with the following goals: 1. to evaluate how this literature has informed our understanding of youth AB, 2. to evaluate current neuroimaging studies of youth AB from a developmental psychopathology perspective with a focus on integrating research from neuroscience and developmental psychopathology, as well as placing this research in the context of other related areas (e.g., psychopathy, molecular genetics), and 3. to examine strengths and weaknesses of neuroimaging and behavioral studies of youth AB to suggest how future studies can develop a more informed and integrated understanding of youth AB.

Neural bases of antisocial behavior: a voxel-based meta-analysis

Individuals with antisocial behavior place a great physical and economic burden on society. Deficits in emotional processing have been recognized as a fundamental cause of antisocial behavior. Emerging evidence also highlights a significant contribution of attention allocation deficits to such behavior. A comprehensive literature search identified 12 studies that were eligible for inclusion in the meta-analysis, which compared 291 individuals with antisocial problems and 247 controls. Signed Differential Mapping revealed that compared with controls, gray matter volume (GMV) in subjects with antisocial behavior was reduced in the right lentiform nucleus (P < 0.0001), left insula (P = 0.0002) and left frontopolar cortex (FPC) (P = 0.0006), and was increased in the right fusiform gyrus (P < 0.0001), right inferior parietal lobule (P = 0.0003), right superior parietal lobule (P = 0.0004), right cingulate gyrus (P = 0.0004) and the right postcentral gyrus (P = 0.0004). Given the well-known contributions of limbic and paralimbic areas to emotional processing, the observed reductions in GMV in these regions might represent neural correlates of disturbance in emotional processing underlying antisocial behavior. Previous studies have suggested an FPC role in attention allocation during emotional processing. Therefore, GMV deviations in this area may constitute a neural basis of deficits in attention allocation linked with antisocial behavior.

Prenatal cocaine exposure alters functional activation in the ventral prefrontal cortex and its structural connectivity with the amygdala

Prenatal cocaine exposure (PCE) is associated with arousal dysregulation, and alterations of amygdala activity in response to emotional arousal have previously been reported. However, voluntary regulation of emotional affect, enabling appropriate neural response to different streams of stimuli, must also engage prefrontal regions, yet the impact of PCE on these prefrontal mechanisms has not been investigated. Recent neuroimaging studies have shown the involvement of ventral prefrontal cortex (vPFC) in the modulation of amygdala reactivity and the mediation of effective emotional regulation. Based on these findings, using functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), the present study compared functional activations of the vPFC as well as its structural connectivity with the amygdala between groups of PCE and control adolescents. In a working memory task with emotional distracters, the PCE adolescents exhibited less capability of increasing their vPFC activation in response to increased memory load, which corresponded with their less suppressed amygdala activation. Reduced structural connectivity between the vPFC and the amygdala was also observed from DTI measurement in the PCE group. In addition, correlations between amygdala activation and (i) vPFC activation, as well as (ii) amygdala-vPFC structural connectivity, were observed in the control but not in the PCE group. These data complement previous findings of the impact of PCE on the activity of the amygdala and extend our understanding of the neurobiological mechanisms underlying the effect of PCE on arousal dysregulation reported in human and animal studies.

Frontotemporal white-matter microstructural abnormalities in adolescents with conduct disorder: a diffusion tensor imaging study

BACKGROUND

Children with conduct disorder (CD) are at increased risk of developing antisocial personality disorder (ASPD) and psychopathy in adulthood. The biological basis for this is poorly understood. A preliminary diffusion tensor magnetic resonance imaging (DT-MRI) study of psychopathic antisocial adults reported significant differences from controls in the fractional anisotropy (FA) of the uncinate fasciculus (UF), a white-matter tract that connects the amygdala to the frontal lobe. However, it is unknown whether developmental abnormalities are present in the UF of younger individuals with CD.

METHOD

We used DT-MRI tractography to investigate, for the first time, the microstructural integrity of the UF in adolescents with CD, and age-related differences in this tract. We compared FA and perpendicular diffusivity of the UF in 27 adolescents with CD and 16 healthy controls (12 to 19 years old) who did not differ significantly in age, IQ or substance use history. To confirm that these findings were specific to the UF, the same measurements were extracted from two non-limbic control tracts. Participants in the CD group had a history of serious aggressive and violent behaviour, including robbery, burglary, grievous bodily harm and sexual assault.

RESULTS

Individuals with CD had a significantly increased FA (p = 0.006), and reduced perpendicular diffusivity (p = 0.002), in the left UF. Furthermore, there were significant age-related between-group differences in perpendicular diffusivity of the same tract (Z obs = 2.40, p = 0.01). Controls, but not those with CD, showed significant age-related maturation. There were no significant between-group differences in any measure within the control tracts.

CONCLUSIONS

Adolescents with CD have significant differences in the 'connectivity' and maturation of UF.

Comparison of brain volume abnormalities between ADHD and conduct disorder in adolescence

BACKGROUND

Previous studies of brain structure abnormalities in conduct disorder and attention-deficit/hyperactivity disorder (ADHD) samples have been limited owing to cross-comorbidity, preventing clear understanding of which structural brain abnormalities might be specific to or shared by each disorder. To our knowledge, this study was the first direct comparison of grey and white matter volumes in diagnostically "pure" (i.e., no comorbidities) conduct disorder and ADHD samples.

METHODS

Groups of adolescents with noncormobid conduct disorder and with noncomorbid, combined-subtype ADHD were compared with age- and sex-matched controls using DARTEL voxel-based analysis of T1-weighted brain structure images. Analysis of variance with post hoc analyses compared whole brain grey and white matter volumes among the groups.

RESULTS

We included 24 adolescents in each study group. There was an overall 13% reduction in grey matter volume in adolescents with conduct disorder, reflecting numerous frontal, temporal, parietal and subcortical deficits. The same grey matter regions typically were not abnormal in those with ADHD. Deficits in frontal lobe regions previously identified in studies of patients with ADHD either were not detected, or group differences from controls were not as strong as those between the conduct disorder and control groups. White matter volume measurements did not differentiate conduct disorder and ADHD.

LIMITATIONS

Our modest sample sizes prevented meaningful examination of individual features of ADHD or conduct disorder, such as aggression, callousness, or hyperactive versus inattentive symptom subtypes.

CONCLUSION

The evidence supports theories of frontotemporal abnormalities in adolescents with conduct disorder, but raises questions about the prominence of frontal lobe and striatal structural abnormalities in those with noncomorbid, combined-subtype ADHD. The latter point is clinically important, given the widely held belief that ADHD is associated with numerous frontal lobe structural deficits, a conclusion that is not strongly supported following direct comparison of diagnostically pure groups. The results are important for future etiological studies, particularly those seeking to identify how early expression of specific brain structure abnormalities could potentiate the risk for antisocial behaviour.

Cortical thickness and folding deficits in conduct-disordered adolescents

BACKGROUND

Studies of pediatric conduct disorder (CD) have described frontal and temporal lobe structural abnormalities that parallel findings in antisocial adults. The purpose of this study was to examine previously unexplored cortical thickness and folding as markers for brain abnormalities in "pure CD"-diagnosed adolescents. On the basis of current frontotemporal theories, we hypothesized that CD youth would have thinner cortex or less cortical folding in temporal and frontal lobes than control subjects.

METHODS

We obtained T1-weighted brain structure images from 24 control and 19 CD participants aged 12 to 18 years, matched by gender and age. We measured group differences in cortical thickness and local gyrification index (regional cortical folding measure) using surface-based morphometry with clusterwise correction for multiple comparisons.

RESULTS

The CD participants, compared with control subjects, showed both reduced cortical thickness and folding. Thinner cortex was located primarily in posterior brain regions, including left superior temporal and parietal lobes, temporoparietal junction and paracentral lobule, right superior temporal and parietal lobes, temporoparietal junction, and precuneus. Folding deficits were located mainly in anterior brain regions and included left insula, ventro- and dorsomedial prefrontal, anterior cingulate and orbitofrontal cortices, temporal lobe, right superior frontal and parietal lobes, and paracentral lobule.

CONCLUSIONS

Our findings generally agree with previous CD volumetric studies but here show the unique contributions of cortical thickness and folding to gray matter reductions in pure CD in different brain regions.

Die Bedeutung von Ängstlichkeit für die Phänotypisierung dissozialer Störungen des Kindes- und Jugendalters

In den letzten Jahren wurden vermehrt neurobiologische Marker dissozialen Verhaltens bei Kindern mit hohem Risiko für einen ungünstigen Verlauf (so genannter early-starter Subtyp der Conduct disorder, CD nach DSM-IV) identifiziert. Trotz einer Fokussierung auf diese Subpopulation innerhalb eines sehr heterogenen Störungsbildes liegen bisher widersprüchliche Befunde vor. Es deutet sich an, dass die zunehmenden methodischen Möglichkeiten der Untersuchung biologischer Marker eine detaillierte Phänotypisierung der untersuchten Stichproben notwendig macht. Die vorliegende Übersichtsarbeit betont die Berücksichtigung komorbider Ängstlichkeit als ein potenziell wichtiges Differenzierungsmerkmal, welches zu einer konsistenteren Befundlage vor allem im Bereich neuroendokriner Studien beitragen könnte. Möglicherweise bestehen darüber hinaus auch Assoziationen zu neurostrukturellen und neurofunktionellen Veränderungen des Gehirns. Es wird weiter der Einfluss des Merkmals Ängstlichkeit auf aggressives Verhalten sowie auf die Prognose der Betroffenen aufgezeigt. Eine detaillierte psychometrische und neurobiologische Charakterisierung könnte dazu beitragen, die an dissozialen Entwicklungen beteiligten neurobiologischen Mechanismen besser zu verstehen und die Effektivität derzeitiger therapeutische Optionen zu steigern.

Maturity in adolescent and young adult offenders: the role of cognitive control

This study examined the role of cognitive control in explaining the psychosocial maturity of adolescent (n = 43) and young adult male (n = 40) offenders. We separated psychosocial maturity into prosocial and criminal components, which were statistically unrelated and were explained by different variables. Individuals with higher levels of prosocial maturity were older, had better proactive cognitive control, and had better short-term memory than those with lower levels of prosocial maturity. Individuals with higher levels of criminal maturity were older and had better reactive cognitive control than those with lower levels of criminal maturity. We discuss the implications of these findings with regard to juvenile justice policy and practice.

Getting the phenotypes right: an essential ingredient for understanding aetiological mechanisms underlying persistent violence and developing effective treatments

In order to reduce societal levels of violence, it is essential to advance understanding of the neurobiological mechanisms involved in initiating and maintaining individual patterns of physical aggression. New technologies such as Magnetic Resonance Imagining and analyses of DNA provide tools for identifying these mechanisms. The reliability and validity of the results of studies using these tools depend not only on aspects of the technology, but also on the methodological rigour with which the studies are conducted, particularly with respect to characterizing the phenotype. The present article discusses five challenges confronting scientists who aim to advance understanding of the neurobiological mechanisms associated with persistent violence. These challenges are: (1) to develop evidence-based hypotheses and to design studies that test alternate hypotheses; (2) to recruit samples that are homogeneous with respect to variables that may be linked to neurobiological mechanisms underpinning violent behaviour; (3) to use reliable and valid measures in order to fully characterize participants so that the external validity of the results is evident; (4) to restrict the range of age of participants so as not to confuse developmental change with group differences; and (5) to take account of sex. Our goal is to contribute to elevating methodological standards in this new field of research and to thereby improve the validity of results and move closer to finding effective ways to reduce violence.

[Neuroethics in clinical practice]

In recent years the ability of neuroscience to identify and intervene in mental functions has progressed immensely, which raises several anthropologic and ethical questions. Meanwhile neuroethics arose as a new interdisciplinary field for critical analysis of neuroscientific actions and ethical reflection on the increasing knowledge of the human brain, with regard to society and politics. This article provides a survey of neuroethical implications for clinical practice.