Amygdala-frontal connectivity predicts internalizing symptom recovery among inpatient adolescents

Right frontal cingulate cortex mediates the effect of prenatal complications on youth internalizing behaviors

Prenatal and perinatal complications represent well-known risk factors for the future development of psychiatric disorders. Such influence might become manifested during childhood and adolescence, as key periods for brain and behavioral changes. Internalizing and externalizing behaviors in adolescence have been associated with the risk of psychiatric onset later in life. Both brain morphology and behavior seem to be affected by obstetric complications, but a clear link among these three aspects is missing. Here, we aimed at analyzing the association between prenatal and perinatal complications, behavioral issues, and brain volumes in a group of children and adolescents. Eighty-two children and adolescents with emotional-behavioral problems underwent clinical and 3 T brain magnetic resonance imaging (MRI) assessments. The former included information on behavior, through the Child Behavior Checklist/6-18 (CBCL/6-18), and on the occurrence of obstetric complications. The relationships between clinical and gray matter volume (GMV) measures were investigated through multiple generalized linear models and mediation models. We found a mutual link between prenatal complications, GMV alterations in the frontal gyrus, and withdrawn problems. Specifically, complications during pregnancy were associated with higher CBCL/6-18 withdrawn scores and GMV reductions in the right superior frontal gyrus and anterior cingulate cortex. Finally, a mediation effect of these GMV measures on the association between prenatal complications and the withdrawn dimension was identified. Our findings suggest a key role of obstetric complications in affecting brain structure and behavior. For the first time, a mediator role of frontal GMV in the relationship between prenatal complications and internalizing symptoms was suggested. Once replicated on independent cohorts, this evidence will have relevant implications for planning preventive interventions.

Partial Klüver-Bucy syndrome in a Paediatric patient: A post-neurosurgical and neuropsychological cases

A variety of cognitive, behavioural, and emotional impairments have been reported in the literature that are associated with the resection of the temporal cortex. Klüver-Bucy syndrome is one infrequently reported disorder in the paediatric population. This paper describes the neuropsychological findings of a female paediatric patient at 7 and 10 years of age with a diagnosis of partial Klüver-Bucy syndrome (pKBS) following total resection of the amygdala and right hippocampus to resect a glioma. The patient presented emotional problems, aggressiveness, hypermetamorphosis, social indifference, and behavioural dysexecutive syndrome, which was found at both 7 and 10 years, but with a decrease in the severity of alterations in attention, impulsivity, hyperactivity, and aggressive behaviour in a second evaluation after she had a neuropsychological intervention. These findings describe the neuropsychological profile of paediatric case with resection of the amygdala and right temporal lobe.

Parental Education, Household Income, Race, and Children's Working Memory: Complexity of the Effects

Background. Considerable research has linked social determinants of health (SDoHs) such as race, parental education, and household income to school performance, and these effects may be in part due to working memory. However, a growing literature shows that these effects may be complex: while the effects of parental education may be diminished for Blacks than Whites, household income may explain such effects. Purpose. Considering race as sociological rather than a biological construct (race as a proxy of racism) and built on Minorities' Diminished Returns (MDRs), this study explored complexities of the effects of SDoHs on children's working memory. Methods. We borrowed data from the Adolescent Brain Cognitive Development (ABCD) study. The total sample was 10,418, 9- and 10-year-old children. The independent variables were race, parental education, and household income. The primary outcome was working memory measured by the NIH Toolbox Card Sorting Test. Age, sex, ethnicity, and parental marital status were the covariates. To analyze the data, we used mixed-effect regression models. Results. High parental education and household income were associated with higher and Black race was associated with lower working memory. The association between high parental education but not household income was less pronounced for Black than White children. This differential effect of parental education on working memory was explained by household income. Conclusions. For American children, parental education generates unequal working memory, depending on race. This means parental education loses some of its expected effects for Black families. It also suggests that while White children with highly educated parents have the highest working memory, Black children report lower working memory, regardless of their parental education. This inequality is mainly because of differential income in highly educated White and Black families. This finding has significant public policy and economic implications and suggests we need to do far more than equalizing education to eliminate racial inequalities in children's cognitive outcomes. While there is a need for multilevel policies that reduce the effect of racism and social stratification for middle-class Black families, equalizing income may have more returns than equalizing education.

Socioeconomic Status Inequalities Partially Mediate Racial and Ethnic Differences in Children's Amygdala Volume

BACKGROUND

While race/ethnicity and socioeconomic status (SES) impact brain structures such as the amygdala, less is known on whether or not family SES partially explains why amygdala volume is smaller for racial and ethnic minority groups.

PURPOSE

This study tested the mediating effects of family SES on racial and ethnic differences in right and left amygdala volume.

METHODS

We borrowed the structural Magnetic Resonance Imaging (sMRI) data of the Children Brain Cognitive Development (ABCD) study, a brain imaging investigation of childhood brain development in the US. The total sample was 8977, 9-10-year-old children. The independent variables were race and ethnicity. The primary outcomes were right and left amygdala volume. Age, sex, household size, and marital status were the covariates. Multiple SES indicators such as family income, subjective family SES, parental employment, parental education, and neighborhood income were the mediators. To analyze the data, we used regression models without and with our mediators. Sobel test was used to test if these mediational paths are statistically significant.

RESULTS

Black and Latino children had smaller amygdala sizes than non-Latino White children. The effects of race and ethnicity on amygdala volume were partially mediated by SES indicators, suggesting that one of the many reasons Black and Latino children have smaller volumes of right and left amygdala is their lower SES.

CONCLUSIONS

For American children, lower family and neighborhood SES indicators partially, but not fully, explain smaller amygdala sizes of Black and Latino children compared to non- Latino White children.

Subjective Socioeconomic Status and Children's Amygdala Volume: Minorities' Diminish Returns

Considerable research has suggested that low socioeconomic status (SES) negatively influences brain structure, including but not limited to decreased amygdala volume. Considering race and ethnicity as sociological rather than biological constructs, this study was built on minorities' diminished returns (MDRs) to test if the effects of family SES on the total amygdala volume is weaker for black and Latino children than white and non-Latino children. We borrowed data from the Adolescent Brain Cognitive Development (ABCD) study, a national multi-center brain imaging investigation of childhood brain development in the US. The total sample was 9380 9-10-year-old children. The independent variables were subjective family SES and parental education. The primary outcome was total amygdala volume. High subjective SES and parental education were independently associated with larger total amygdala size. The association between high subjective SES and larger total amygdala volume was less pronounced for black and Latino children than white and non-Latino children. For American children, family SES has unequal effects on amygdala size and function, a pattern that is consistent with MDRs. This result suggests that SES loses some of its expected effects for racial and ethnic minority families.

Neighborhood Poverty and Amygdala Response to Negative Face

Introduction

Considerable research has established a link between socioeconomic status (SES) and brain function. While studies have shown a link between poverty status and amygdala response to negative stimuli, a paucity of knowledge exists on whether neighborhood poverty is also independently associated with amygdala hyperactive response to negative stimuli.

Purpose

Using functional brain imaging data, this study tested the association between neighborhood SES and the amygdala's response to negative stimuli. Considering race as a sociological rather than a biological construct, we also explored racial heterogeneity in this association between non-Hispanic Black and non-Hispanic White youth.

Methods

We borrowed the functional Magnetic Resonance Imaging (fMRI) data of the Adolescent Brain Cognitive Development (ABCD) study. The sample was 2,490 nine to ten year old non-Hispanic Black and non-Hispanic White adolescents. The independent variable was neighborhood income which was treated as a continuous measure. The primary outcomes were the right and left amygdala response to negative face during an N-Back task. Age, sex, race, marital status, and family SES were the covariates. To analyze the data, we used linear regression models.

Results

Low neighborhood income was independently associated with a higher level of amygdala response to negative face. Similar results were seen for the right and left amygdala. These effects were significant net of race, age, sex, marital status, and family SES. An association between low neighborhood SES and higher left but not right amygdala response to negative face could be observed for non-Hispanic Black youth. No association between neighborhood SES and left or right amygdala response to negative face could be observed for non-Hispanic White youth.

Conclusions

For American youth, particularly non-Hispanic Black youth, living in a poor neighborhood predicts the left amygdala reaction to negative face. This result suggested that Black youth who live in poor neighborhoods are at a high risk of poor emotion regulation. This finding has implications for policy making to reduce inequalities in undesired behavioral and emotional outcomes. Policy solutions to health inequalities should address inequalities in neighborhood SES.

Resting-state functional connectivity in medication-naïve adolescents with major depressive disorder

Adolescence is a vulnerable period for major depressive disorder (MDD). The aim of our study was to investigate resting-state functional connectivity (RSFC) in first-episode, medication-naïve adolescent MDD patients. Twenty-three drug-naïve adolescents diagnosed with first-episode MDD and 27 healthy participants were enrolled. Seed-to-voxel RSFC analyses were performed. The frontolimbic circuit regions of interest included the amygdala, anterior cingulate cortex, insula, and hippocampus. A correlation analysis between the RSFC and Children's Depression Inventory, Hamilton depression rating scale, and duration of episodes was performed. The adolescents with MDD exhibited the following characteristics: a lower RSFC between the right amygdala and right superior frontal gyrus; a lower RSFC between the right hippocampus and clusters including the right insula and right middle frontal gyrus; a higher RSFC between the left insula and clusters including the bilateral middle frontal gyrus, right superior frontal gyrus, and right frontal pole; and a higher RSFC between the left dorsal anterior cingulate cortex and a cluster including the left insula. Medication-naïve adolescents with depression display lower connectivity of several brain regions implicated in processing, regulation, and memory of emotions. Higher connectivity was observed in brain regions that potentially explain rumination, impaired concentration, and physiological arousal.

Functional connectivity across social inclusion and exclusion is related to peer victimization and depressive symptoms in young adults

BACKGROUND

Peer victimization is associated with increased risk for depression, as well as increased neural response to social exclusion in the anterior cingulate cortex (ACC) and the amygdala. Altered functional connectivity (FxC) of fronto-limbic circuitry is associated with risk for various affective disorders. The present study examined the relationship between fronto-limbic FxC during social exclusion, prior peer victimization experience and depressive symptoms.

METHODS

Three mutually exclusive groups were formed: peer victimized (with a history of peer victimization), defenders (history of defending peers), and controls (no prior peer victimization experience) (n = 15/group; M_age = 17.7 years). Functional Magnetic Resonance Imaging data were collected while participants completed the Cyberball paradigm (simulating the experience of social exclusion). FxC between the Medial Prefrontal Cortex (MPFC), ACC, right insula and left amygdala, was compared between groups and examined in relation to depressive symptoms.

RESULTS

Prior peer victimization experience was associated with differences in fronto-limbic FxC across social inclusion and exclusion. Defenders displayed distinct shifts in FxC across the transition from being included to excluded. Peer victimized individuals exhibited a unique pattern of amygdala-specific FxC during inclusive interaction with peers, and in the continuous FxC across inclusion and exclusion. FxC of the MPFC-amygdala across inclusion and exclusion moderated the relationship between peer victimization and depressive symptoms.

LIMITATIONS

Small sample size and cross-sectional design limit interpretation of the findings.

CONCLUSIONS

Peer victimized individuals who exhibit continuous positive FxC of the MPFC-left amygdala across inclusion and exclusion may be at greater risk for depressive symptoms.

Psychotherapy for Borderline Personality Disorder in Adolescents

Research on borderline personality disorder (BPD) in adolescence has helped to clarify the characteristics of BPD in young people. The considerable emotional and economic cost associated with adolescent BPD supports calls for early intervention and requires that the assessment of personality functioning be an essential component in the psychological evaluation of adolescents. Adult treatment models with demonstrated efficacy have been adapted for adolescents. This article describes the implementation of these treatment approaches, factors that frequently complicate the recognition and diagnosis of BPD in young people, and an overview of research on BPD in adolescents that delineates its clinically relevant features.