1
|
Koerner S, Staginnus M, Cornwell H, Smaragdi A, González-Madruga K, Pauli R, Rogers JC, Gao Y, Chester S, Townend S, Bernhard A, Martinelli A, Kohls G, Raschle NM, Konrad K, Stadler C, Freitag CM, De Brito SA, Fairchild G. Does the Relationship between Age and Brain Structure Differ in Youth with Conduct Disorder? Res Child Adolesc Psychopathol 2024; 52:1135-1146. [PMID: 38557727 PMCID: PMC11217071 DOI: 10.1007/s10802-024-01178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
Conduct disorder (CD) is characterised by persistent antisocial and aggressive behaviour and typically emerges in childhood or adolescence. Although several authors have proposed that CD is a neurodevelopmental disorder, very little evidence is available about brain development in this condition. Structural brain alterations have been observed in CD, and some indirect evidence for delayed brain maturation has been reported. However, no detailed analysis of age-related changes in brain structure in youth with CD has been conducted. Using cross-sectional MRI data, this study aimed to explore differences in brain maturation in youth with CD versus healthy controls to provide further understanding of the neurodevelopmental processes underlying CD. 291 CD cases (153 males) and 379 healthy controls (160 males) aged 9-18 years (Mage = 14.4) were selected from the European multisite FemNAT-CD study. Structural MRI scans were analysed using surface-based morphometry followed by application of the ENIGMA quality control protocols. An atlas-based approach was used to investigate group differences and test for group-by-age and group-by-age-by-sex interactions in cortical thickness, surface area and subcortical volumes. Relative to healthy controls, the CD group showed lower surface area across frontal, temporal and parietal regions as well as lower total surface area. No significant group-by-age or group-by-age-by-sex interactions were observed on any brain structure measure. These findings suggest that CD is associated with lower surface area across multiple cortical regions, but do not support the idea that CD is associated with delayed brain maturation, at least within the age bracket considered here.
Collapse
Affiliation(s)
- Sarah Koerner
- Department of Psychology, University of Bath, Bath, UK
| | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Yidian Gao
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Sally Chester
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
- School of Psychology, Fresenius University of Applied Sciences, Frankfurt, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty, TU Dresden, Dresden, Germany
| | - Nora Maria Raschle
- Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland
- Neuroscience Centre Zurich (ZNZ), University and ETH Zurich, Zurich, Switzerland
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA- Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | |
Collapse
|
2
|
Funk AT, Hassan AAO, Waugh JL. In humans, insulo-striate structural connectivity is largely biased toward either striosome-like or matrix-like striatal compartments. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.07.588409. [PMID: 38645229 PMCID: PMC11030402 DOI: 10.1101/2024.04.07.588409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The insula is an integral component of sensory, motor, limbic, and executive functions, and insular dysfunction is associated with numerous human neuropsychiatric disorders. Insular afferents project widely, but insulo-striate projections are especially numerous. The targets of these insulo-striate projections are organized into tissue compartments, the striosome and matrix. These striatal compartments have distinct embryologic origins, afferent and efferent connectivity, dopamine pharmacology, and susceptibility to injury. Striosome and matrix appear to occupy separate sets of cortico-striato-thalamo-cortical loops, so a bias in insulo-striate projections towards one compartment may also embed an insular subregion in distinct regulatory and functional networks. Compartment-specific mapping of insulo-striate structural connectivity is sparse; the insular subregions are largely unmapped for compartment-specific projections. In 100 healthy adults, we utilized probabilistic diffusion tractography to map and quantify structural connectivity between 19 structurally-defined insular subregions and each striatal compartment. Insulo-striate streamlines that reached striosome-like and matrix-like voxels were concentrated in distinct insular zones (striosome: rostro- and caudoventral; matrix: caudodorsal) and followed different paths to reach the striatum. Though tractography was generated independently in each hemisphere, the spatial distribution and relative bias of striosome-like and matrix-like streamlines were highly similar in the left and right insula. 16 insular subregions were significantly biased towards one compartment: seven toward striosome-like voxels and nine toward matrix-like voxels. Striosome-favoring bundles had significantly higher streamline density, especially from rostroventral insular subregions. The biases in insulo-striate structural connectivity we identified mirrored the compartment-specific biases identified in prior studies that utilized injected tract tracers, cytoarchitecture, or functional MRI. Segregating insulo-striate structural connectivity through either striosome or matrix may be an anatomic substrate for functional specialization among the insular subregions.
Collapse
Affiliation(s)
- AT Funk
- Division of Pediatric Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX
| | - AAO Hassan
- Department of Natural Sciences and Mathematics, University of Texas at Dallas
| | - JL Waugh
- Division of Pediatric Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
| |
Collapse
|
3
|
Wu H, Guo Y, Zhang Y, Zhao L, Guo C. Self-esteem and cortical thickness correlate with aggression in healthy children: A surface-based analysis. Behav Brain Res 2024; 458:114737. [PMID: 37924850 DOI: 10.1016/j.bbr.2023.114737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Aggressive behavior can have serious physical, psychological, and social consequences. However, little is known about the personality and neurological antecedents underlying aggressive behavior in children. The objective of this study was to investigate the relationship between self-esteem, aggression, and brain structure (i.e., cortical thickness and surface area) in a population of healthy children (N = 78; 9-12 years; mean age: 9.95 ± 0.90 years). The results revealed that self-esteem showed a negative association with aggression and significantly predicted aggressive behavior. No gender differences were found in aggression and its neural correlates. We performed the cortical parcellation method to further explore the neural foundations underlying the association of self-esteem with aggression. Children with higher aggression had increased cortical thickness in four clusters after multiple comparison correction: right medial orbitofrontal cortex, right lateral orbitofrontal cortex, right superior frontal gyrus, and left insula. In a mediation analysis, cortical thickness in the right medial orbitofrontal cortex contributed to the effect of self-esteem on aggression. These findings extend our understanding of morphological correlates of aggression in children, suggesting that an increased cortical thickness in childhood is a potential mechanism linking low self-esteem to aggression.
Collapse
Affiliation(s)
- Huimin Wu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Yiqun Guo
- School of Innovation and Entrepreneurship Education, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Yaoyao Zhang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Le Zhao
- School of Applied Psychology, Beijing Normal University, Zhuhai, China
| | - Cheng Guo
- Faculty of Psychology, Southwest University, Chongqing, China.
| |
Collapse
|
4
|
Jiang Y, Gao Y, Dong D, Sun X, Situ W, Yao S. Brain Anatomy in Boys with Conduct Disorder: Differences Among Aggression Subtypes. Child Psychiatry Hum Dev 2024; 55:3-13. [PMID: 35704134 DOI: 10.1007/s10578-022-01360-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/03/2022]
Abstract
Aggression is a core feature of conduct disorder (CD), but the motivation, execution of aggression may vary. A deeper understanding of the neural substrates of aggressive behaviours is critical for effective clinical intervention. Seventy-six Boys with CD (50 with impulsive aggression (I-CD) and 26 with premeditated aggression (P-CD)) and 69 healthy controls (HCs) underwent a structural MRI scan and behavioural assessments. Whole-brain analyses revealed that, compared to HCs, the I-CD group showed significant cortical thinning in the right frontal cortex, while the P-CD group demonstrated significant folding deficits in the bilateral superior parietal cortex. Both types of aggression negatively correlated with the left amygdala volume, albeit in different ways. The present results demonstrated that the complex nature of aggression relies on differentiated anatomical substrates, highlighting the importance of exploring differential circuit-targeted interventions for CD patients.
Collapse
Affiliation(s)
- Yali Jiang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, 410011, Changsha, Hunan, People's Republic of China
- Department of Radiology, the Second Xiangya Hospital, Central South University, 139, Middle Renmin Road, 410011, Changsha, Hunan, People's Republic of China
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, Guangzhou, China
- School of Psychology, South China Normal University, Guangzhou, China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yidian Gao
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Daifeng Dong
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xiaoqiang Sun
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Weijun Situ
- Department of Radiology, the Second Xiangya Hospital, Central South University, 139, Middle Renmin Road, 410011, Changsha, Hunan, People's Republic of China.
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
| | - Shuqiao Yao
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, No. 139, Middle Renmin Road, 410011, Changsha, Hunan, People's Republic of China.
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center on Psychiatry and Psychology, Changsha, China.
- Medical Psychological Institute of Central South University, Changsha, China.
| |
Collapse
|
5
|
Zhang R, Blair RJR, Blair KS, Dobbertin M, Elowsky J, Bashford-Largo J, Dominguez AJ, Hatch M, Bajaj S. Reduced grey matter volume in adolescents with conduct disorder: a region-of-interest analysis using multivariate generalized linear modeling. DISCOVER MENTAL HEALTH 2023; 3:25. [PMID: 37975932 PMCID: PMC10656392 DOI: 10.1007/s44192-023-00052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV). METHODS The whole-brain structural MRI data were collected from 96 adolescents with CD (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 63 males) and 90 TD individuals (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate. RESULTS A diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460-10.317, p < 0.05, partial eta squared = 0.029-0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD-MTD = [- 614.898] mm3-[- 53.461] mm3). CONCLUSIONS Altered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.
Collapse
Affiliation(s)
- Ru Zhang
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Matthew Dobbertin
- Inpatient Psychiatric Care Unit, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jaimie Elowsky
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Ahria J Dominguez
- Clinical Health, Emotion, and Neuroscience (CHEN) Laboratory, Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Melissa Hatch
- Mind and Brain Health Labs (MBHL), Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Sahil Bajaj
- Department of Cancer Systems Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
6
|
Zhang R, Blair RJR, Blair KS, Dobbertin M, Elowsky J, Bashford-Largo J, Dominguez AJ, Hatch M, Bajaj S. Reduced Grey Matter Volume in Adolescents with Conduct Disorder: A Region-of-Interest Analysis Using Multivariate Generalized Linear Modeling. RESEARCH SQUARE 2023:rs.3.rs-3425545. [PMID: 37961148 PMCID: PMC10635381 DOI: 10.21203/rs.3.rs-3425545/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV). Methods The whole-brain structural MRI data were collected from 96 adolescents with CD (mean age = years; mean IQ = ; 63 males) and 90 TD individuals (mean age = years; mean IQ = ; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate. Results A diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460 - 10.317, p < 0.05, partial eta squared = 0.029 - 0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD - MTD = [-614.898] mm3 - [-53.461] mm3). Conclusions Altered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.
Collapse
Affiliation(s)
- Ru Zhang
- University of Southern California
| | | | | | | | | | | | | | | | - Sahil Bajaj
- The University of Texas MD Anderson Cancer Center
| |
Collapse
|
7
|
Gottfredson RK, Becker WJ. How past trauma impacts emotional intelligence: Examining the connection. Front Psychol 2023; 14:1067509. [PMID: 37275697 PMCID: PMC10234103 DOI: 10.3389/fpsyg.2023.1067509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Backed by both research and practice, the organizational psychology field has come to value emotional intelligence (EI) as being vital for leader and employee effectiveness. While this field values EI, it has paid little attention to the antecedents of emotional intelligence, leaving the EI domain without clarity on (1) why EI might vary across individuals, and (2) how to best develop EI. In this article, we rely on neuroscience and psychology research to make the case that past psychological trauma impacts later EI capabilities. Specifically, we present evidence that psychological trauma impairs the brain areas and functions that support EI. Establishing psychological trauma has valuable theoretical and practical implications that include providing an explanation of why EI might vary across individuals and providing a focus for improving EI: healing from past trauma. Further theoretical and practical implications for the field of organizational psychology are provided.
Collapse
Affiliation(s)
- Ryan K Gottfredson
- Department of Management, College of Business and Economics, California State University, Fullerton, CA, United States
| | - William J Becker
- Department of Management, Pamplin College of Business, Virginia Tech, Blacksburg, VA, United States
| |
Collapse
|
8
|
Fairchild G, Sully K, Passamonti L, Staginnus M, Darekar A, Sonuga-Barke EJS, Toschi N. Neuroanatomical markers of familial risk in adolescents with conduct disorder and their unaffected relatives. Psychol Med 2023; 53:1721-1731. [PMID: 34607618 DOI: 10.1017/s0033291721003202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Previous studies have reported brain structure abnormalities in conduct disorder (CD), but it is unclear whether these neuroanatomical alterations mediate the effects of familial (genetic and environmental) risk for CD. We investigated brain structure in adolescents with CD and their unaffected relatives (URs) to identify neuroanatomical markers of familial risk for CD. METHODS Forty-one adolescents with CD, 24 URs of CD probands, and 38 healthy controls (aged 12-18), underwent structural magnetic resonance imaging. We performed surface-based morphometry analyses, testing for group differences in cortical volume, thickness, surface area, and folding. We also assessed the volume of key subcortical structures. RESULTS The CD and UR groups both displayed structural alterations (lower surface area and folding) in left inferior parietal cortex compared with controls. In contrast, CD participants showed lower insula and pars opercularis volume than controls, and lower surface area and folding in these regions than controls and URs. The URs showed greater folding in rostral anterior cingulate and inferior temporal cortex than controls and greater medial orbitofrontal folding than CD participants. The surface area and volume differences were not significant when controlling for attention-deficit/hyperactivity disorder comorbidity. There were no group differences in subcortical volumes. CONCLUSIONS These findings suggest that alterations in inferior parietal cortical structure partly mediate the effects of familial risk for CD. These structural changes merit investigation as candidate endophenotypes for CD. Neuroanatomical changes in medial orbitofrontal and anterior cingulate cortex differentiated between URs and the other groups, potentially reflecting neural mechanisms of resilience to CD.
Collapse
Affiliation(s)
| | - Kate Sully
- School of Psychology, University of Southampton, Southampton, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milan, Italy
| | | | - Angela Darekar
- Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- Martinos Center for Biomedical Imaging, Boston, USA
- Harvard Medical School, Boston, USA
| |
Collapse
|
9
|
The computational psychiatry of antisocial behaviour and psychopathy. Neurosci Biobehav Rev 2023; 145:104995. [PMID: 36535376 DOI: 10.1016/j.neubiorev.2022.104995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/21/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
Antisocial behaviours such as disobedience, lying, stealing, destruction of property, and aggression towards others are common to multiple disorders of childhood and adulthood, including conduct disorder, oppositional defiant disorder, psychopathy, and antisocial personality disorder. These disorders have a significant negative impact for individuals and for society, but whether they represent clinically different phenomena, or simply different approaches to diagnosing the same underlying psychopathology is highly debated. Computational psychiatry, with its dual focus on identifying different classes of disorder and health (data-driven) and latent cognitive and neurobiological mechanisms (theory-driven), is well placed to address these questions. The elucidation of mechanisms that might characterise latent processes across different disorders of antisocial behaviour can also provide important advances. In this review, we critically discuss the contribution of computational research to our understanding of various antisocial behaviour disorders, and highlight suggestions for how computational psychiatry can address important clinical and scientific questions about these disorders in the future.
Collapse
|
10
|
Jiang Y, Gao Y, Dong D, Sun X, Situ W, Yao S. Structural abnormalities in adolescents with conduct disorder and high versus low callous unemotional traits. Eur Child Adolesc Psychiatry 2023; 32:193-203. [PMID: 34635947 DOI: 10.1007/s00787-021-01890-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
There may be distinct conduct disorder (CD) etiologies and neural morphologies in adolescents with high callous unemotional (CU) traits versus low CU traits. Here, we employed surface-based morphometry methods to investigate morphological differences in adolescents diagnosed with CD [42 with high CU traits (CD-HCU) and 40 with low CU traits (CD-LCU)] and healthy controls (HCs, N = 115) in China. Whole-brain analyses revealed significantly increased cortical surface area (SA) in the left inferior temporal cortex and the right precuneus, but decreased SA in the left superior temporal cortex in the CD-LCU group, compared with the HC group. There were no significant cortical SA differences between the CD-HCU and the HC groups. Compared to the CD-HCU group, the CD-LCU group had a greater cortical thickness (CT) in the left rostral middle frontal cortex. Region-of-interest analyses revealed significant group differences in the right hippocampus, with CD-HCU group having lower right hippocampal volumes than HCs. We did not detect significant group differences in the amygdalar volume, however, the right amygdalar volume was found to be a significant moderator of the correlation between CU traits and the proactive aggression in CD patients. The present results suggested that the manifestations of CD differ between those with high CU traits versus low CU traits, and underscore the importance of sample characteristics in understanding the neural substrates of CD.
Collapse
Affiliation(s)
- Yali Jiang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, People's Republic of China
- School of Psychology, South China Normal University, Guangzhou, People's Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, People's Republic of China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Weijun Situ
- Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
- National Clinical Research Center on Psychiatry and Psychology, Changsha, People's Republic of China.
- Medical Psychological Institute of Central South University, Changsha, People's Republic of China.
- National Clinical Research Center for Mental Disorders, Changsha, People's Republic of China.
| |
Collapse
|
11
|
Ma S, Huang H, Zhong Z, Zheng H, Li M, Yao L, Yu B, Wang H. Effect of acupuncture on brain regions modulation of mild cognitive impairment: A meta-analysis of functional magnetic resonance imaging studies. Front Aging Neurosci 2022; 14:914049. [PMID: 36212046 PMCID: PMC9540390 DOI: 10.3389/fnagi.2022.914049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background As a non-pharmacological therapy, acupuncture has significant efficacy in treating Mild Cognitive Impairment (MCI) compared to pharmacological therapies. In recent years, advances in neuroimaging techniques have provided new perspectives to elucidate the central mechanisms of acupuncture for MCI. Many acupuncture brain imaging studies have found significant improvements in brain function after acupuncture treatment of MCI, but the underlying mechanisms of brain regions modulation are unclear. Objective A meta-analysis of functional magnetic resonance imaging studies of MCI patients treated with acupuncture was conducted to summarize the effects of acupuncture on the modulation of MCI brain regions from a neuroimaging perspective. Methods Using acupuncture, neuroimaging, magnetic resonance, and Mild Cognitive Impairment as search terms, PubMed, EMBASE, Web of Science, Cochrane Library, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects (DARE), Google Scholar, China National Knowledge Infrastructure (CNKI), China Biology Medicine disk (CBM disk), Wanfang and Chinese Scientific Journal Database (VIP) for brain imaging studies on acupuncture on MCI published up to April 2022. Voxel-based neuroimaging meta-analysis of fMRI data was performed using voxel-based d Mapping with Permutation of Subject Images (SDM-PSI), allowing for Family-Wise Error Rate (FWER) correction correction for correction multiple comparisons of results. Subgroup analysis was used to compare the differences in brain regions between the acupuncture treatment group and other control groups. Meta-regression was used to explore demographic information and altered cognitive function effects on brain imaging outcomes. Linear models were drawn using MATLAB 2017a, and visual graphs for quality evaluation were produced using R software and RStudio software. Results A total of seven studies met the inclusion criteria, with 94 patients in the treatment group and 112 patients in the control group. All studies were analyzed using the regional homogeneity (ReHo) method. The experimental design of fMRI included six task state studies and one resting-state study. The meta-analysis showed that MCI patients had enhanced activity in the right insula, left anterior cingulate/paracingulate gyri, right thalamus, right middle frontal gyrus, right median cingulate/paracingulate gyri, and right middle temporal gyrus brain regions after acupuncture treatment. Further analysis of RCT and longitudinal studies showed that Reho values were significantly elevated in two brain regions, the left anterior cingulate/paracingulate gyrus and the right insula, after acupuncture. The MCI group showed stronger activity in the right supramarginal gyrus after acupuncture treatment compared to healthy controls. Meta-regression analysis showed that the right anterior thalamic projection ReHo index was significantly correlated with the MMSE score after acupuncture treatment in all MCI patients. Conclusions Acupuncture therapy has a modulating effect on the brain regions of MCI patients. However, due to the inadequate experimental design of neuroimaging studies, multi-center neuroimaging studies with large samples are needed better to understand the potential neuroimaging mechanisms of acupuncture for MCI. In addition, machine learning algorithm-based predictive models for evaluating the efficacy of acupuncture for MCI may become a focus of future research. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022287826, identifier: CRD 42022287826.
Collapse
Affiliation(s)
- Shiqi Ma
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Haipeng Huang
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zhen Zhong
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Haizhu Zheng
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Mengyuan Li
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Lin Yao
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Bin Yu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Hongfeng Wang
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| |
Collapse
|
12
|
Kamalian A, Khodadadifar T, Saberi A, Masoudi M, Camilleri JA, Eickhoff CR, Zarei M, Pasquini L, Laird AR, Fox PT, Eickhoff SB, Tahmasian M. Convergent regional brain abnormalities in behavioral variant frontotemporal dementia: A neuroimaging meta-analysis of 73 studies. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12318. [PMID: 35664889 PMCID: PMC9148620 DOI: 10.1002/dad2.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/13/2022] [Accepted: 04/10/2022] [Indexed: 12/19/2022]
Abstract
Introduction Numerous studies have reported brain alterations in behavioral variant frontotemporal dementia (bvFTD). However, they pointed to inconsistent findings. Methods We used a meta‐analytic approach to identify the convergent structural and functional brain abnormalities in bvFTD. Following current best‐practice neuroimaging meta‐analysis guidelines, we searched PubMed and Embase databases and performed reference tracking. Then, the coordinates of group comparisons between bvFTD and controls from 73 studies were extracted and tested for convergence using activation likelihood estimation. Results We identified convergent abnormalities in the anterior cingulate cortices, anterior insula, amygdala, paracingulate, striatum, and hippocampus. Task‐based and resting‐state functional connectivity pointed to the networks that are connected to the obtained consistent regions. Functional decoding analyses suggested associated dysfunction of emotional processing, interoception, reward processing, higher‐order cognitive functions, and olfactory and gustatory perceptions in bvFTD. Discussion Our findings highlighted the key role of the salience network and subcortical regions in the pathophysiology of bvFTD.
Collapse
Affiliation(s)
- Aida Kamalian
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Tina Khodadadifar
- School of Cognitive Sciences Institute for Research in Fundamental Sciences Tehran Iran
| | - Amin Saberi
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Maryam Masoudi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Claudia R Eickhoff
- Institute of Clinical Neuroscience and Medical Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany.,Institute of Neuroscience and Medicine Research Center Jülich Structural and Functional Organisation of the Brain (INM-1) Jülich Germany
| | - Mojtaba Zarei
- Institute of Medical Science and Technology Shahid Beheshti University Tehran Iran
| | - Lorenzo Pasquini
- Department of Neurology Memory and Aging Center University of California-San Francisco San Francisco California USA
| | - Angela R Laird
- Department of Physics Florida International University Miami Florida USA
| | - Peter T Fox
- Research Imaging Institute University of Texas Health Science Center San Antonio Texas USA.,South Texas Veterans Health Care System San Antonio Texas USA
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| |
Collapse
|
13
|
Blok E, Geenjaar EPT, Geenjaar EAW, Calhoun VD, White T. Neurodevelopmental Trajectories in Children With Internalizing, Externalizing and Emotion Dysregulation Symptoms. Front Psychiatry 2022; 13:846201. [PMID: 35370828 PMCID: PMC8974911 DOI: 10.3389/fpsyt.2022.846201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Childhood and adolescence are crucial periods for brain and behavioral development. However, it is not yet clear how and when deviations from typical brain development are related to broad domains of psychopathology. METHODS Using three waves of neuroimaging data within the population-based Generation R Study sample, spanning a total age range of 6-16 years, we applied normative modeling to establish typical development curves for (sub-)cortical volume in 37 brain regions, and cortical thickness in 32 brain regions. Z-scores representing deviations from typical development were extracted and related to internalizing, externalizing and dysregulation profile (DP) symptoms. RESULTS Normative modeling showed regional differences in developmental trajectories. Psychopathology symptoms were related to negative deviations from typical development for cortical volume in widespread regions of the cortex and subcortex, and to positive deviations from typical development for cortical thickness in the orbitofrontal, frontal pole, pericalcarine and posterior cingulate regions of the cortex. DISCUSSION Taken together, this study charts developmental curves across the cerebrum for (sub-)cortical volume and cortical thickness. Our findings show that psychopathology symptoms, are associated with widespread differences in brain development, in which those with DP symptoms are most heavily affected.
Collapse
Affiliation(s)
- Elisabet Blok
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Childrens Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Eloy P T Geenjaar
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.,Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, United States
| | - Eloïse A W Geenjaar
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Childrens Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Vince D Calhoun
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.,Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Atlanta, GA, United States
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Childrens Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
14
|
Carlisi CO, Moffitt TE, Knodt AR, Harrington H, Langevin S, Ireland D, Melzer TR, Poulton R, Ramrakha S, Caspi A, Hariri AR, Viding E. Association of subcortical gray-matter volumes with life-course-persistent antisocial behavior in a population-representative longitudinal birth cohort. Dev Psychopathol 2021; 34:1-11. [PMID: 34657646 PMCID: PMC7613992 DOI: 10.1017/s0954579421000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Neuropsychological evidence supports the developmental taxonomy theory of antisocial behavior, suggesting that abnormal brain development distinguishes life-course-persistent from adolescence-limited antisocial behavior. Recent neuroimaging work confirmed that prospectively-measured life-course-persistent antisocial behavior is associated with differences in cortical brain structure. Whether this extends to subcortical brain structures remains uninvestigated. This study compared subcortical gray-matter volumes between 672 members of the Dunedin Study previously defined as exhibiting life-course-persistent, adolescence-limited or low-level antisocial behavior based on repeated assessments at ages 7-26 years. Gray-matter volumes of 10 subcortical structures were compared across groups. The life-course-persistent group had lower volumes of amygdala, brain stem, cerebellum, hippocampus, pallidum, thalamus, and ventral diencephalon compared to the low-antisocial group. Differences between life-course-persistent and adolescence-limited individuals were comparable in effect size to differences between life-course-persistent and low-antisocial individuals, but were not statistically significant due to less statistical power. Gray-matter volumes in adolescence-limited individuals were near the norm in this population-representative cohort and similar to volumes in low-antisocial individuals. Although this study could not establish causal links between brain volume and antisocial behavior, it constitutes new biological evidence that all people with antisocial behavior are not the same, supporting a need for greater developmental and diagnostic precision in clinical, forensic, and policy-based interventions.
Collapse
Affiliation(s)
- Christina O Carlisi
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Annchen R Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Stephanie Langevin
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- School of Criminology, University of Montreal, Quebec, Canada
| | - David Ireland
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Brain Research New Zealand - Rangahau Roro Aotearo Centre of Research Excellence, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ahmad R Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| |
Collapse
|
15
|
Dziedzic TA, Bala A, Marchel A. Anatomical aspects of the insula, opercula and peri-insular white matter for a transcortical approach to insular glioma resection. Neurosurg Rev 2021; 45:793-806. [PMID: 34292438 PMCID: PMC8827298 DOI: 10.1007/s10143-021-01602-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/01/2022]
Abstract
The insula is a lobe located deep in each hemisphere of the brain and is surrounded by eloquent cortical, white matter, and basal ganglia structures. The aim of this study was to provide an anatomical description of the insula and white matter tracts related to surgical treatment of gliomas through a transcortical approach. The study also discusses surgical implications in terms of intraoperative brain mapping. Five adult brains were prepared according to the Klingler technique. Cortical anatomy was evaluated with the naked eye, whereas white matter dissection was performed with the use of a microscope. The widest exposure of the insular surface was noted through the temporal operculum, mainly in zones III and IV according to the Berger-Sanai classification. By going through the pars triangularis in all cases, the anterior insular point and most of zone I were exposed. The narrowest and deepest operating field was observed by going through the parietal operculum. This method provided a suitable approach to zone II, where the corticospinal tract is not covered by the basal ganglia and is exposed just under the superior limiting sulcus. At the subcortical level, the identification of the inferior frontoocipital fasciculus at the level of the limen insulae is critical in terms of preserving the lenticulostriate arteries. Detailed knowledge of the anatomy of the insula and subcortical white matter that is exposed through each operculum is essential in preoperative planning as well as in the intraoperative decision-making process in terms of intraoperative brain mapping.
Collapse
Affiliation(s)
- Tomasz Andrzej Dziedzic
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097, Warszawa, Poland.
| | - Aleksandra Bala
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097, Warszawa, Poland.,Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Andrzej Marchel
- Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097, Warszawa, Poland
| |
Collapse
|
16
|
Macro- and micro-structural cerebellar and cortical characteristics of cognitive empathy towards fictional characters in healthy individuals. Sci Rep 2021; 11:8804. [PMID: 33888760 PMCID: PMC8062506 DOI: 10.1038/s41598-021-87861-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/31/2021] [Indexed: 12/21/2022] Open
Abstract
Few investigations have analyzed the neuroanatomical substrate of empathic capacities in healthy subjects, and most of them have neglected the potential involvement of cerebellar structures. The main aim of the present study was to investigate the associations between bilateral cerebellar macro- and micro-structural measures and levels of cognitive and affective trait empathy (measured by Interpersonal Reactivity Index, IRI) in a sample of 70 healthy subjects of both sexes. We also estimated morphometric variations of cerebral Gray Matter structures, to ascertain whether the potential empathy-related peculiarities in cerebellar areas were accompanied by structural differences in other cerebral regions. At macro-structural level, the volumetric differences were analyzed by Voxel-Based Morphometry (VBM)- and Region of Interest (ROI)-based approaches, and at a micro-structural level, we analyzed Diffusion Tensor Imaging (DTI) data, focusing in particular on Mean Diffusivity and Fractional Anisotropy. Fantasy IRI-subscale was found to be positively associated with volumes in right cerebellar Crus 2 and pars triangularis of inferior frontal gyrus. The here described morphological variations of cerebellar Crus 2 and pars triangularis allow to extend the traditional cortico-centric view of cognitive empathy to the cerebellar regions and indicate that in empathizing with fictional characters the cerebellar and frontal areas are co-recruited.
Collapse
|
17
|
Gouveia FV, Germann J, de Morais R, Fonoff ET, Hamani C, Alho EJ, Brentani H, Martins AP, Devenyi G, Patel R, Steele C, Gramer R, Chakravarty M, Martinez RCR. Longitudinal Changes After Amygdala Surgery for Intractable Aggressive Behavior: Clinical, Imaging Genetics, and Deformation-Based Morphometry Study-A Case Series. Neurosurgery 2021; 88:E158-E169. [PMID: 33026432 DOI: 10.1093/neuros/nyaa378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/27/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Intractable aggressive behavior (iAB) is a devastating behavioral disorder that may affect psychiatric patients. These patients have reduced quality of life, are more challenging to treat as they impose a high caregiver burden and require specialized care. Neuromodulatory interventions targeting the amygdala, a key hub in the circuitry of aggressive behavior (AB), may provide symptom alleviation. OBJECTIVE To Report clinical and imaging findings from a case series of iAB patients treated with bilateral amygdala ablation. METHODS This series included 4 cases (3 males, 19-32 years old) who underwent bilateral amygdala radiofrequency ablation for iAB hallmarked by life-threatening self-injury and social aggression. Pre- and postassessments involved full clinical, psychiatric, and neurosurgical evaluations, including scales quantifying AB, general agitation, quality of life, and magnetic resonance imaging (MRI). RESULTS Postsurgery assessments revealed decreased aggression and agitation and improved quality of life. AB was correlated with testosterone levels and testosterone/cortisol ratio in males. No clinically significant side effects were observed. Imaging analyses showed preoperative amygdala volumes within normal populational range and confirmed lesion locations. The reductions in aggressive symptoms were accompanied by significant postsurgical volumetric reductions in brain areas classically associated with AB and increases in regions related to somatosensation. The local volumetric reductions are found in areas that in a normal brain show high expression levels of genes related to AB (eg, aminergic transmission) using gene expression data provided by the Allen brain atlas. CONCLUSION These findings provide new insight into the whole brain neurocircuitry of aggression and suggest a role of altered somatosensation and possible novel neuromodulation targets.
Collapse
Affiliation(s)
- Flavia Venetucci Gouveia
- Laboratory of Neuromodulation, Teaching and Research Institute, Hospital Sirio-Libanes, Sao Paulo, Brazil.,Sunnybrook Research Institute, Toronto, Canada
| | - Jürgen Germann
- CIC, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Rosa de Morais
- PROTEA, Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Erich Talamoni Fonoff
- Department of Neurology, Division of Functional Neurosurgery, Institute of Psychiatry, Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Clement Hamani
- Sunnybrook Research Institute, Toronto, Canada.,Department of Neurology, Division of Functional Neurosurgery, Institute of Psychiatry, Medical School, University of Sao Paulo, Sao Paulo, Brazil.,Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Eduardo Joaquim Alho
- Department of Neurology, Division of Functional Neurosurgery, Institute of Psychiatry, Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Helena Brentani
- Department of Psychiatry, Medical School, University of Sao Paulo, Sao Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Sao Paulo, Brazil
| | - Ana Paula Martins
- PROTEA, Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Gabriel Devenyi
- CIC, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Raihaan Patel
- CIC, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Christopher Steele
- CIC, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Robert Gramer
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Mallar Chakravarty
- CIC, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | | |
Collapse
|
18
|
Ibrahim K, Kalvin C, Li F, He G, Pelphrey KA, McCarthy G, Sukhodolsky DG. Sex differences in medial prefrontal and parietal cortex structure in children with disruptive behavior. Dev Cogn Neurosci 2021; 47:100884. [PMID: 33254067 PMCID: PMC7704291 DOI: 10.1016/j.dcn.2020.100884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/25/2020] [Accepted: 11/14/2020] [Indexed: 01/08/2023] Open
Abstract
Sex differences in brain structure in children with disruptive behavior disorders (DBD) remain poorly understood. This study examined sex differences in gray matter volume in children with DBD in a priori regions-of-interest implicated in the pathophysiology of disruptive behavior. We then conducted a whole-brain analysis of cortical thickness to examine sex differences in regions not included in our hypothesis. Exploratory analyses investigated unique associations between structure, and dimensional measures of severity of disruptive behavior and callous-unemotional traits. This cross-sectional study included 88 children with DBD (30 females) aged 8-16 years and 50 healthy controls (20 females). Structural MRI data were analyzed using surface-based morphometry to test for interactions between sex and group. Multiple-regression analyses tested for sex-specific associations between structure, callous-unemotional traits, and disruptive behavior severity. Boys with DBD showed reduced gray matter volume in the left ventromedial prefrontal cortex (vmPFC) and reduced cortical thickness in the supramarginal gyrus, but not girls compared to respective controls. Dimensional analyses revealed associations between sex, callous-unemotional traits, and disruptive behavior for amygdala and vmPFC volume, and ventrolateral prefrontal cortex cortical thickness. Sex-specific differences in prefrontal structures involved in emotion regulation may support identification of neural biomarkers of disruptive behavior to inform target-based treatments.
Collapse
Affiliation(s)
- Karim Ibrahim
- Yale University School of Medicine, Child Study Center, United States.
| | - Carla Kalvin
- Yale University School of Medicine, Child Study Center, United States
| | - Fangyong Li
- Yale University School of Medicine, Center for Analytical Sciences, United States
| | - George He
- Yale University, Department of Psychology, United States
| | | | | | | |
Collapse
|
19
|
Chaidir KR, Nathania E, Mahdiyyah K, Phallavi YR, Wiguna T. Gender differences in brain type according to the Empathy/Systemising Quotient for Children (EQ/SQ-C) questionnaire in Indonesia. J Child Adolesc Ment Health 2020; 32:111-117. [PMID: 33345735 DOI: 10.2989/17280583.2020.1848850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: This research was conducted to support the hypothesis that boys and girls have different brain types that affect their empathy and systemising quotients. Method: This was a cross-sectional study using an online survey. The Indonesian version of the Empathy/Systemising Quotient for Children (EQ/SQ-C) questionnaire was used to identify the brain type and empathy and systemising quotients. Participants were 620 parents who had primary school children and having minimal junior high school background. The data analysis used chi-square test and Mann-Whitney U-test on SPSS program for Mac version 20. Results: Boys and girls had different brain types (p < 0.05). The extreme-empathising brain type consisted of 1.9% girls and 0.5% boys; the empathising brain type was 15.8% in girls and 9.0% in boys. Further, 0.8% of girls and 2.6% of boys had the extreme-systemising brain type. Although the empathy quotient average mean score of the boys was significantly lower than the girls (p < 0.05), the systemising quotient average mean score was slightly higher than that of the girls. Conclusion: This study found that gender plays an important role in empathy and systemising skills. Therefore, creating a stimulating program that supports empathy and systemising quotients in primary school students should be developed according to gender.
Collapse
Affiliation(s)
- Kamila Ratu Chaidir
- Undergraduate Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Eloisa Nathania
- Undergraduate Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Kindah Mahdiyyah
- Undergraduate Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yudi Rheza Phallavi
- Undergraduate Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, Dr Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
20
|
Menks WM, Fehlbaum LV, Borbás R, Sterzer P, Stadler C, Raschle NM. Eye gaze patterns and functional brain responses during emotional face processing in adolescents with conduct disorder. Neuroimage Clin 2020; 29:102519. [PMID: 33316763 PMCID: PMC7735971 DOI: 10.1016/j.nicl.2020.102519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Conduct disorder (CD) is characterized by severe aggressive and antisocial behavior. Initial evidence suggests neural deficits and aberrant eye gaze pattern during emotion processing in CD; both concepts, however, have not yet been studied simultaneously. The present study assessed the functional brain correlates of emotional face processing with and without consideration of concurrent eye gaze behavior in adolescents with CD compared to typically developing (TD) adolescents. METHODS 58 adolescents (23CD/35TD; average age = 16 years/range = 14-19 years) underwent an implicit emotional face processing task. Neuroimaging analyses were conducted for a priori-defined regions of interest (insula, amygdala, and medial orbitofrontal cortex) and using a full-factorial design assessing the main effects of emotion (neutral, anger, fear), group and the interaction thereof (cluster-level, p < .05 FWE-corrected) with and without consideration of concurrent eye gaze behavior (i.e., time spent on the eye region). RESULTS Adolescents with CD showed significant hypo-activations during emotional face processing in right anterior insula compared to TD adolescents, independent of the emotion presented. In-scanner eye-tracking data revealed that adolescents with CD spent significantly less time on the eye, but not mouth region. Correcting for eye gaze behavior during emotional face processing reduced group differences previously observed for right insula. CONCLUSIONS Atypical insula activation during emotional face processing in adolescents with CD may partly be explained by attentional mechanisms (i.e., reduced gaze allocation to the eyes, independent of the emotion presented). An increased understanding of the mechanism causal for emotion processing deficits observed in CD may ultimately aid the development of personalized intervention programs.
Collapse
Affiliation(s)
- Willeke Martine Menks
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland; Department of Psychology, Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland
| | - Réka Borbás
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland; Department of Psychology, Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland
| | - Philipp Sterzer
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland; Department of Psychology, Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland.
| |
Collapse
|
21
|
Cortical thickness of the insula and prefrontal cortex relates to externalizing behavior: Cross-sectional and prospective findings. Dev Psychopathol 2020; 33:1437-1447. [PMID: 32638690 DOI: 10.1017/s0954579420000619] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Externalizing behaviors (EBs) pertain to a diverse set of aggressive, antisocial, and potentially destructive behaviors directed toward the external environment. They range from nonclinical to clinical in severity, associated with opposition, aggression, hyperactivity, or impulsivity, and are considered a risk factor for the emergence of psychopathology later in adulthood. Focusing on community adolescents (N = 102; 49 female and 53 male adolescents; age range 12-19 years), this study aimed to explore the relations between EBs and the cortical thickness of regions of interest as well as to identify possible risk markers that could improve understanding of the EB construct. Using a mixed cross-sectional and prospective design (1-year follow-up), we report specific associations with cortical thickness of the left insular, right orbitofrontal, and left anterior cingulate cortex. Specifically, thinner left insular and right orbitofrontal cortex was associated with higher EBs, and thinner left anterior cingulate cortex predicted less reduction in EBs 1 year later. In addition, further examination of the aggression and rule-breaking subscales of the Youth/Adult Self-Report, used to assess EBs, revealed specific associations with insular subregions. Findings suggest that cortical structure morphology may significantly relate to the expression and maintenance of EBs within the general population of adolescents.
Collapse
|
22
|
Seok JW, Cheong C. Gray Matter Deficits and Dysfunction in the Insula Among Individuals With Intermittent Explosive Disorder. Front Psychiatry 2020; 11:439. [PMID: 32508687 PMCID: PMC7251158 DOI: 10.3389/fpsyt.2020.00439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
Although numerous neuroimaging studies have evaluated the characteristics of intermittent explosive disorder (IED), studies on the structural alterations and focal dysfunction in the brain in this condition are limited. This study aimed to identify gray matter deficits and functional alterations in individuals with IED using voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) analyses. Fifteen men with IED and 15 age- and sex-matched healthy controls participated in this study. Gray matter volume and brain activation while viewing the anger-inducing films were measured using 7T MRI. VBM results indicated that individuals with IED had significantly reduced gray matter volume in the insula, amygdala, and orbitofrontal area, relative to controls. Gray matter volume in the left insula was negatively correlated with composite aggression scores. fMRI results demonstrated that relative to healthy controls, individuals with IED showed greater activation in the insula, putamen, anterior cingulate cortex, and amygdala during anger processing. Left insular activity was positively correlated with composite aggression scores. Collectively, these findings suggest that structural and functional alterations in the left insula are linked to IED; this provides insight into the neural mechanisms underlying IED.
Collapse
Affiliation(s)
- Ji-Woo Seok
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Rehabilitation Counseling Psychology, Seoul Hanyoung University, Seoul, South Korea
| | - Chaejoon Cheong
- Bioimaging Research Team, Korean Basic Science Institute, Cheongju, South Korea
| |
Collapse
|
23
|
Gao Y, Jiang Y, Ming Q, Zhang J, Ma R, Wu Q, Dong D, Guo X, Liu M, Wang X, Situ W, Pauli R, Yao S. Gray Matter Changes in the Orbitofrontal-Paralimbic Cortex in Male Youths With Non-comorbid Conduct Disorder. Front Psychol 2020; 11:843. [PMID: 32435221 PMCID: PMC7218112 DOI: 10.3389/fpsyg.2020.00843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 04/06/2020] [Indexed: 11/29/2022] Open
Abstract
Conduct disorder is one of the most common developmental psychiatric disorders which is characterized by persistent aggressive and antisocial behaviors during childhood or adolescence. Previous neuroimaging studies have investigated the neural correlates underlying CD and demonstrated several constructive findings. However, Individuals with CD are at high risk for comorbidities, which might give rise to the inconsistencies of existed findings. It remains unclear which neuroanatomical abnormalities are specifically related to CD without comorbidities. Using structural magnetic resonance imaging (sMRI) data of 69 CD and 69 typically developing (TD) male youths (aged 14–17 years), the present study aims at investigating gray matter volume alterations of non-comorbid CD (i.e., not comorbid with attention deficit hyperactivity disorder, substance abuse disorder, anxiety or depression). We also examined how regional gray matter volumes were related to callous-unemotional (CU) traits and conduct problems in the CD group. The whole-brain analysis revealed decreased gray matter volumes in the right pre-postcentral cortex, supramarginal gyrus and right putamen in CD youths compared with TD youths. The region-of-interest analyses showed increased gray matter volumes in the superior temporal gyrus (STG) and right orbitofrontal cortex (OFC) in CD youths. Correlation analysis found that gray matter volume in the left amygdala was negatively correlated with CU traits in CD participants. These results demonstrated that gray matter volume in the orbitofrontal-paralimbic cortex, including OFC, STG and amygdala, might characterize the male youths with non-comorbid CD and might contribute to different severe forms and trajectories of CD.
Collapse
Affiliation(s)
- Yidian Gao
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Yali Jiang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Qingsen Ming
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jibiao Zhang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Ren Ma
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Qiong Wu
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Daifeng Dong
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Xiao Guo
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Mingli Liu
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Xiang Wang
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Weijun Situ
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Shuqiao Yao
- Medical Psychological Center of Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| |
Collapse
|
24
|
Jiang Y, Ming Q, Gao Y, Dong D, Sun X, Zhang X, Situ W, Yao S, Rao H. Effects of BDNF Val66Met polymorphisms on brain structures and behaviors in adolescents with conduct disorder. Eur Child Adolesc Psychiatry 2020; 29:479-488. [PMID: 31264106 DOI: 10.1007/s00787-019-01363-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
Accumulating evidence suggests that neural abnormalities in conduct disorder (CD) may be subject to genetic influences, but few imaging studies have taken genetic variants into consideration. The Val66Met polymorphism of brain-derived neurotrophic factor (BDNF) has emerged as a high-interest genetic variant due to its importance in cortical maturation, and several studies have implicated its involvement in neurodevelopmental disorders. Thus, it is unclear how this polymorphism may influence brain anatomy and aberrant behaviors in CD. A total of 65 male adolescents with CD and 69 gender-, IQ- and socioeconomic status-matched healthy controls (HCs) (age range 13-17 years) were enrolled in this study. Analyses of variance (ANOVAs) were used to assess the main effects of CD diagnosis, BDNF genotype, and diagnosis-genotype interactions on brain anatomy and behaviors. We detected a significant main effect of BDNF genotype on temporal gyrification and antisocial behaviors, but not on CD symptoms. Diagnosis-genotype interactive effects were found for cortical thickness of the superior temporal and adjacent areas. These results suggest that the BDNF Val66Met polymorphism may exert its influence both on neural alterations and delinquent behaviors in CD patients. This initial evidence highlights the importance of elucidating potentially different pathways between BDNF genotype and cortical alterations or delinquent behaviors in CD patients.
Collapse
Affiliation(s)
- Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China.,Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China
| | - Qingsen Ming
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Weijun Situ
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, No. 139, Middle Renmin Road, Changsha, 410011, Hunan, People's Republic of China. .,National Clinical Research Center on Psychiatry and Psychology, Changsha, Hunan, People's Republic of China. .,Medical Psychological Institute of Central South University, Changsha, Hunan, People's Republic of China.
| | - Hengyi Rao
- Center of Functional Neuroimaging, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| |
Collapse
|
25
|
Beauchaine TP, Sauder CL, Derbidge CM, Uyeji LL. Self-injuring adolescent girls exhibit insular cortex volumetric abnormalities that are similar to those seen in adults with borderline personality disorder. Dev Psychopathol 2019; 31:1203-1212. [PMID: 30394252 PMCID: PMC6500772 DOI: 10.1017/s0954579418000822] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Self-inflicted injury (SII) in adolescence is a serious public health concern that portends prospective vulnerability to internalizing and externalizing psychopathology, borderline personality development, suicide attempts, and suicide. To date, however, our understanding of neurobiological vulnerabilities to SII is limited. Behaviorally, affect dysregulation is common among those who self-injure. This suggests ineffective cortical modulation of emotion, as observed among adults with borderline personality disorder. In borderline samples, structural and functional abnormalities are observed in several frontal regions that subserve emotion regulation (e.g., anterior cingulate, insula, dorsolateral prefrontal cortex). However, no volumetric analyses of cortical brain regions have been conducted among self-injuring adolescents. We used voxel-based morphometry to compare cortical gray matter volumes between self-injuring adolescent girls, ages 13-19 years (n = 20), and controls (n = 20). Whole-brain analyses revealed reduced gray matter volumes among self-injurers in the insular cortex bilaterally, and in the right inferior frontal gyrus, an adjacent neural structure also implicated in emotion and self-regulation. Insular and inferior frontal gyrus gray matter volumes correlated inversely with self-reported emotion dysregulation, over-and-above effects of psychopathology. Findings are consistent with an emotion dysregulation construal of SII, and indicate structural abnormalities in some but not all cortical brain regions implicated in borderline personality disorder among adults.
Collapse
Affiliation(s)
| | - Colin L Sauder
- Department of Psychiatry,University of Texas San Antonio,San Antonio, TX,USA
| | - Christina M Derbidge
- Department of Physical Medicine and Rehabilitation,University of Utah,Salt Lake City, UT,USA
| | - Lauren L Uyeji
- Department of Psychology,Temple University,Philadelphia, PA,USA
| |
Collapse
|
26
|
Craig MC, Mulder LM, Zwiers MP, Sethi A, Hoekstra PJ, Dietrich A, Baumeister S, Aggensteiner PM, Banaschewski T, Brandeis D, Werhahn JE, Walitza S, Castro-Fornieles J, Arango C, Schulze UME, Glennon JC, Franke B, Santosh PJ, Mastroianni M, van Asten JJA, Buitelaar JK, Lythgoe DJ, Naaijen J. Distinct associations between fronto-striatal glutamate concentrations and callous-unemotional traits and proactive aggression in disruptive behavior. Cortex 2019; 121:135-146. [PMID: 31622899 DOI: 10.1016/j.cortex.2019.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/02/2019] [Accepted: 08/05/2019] [Indexed: 01/17/2023]
Abstract
Disruptive behavior is associated with societally and personally problematic levels of aggression and has been linked to abnormal structure and function of fronto-amygdala-striatal regions. Abnormal glutamatergic signalling within this network may play a role in aggression. However, disruptive behavior does not represent a homogeneous construct, but can be fractionated across several dimensions. Of particular interest, callous-unemotional (CU) traits have been shown to modulate the severity, neural and behavioural characterisation, and therapeutic outcomes of disruptive behaviour disorders (DBDs) and aggression. Further, individuals showing disruptive behavior differ to the extent that they engage in subtypes of aggression (i.e., proactive [PA] and reactive aggression [RA]) which may also represent distinct therapeutic targets. Here we investigated how glutamate signalling within the fronto-amygdala-striatal circuitry was altered along these dimensions in youths showing disruptive behavior (n = 140) and typically developing controls (TD, n = 93) within the age-range of 8-18 years. We used proton magnetic resonance spectroscopy (1H-MRS) in the anterior cingulate cortex (ACC), striatum, amygdala and insula and associated glutamate concentrations with continuous measures of aggression and CU-traits using linear mixed-effects models. We found evidence of a dissociation for the different measures and glutamate concentrations. CU traits were associated with increased ACC glutamate ('callousness': b = .19, t (108) = 2.63, p = .01, r = .25; 'uncaring': b = .18, t (108) = 2.59, p = .011, r = .24) while PA was associated with decreased striatal glutamate concentration (b = -.23, t (28) = -3.02, p = .005, r = .50). These findings suggest dissociable correlates of CU traits and PA in DBDs, and indicate that the ACC and striatal glutamate may represent novel pharmacological targets in treating these different aspects.
Collapse
Affiliation(s)
- Michael C Craig
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom. National Autism Unit (NAU), SLaM NHS Foundation Trust, London, UK
| | - Leandra M Mulder
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - Marcel P Zwiers
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom. National Autism Unit (NAU), SLaM NHS Foundation Trust, London, UK
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Andrea Dietrich
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain, Universitat de Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Maranon, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Jeffrey C Glennon
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Human Genetics, Nijmegen, the Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Paramala J Santosh
- Department of Child and Adolescent Psychiatry, King's College London, London, UK; Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Mathilde Mastroianni
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Jack J A van Asten
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, the Netherlands
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
| | - Jilly Naaijen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| |
Collapse
|
27
|
Zhang J, Li X, Li Y, Wang M, Huang B, Yao S, Shen L. Three dimensional convolutional neural network-based classification of conduct disorder with structural MRI. Brain Imaging Behav 2019; 14:2333-2340. [PMID: 31538277 DOI: 10.1007/s11682-019-00186-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Conduct disorder (CD) is a common child and adolescent psychiatric disorder with various representative symptoms, and may cause long-term burden to patients and society. Recently, an increasing number of studies have used deep learning-based approaches, such as convolutional neural network (CNN), to analyze neuroimaging data and to identify biomarkers. In this study, we applied an optimized 3D AlexNet CNN model to automatically extract multi-layer high dimensional features of structural magnetic resonance imaging (sMRI), and to classify CD from healthy controls (HCs). We acquired high-resolution sMRI from 60 CD and 60 age- and gender-matched HCs. All subjects were male, and the age (mean ± std. dev) of participants in the CD and HC groups was 15.3 ± 1.0 and 15.5 ± 0.7, respectively. Five-fold cross validation (CV) was used to train and test this model. The receiver operating characteristic (ROC) curve for this model and that for support vector machine (SVM) model were compared. Feature visualization was performed to obtain intuition about the sMRI features learned by our AlexNet model. Our proposed AlexNet model achieved high classification performance with accuracy of 0.85, specificity of 0.82 and sensitivity of 0.87. The area under the ROC curve (AUC) of AlexNet was 0.86, significantly higher than that of SVM (AUC = 0.78; p = 0.046). The saliency maps for each convolutional layer highlighted the different brain regions in sMRI of CD, mainly including the frontal lobe, superior temporal gyrus, parietal lobe and occipital lobe. The classification results indicated that deep learning-based method is able to explore the hidden features from the sMRI of CD and might assist clinicians in the diagnosis of CD.
Collapse
Affiliation(s)
- Jianing Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, People's Republic of China
| | - Xuechen Li
- Computer Vision Institute, School of Computer Science and Software Engineering, Shenzhen University, Shenzhen, People's Republic of China
| | - Yuexiang Li
- Computer Vision Institute, School of Computer Science and Software Engineering, Shenzhen University, Shenzhen, People's Republic of China
| | - Mingyu Wang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, People's Republic of China
| | - Bingsheng Huang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, People's Republic of China
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
| | - Linlin Shen
- Computer Vision Institute, School of Computer Science and Software Engineering, Shenzhen University, Shenzhen, People's Republic of China.
| |
Collapse
|
28
|
Zhang YD, Zhou JS, Lu FM, Wang XP. Reduced gray matter volume in male adolescent violent offenders. PeerJ 2019; 7:e7349. [PMID: 31534834 PMCID: PMC6730529 DOI: 10.7717/peerj.7349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/25/2019] [Indexed: 01/20/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Ying-Dong Zhang
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Jian-Song Zhou
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Feng-Mei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.,School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, Cichuan, China
| | - Xiao-Ping Wang
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| |
Collapse
|
29
|
Moore TM, Calkins ME, Satterthwaite TD, Roalf DR, Rosen AFG, Gur RC, Gur RE. Development of a computerized adaptive screening tool for overall psychopathology ("p"). J Psychiatr Res 2019; 116:26-33. [PMID: 31176109 PMCID: PMC6649661 DOI: 10.1016/j.jpsychires.2019.05.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 04/29/2019] [Accepted: 05/31/2019] [Indexed: 11/21/2022]
Abstract
A substantial body of work supports the existence of a general psychopathology factor ("p"). Psychometrically, this is important because it implies that there is a psychological phenomenon (overall psychopathology) that can be measured and potentially used in clinical research or treatment. The present study aimed to construct, calibrate, and begin to validate a computerized adaptive (CAT) screener for "p". In a large community sample (N = 4544; age 11-21), we modeled 114 clinical items using a bifactor multidimensional item response theory (MIRT) model and constructed a fully functional (and public) CAT for assessing "p" called the Overall mental illness (OMI) screener. In a random, non-overlapping sample (N = 1019) with extended phenotyping (neuroimaging) from the same community cohort, adaptive versions of the OMI screener (10-, 20-, and 40-item) were simulated and compared to the full 114-item test in their ability to predict demographic characteristics, common mental disorders, and brain parameters. The OMI screener performed almost as well as the full test, despite being only a small fraction of the length. For prediction of 13 mental disorders, the mid-length (20-item) adaptive version showed mean area under the receiver operating characteristic curve of 0.76, compared to 0.79 for the full version. For prediction of brain parameters, mean absolute standardized relationship was 0.06 for the 20-item adaptive version, compared to 0.07 for the full form. This brief, public tool may facilitate the rapid and accurate measurement of overall psychopathology in large-scale studies and in clinical practice.
Collapse
Affiliation(s)
- Tyler M Moore
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Monica E Calkins
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Theodore D Satterthwaite
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David R Roalf
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Adon F G Rosen
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ruben C Gur
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, 19104, USA
| | - Raquel E Gur
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| |
Collapse
|
30
|
Noten M, Van der Heijden K, Huijbregts S, Van Goozen S, Swaab H. Indicators of affective empathy, cognitive empathy, and social attention during emotional clips in relation to aggression in 3-year-olds. J Exp Child Psychol 2019; 185:35-50. [DOI: 10.1016/j.jecp.2019.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/13/2019] [Accepted: 04/17/2019] [Indexed: 01/10/2023]
|
31
|
Pineau G, Villemonteix T, Slama H, Kavec M, Balériaux D, Metens T, Baijot S, Mary A, Ramoz N, Gorwood P, Peigneux P, Massat I. Dopamine transporter genotype modulates brain activity during a working memory task in children with ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 92:103430. [PMID: 31306870 DOI: 10.1016/j.ridd.2019.103430] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/04/2019] [Accepted: 06/23/2019] [Indexed: 06/10/2023]
Abstract
Dopamine active transporter gene (DAT1) is a candidate gene associated with attention-deficit/hyperactivity disorder (ADHD). The DAT1 variable number tandem repeat (VNTR)-3' polymorphism is functional and 9R carriers have been shown to produce more DAT than 10R homozygotes. We used functional magnetic resonance imaging (fMRI) to investigate the effects of this polymorphism on the neural substrates of working memory (WM) in a small but selected population of children with ADHD, naïve of any psychotropic treatment and without comorbidity. MRI and genotype data were obtained for 36 children (mean age: 10,36 +/- 1,49 years) with combined-type ADHD (9R n = 15) and 25 typically developing children (TDC) (mean age: 9,55 +/- 1,25 years) (9R n = 12). WM performance was similar between conditions. We found a cross-over interaction effect between gene (9R vs. 10R) and diagnosis (TDC vs. ADHD) in the orbito-frontal gyrus, cerebellum and inferior temporal lobe. In these areas, WM-related activity was higher for 9R carriers in ADHD subjects and lower in TDC. In ADHD children only, 10R homozygotes exhibited higher WM-related activity than 9R carriers in a network encompassing the parietal and the temporal lobes, the ventral visual cortex, the orbito-frontal gyrus and the head of the caudate nucleus. There was no significant results in TDC group. Our preliminary findings suggest that DAT1 VNTR polymorphism can modulate WM-related brain activity ADHD children.
Collapse
Affiliation(s)
- Guillaume Pineau
- GHU Paris Psychiatrie and Neurosciences (CMME, Hôpital Sainte-Anne), 1 rue Cabanis, 75014 Paris, France; INSERM U1266 (Team 1, Institute of Psychiatry and Neurosciences of Paris), Paris, France.
| | - Thomas Villemonteix
- Psychopathology and Neuropsychology Lab, Paris 8 University, 2 Rue de la Liberté, 93526 Saint-Denis, France
| | - Hichem Slama
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium; UNESCOG - Research Unit in Cognitive Neurosciences, at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, ULB, Belgium; Department of Clinical and Cognitive Neuropsychology, Erasme Hospital, Belgium
| | - Martin Kavec
- Department of Radiology, Clinics of Magnetic Resonance, Erasme Hospital, 808 Lennik street, CP601, 1070 Brussels, Belgium; UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium
| | - Danielle Balériaux
- Department of Radiology, Clinics of Magnetic Resonance, Erasme Hospital, 808 Lennik street, CP601, 1070 Brussels, Belgium; UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium
| | - Thierry Metens
- Department of Radiology, Clinics of Magnetic Resonance, Erasme Hospital, 808 Lennik street, CP601, 1070 Brussels, Belgium; UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium
| | - Simon Baijot
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium; UNESCOG - Research Unit in Cognitive Neurosciences, at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, ULB, Belgium
| | - Alison Mary
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium; National Fund of Scientific Research, Belgium
| | - Nicolas Ramoz
- INSERM U1266 (Team 1, Institute of Psychiatry and Neurosciences of Paris), Paris, France
| | - Philip Gorwood
- GHU Paris Psychiatrie and Neurosciences (CMME, Hôpital Sainte-Anne), 1 rue Cabanis, 75014 Paris, France; INSERM U1266 (Team 1, Institute of Psychiatry and Neurosciences of Paris), Paris, France
| | - Philippe Peigneux
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium
| | - Isabelle Massat
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Centre de Recherche Cognition et Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Belgium; National Fund of Scientific Research, Belgium; Laboratory of Experimental Neurology, ULB, Belgium
| |
Collapse
|
32
|
Young AS, Youngstrom EA, Findling RL, Van Eck K, Kaplin D, Youngstrom JK, Calabrese J, Stepanova E, The Lams Consortium. Developing and Validating a Definition of Impulsive/Reactive Aggression in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:787-803. [PMID: 31343896 DOI: 10.1080/15374416.2019.1622121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The goal of this study is to develop a rational data-driven definition of impulsive/reactive aggression and establish distinctions between impulsive/reactive aggression and other common childhood problems. This is a secondary analysis of data from Assessing Bipolar: A Community Academic Blend (ABACAB; N = 636, ages 5-18), Stanley Medical Research Institute N = 392, ages 5-17), and the Longitudinal Assessment of Manic Symptoms (LAMS; N = 679, ages 6-12) studies, which recruited youths seeking outpatient mental health services in academic medical centers and community clinics. Following Jensen et al.'s (2007) procedure, 3 judges independently rated items from several widely used scales in terms of assessing impulsive/reactive aggression. Principal components analyses (PCA) modeled structure of the selected items supplemented by items related to mood symptoms, rule-breaking behavior, and hyperactivity/impulsivity to better define the boundaries between impulsive/reactive aggression and other common childhood symptoms. In the rational item selection process, there was good agreement among the 3 experts who rated items as characterizing impulsive/reactive aggression or not. PCA favored 5 dimension solutions in all 3 samples. Across all samples, PCA resulted in rule-breaking behavior, aggression-impulsive/reactive (AIR), mania, and depression dimensions; there was an additional hyperactive/impulsive dimension in the LAMS sample and a self-harm dimension in ABACAB and Stanley samples. The dimensions demonstrated good internal consistency; criterion validity coefficients also showed consistency across samples. This study is a step toward developing an empirically derived nosology of impulsive aggression/AIR. Findings support the validity of the AIR construct, which can be distinguished from manic and depressive symptoms as well as rule-breaking behavior.
Collapse
Affiliation(s)
- Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Robert L Findling
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Kathryn Van Eck
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Dana Kaplin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Jennifer K Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | | |
Collapse
|
33
|
Glenn AL. Using biological factors to individualize interventions for youth with conduct problems: Current state and ethical issues. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 65:101348. [PMID: 29673560 DOI: 10.1016/j.ijlp.2018.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
A growing body of evidence suggests that biological factors such as genes, hormone levels, brain structure, and brain functioning influence the development and trajectory of conduct problems in youth. In addition, biological factors affect how individuals respond to the environment, including how individuals respond to programs designed to prevent or treat conduct problems. Programs designed to reduce behavior problems in youth would have the greatest impact if they were targeted toward youth who need it the most (e.g., who are mostly likely to demonstrate persistent behavior problems) as well as youth who may benefit the most from the program. Biological information may improve our ability to make decisions about which type or level of intervention is best for a particular child, thus maximizing overall effectiveness, but it also raises a number of ethical concerns. These include the idea that we may be providing fewer services to some youth based on biological factors, and that information about biological risk could potentially lead to discrimination or labeling. In this article, I discuss the risks and benefits of using biological information to individualize interventions for youth with conduct problems.
Collapse
Affiliation(s)
- Andrea L Glenn
- Center for the Prevention of Youth Behavior Problems, Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL 35487, USA.
| |
Collapse
|
34
|
Cardinale EM, O'Connell K, Robertson EL, Meena LB, Breeden AL, Lozier LM, VanMeter JW, Marsh AA. Callous and uncaring traits are associated with reductions in amygdala volume among youths with varying levels of conduct problems. Psychol Med 2019; 49:1449-1458. [PMID: 30139402 PMCID: PMC7074929 DOI: 10.1017/s0033291718001927] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The emergence of callous unemotional (CU) traits, and associated externalizing behaviors, is believed to reflect underlying dysfunction in the amygdala. Studies of adults with CU traits or psychopathy have linked characteristic patterns of amygdala dysfunction to reduced amygdala volume, but studies in youths have not thus far found evidence of similar amygdala volume reductions. The current study examined the association between CU traits and amygdala volume by modeling CU traits and externalizing behavior as independent continuous variables, and explored the relative contributions of callous, uncaring, and unemotional traits. METHODS CU traits and externalizing behavior problems were assessed in 148 youths using the Inventory of Callous Unemotional Traits (ICU) and the Child Behavior Checklist (CBCL). For a subset of participants (n = 93), high-resolution T1-weighted images were collected and volume estimates for the amygdala were extracted. RESULTS Analyses revealed that CU traits were associated with increased externalizing behaviors and decreased bilateral amygdala volume. These results were driven by the callous and uncaring sub-factors of CU traits, with unemotional traits unrelated to either externalizing behaviors or amygdala volume. Results persisted after accounting for covariation between CU traits and externalizing behaviors. Bootstrap mediation analyses indicated that CU traits mediated the relationship between reduced amygdala volume and externalizing severity. CONCLUSIONS These findings provide evidence that callous-uncaring traits account for reduced amygdala volume among youths with conduct problems. These findings provide a framework for further investigation of abnormal amygdala development as a key causal pathway for the development of callous-uncaring traits and conduct problems.
Collapse
Affiliation(s)
| | - Katherine O'Connell
- Georgetown University Interdisciplinary Program in Neuroscience,Washington, DC,USA
| | | | - Lydia B Meena
- Georgetown University Department of Psychology,Washington, DC,USA
| | - Andrew L Breeden
- Georgetown University Interdisciplinary Program in Neuroscience,Washington, DC,USA
| | - Leah M Lozier
- Georgetown University Interdisciplinary Program in Neuroscience,Washington, DC,USA
| | - John W VanMeter
- Georgetown University Center for Functional and Molecular Imaging,Washington, DC,USA
| | - Abigail A Marsh
- Georgetown University Department of Psychology,Washington, DC,USA
| |
Collapse
|
35
|
The structural brain correlates of callous-unemotional traits in incarcerated male adolescents. NEUROIMAGE-CLINICAL 2019; 22:101703. [PMID: 30738373 PMCID: PMC6370859 DOI: 10.1016/j.nicl.2019.101703] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/25/2019] [Accepted: 01/29/2019] [Indexed: 12/13/2022]
Abstract
Youth with severe conduct problems impose a significant cost on society by engaging in high levels of antisocial and aggressive behavior. Within this group, adolescents with high levels of callous- unemotional traits have been found to exhibit more severe and persistent patterns of antisocial behavior than youth with severe conduct problems but normative levels of callous-unemotional traits. Existing neuroimaging studies, along with theoretical accounts of psychopathology, suggest that dysfunction within the paralimbic cortex and limbic system may underlie elevated levels of callous-unemotional traits. The present study examines this hypothesis by investigating gray matter correlates associated with callous-unemotional traits. A sample of incarcerated male adolescents (N = 269), were assessed using voxel-based morphometry. Callous-unemotional traits were assessed using the Inventory of Callous-Unemotional traits (Frick 2004). Total callous-unemotional traits were negatively correlated with anterior temporal lobe gray matter volume (GMV). Callous traits in particular exhibited a reliable negative correlation with gray matter volume in nearly every paralimbic brain region examined. Uncaring traits were positively correlated with GMV in the orbitofrontal and anterior cingulate cortices. These findings demonstrate specific neural features within the paralimbic cortex and limbic system that accompany elevated callous-unemotional traits and serves to expand our understanding of pathophysiological mechanisms that may give rise to severe conduct problems in youth. Total callous-unemotional traits were negatively correlated with anterior temporal lobe gray matter volume (GMV). Callous traits negatively correlated with GMV in nearly every paralimbic regions examined. Uncaring traits were positively correlated with GMV in the orbitofrontal and anterior cingulate cortices.
Collapse
|
36
|
Tyler P, White SF, Thompson RW, Blair R. Applying a Cognitive Neuroscience Perspective to Disruptive Behavior Disorders: Implications for Schools. Dev Neuropsychol 2019; 44:17-42. [PMID: 29432037 PMCID: PMC6283690 DOI: 10.1080/87565641.2017.1334782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A cognitive neuroscience perspective seeks to understand behavior, in this case disruptive behavior disorders (DBD), in terms of dysfunction in cognitive processes underpinned by neural processes. While this type of approach has clear implications for clinical mental health practice, it also has implications for school-based assessment and intervention with children and adolescents who have disruptive behavior and aggression. This review articulates a cognitive neuroscience account of DBD by discussing the neurocognitive dysfunction related to emotional empathy, threat sensitivity, reinforcement-based decision-making, and response inhibition. The potential implications for current and future classroom-based assessments and interventions for students with these deficits are discussed.
Collapse
Affiliation(s)
- Patrick Tyler
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
- Boys Town National Research Institute, Boys Town, Nebraska, USA
| | - Stuart F. White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | | | - R.J.R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| |
Collapse
|
37
|
Fehlbaum LV, Raschle NM, Menks WM, Prätzlich M, Flemming E, Wyss L, Euler F, Sheridan M, Sterzer P, Stadler C. Altered Neuronal Responses During an Affective Stroop Task in Adolescents With Conduct Disorder. Front Psychol 2018; 9:1961. [PMID: 30405475 PMCID: PMC6200838 DOI: 10.3389/fpsyg.2018.01961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/24/2018] [Indexed: 01/08/2023] Open
Abstract
Conduct disorder (CD) is a psychiatric disorder of childhood and adolescence which has been linked to deficient emotion processing and regulation. The behavioral and neuronal correlates targeting the interaction of emotion processing and response inhibition are still under investigation. Whole-brain event-related fMRI was applied during an affective Stroop task in 39 adolescents with CD and 39 typically developing adolescents (TD). Participants were presented with an emotional stimulus (negative/neutral) followed by a Stroop task with varying cognitive load (congruent/incongruent/blank trials). fMRI analysis included standard preprocessing, region of interest analyses (amygdala, insula, ventromedial prefrontal cortex) and whole-brain analyses based on a 2(group) × 2(emotion) × 3(task) full-factorial ANOVA. Adolescents with CD made significantly more errors, while reaction times did not significantly differ compared to TD. Additionally, we observed a lack of downregulation of left amygdala activity in response to incongruent trials and increased anterior insula activity for CD relative to TD during affective Stroop task processing [cluster-level family-wise error-corrected (p < 0.05)]. Even though no three-way interaction (group × emotion × task) interaction was detected, the findings presented still provide evidence for altered neuronal underpinnings of the interaction of emotion processing and response inhibition in CD. Moreover, our results may corroborate previous evidence of emotion dysregulation as a core dysfunction in CD. Future studies shall focus on investigating the interaction of emotion processing and response inhibition in CD subgroups (e.g., variations in callous-unemotional traits, impulsivity, or anxiety).
Collapse
Affiliation(s)
- Lynn V. Fehlbaum
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Nora M. Raschle
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Willeke M. Menks
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Martin Prätzlich
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Eva Flemming
- Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Berlin, Germany
| | - Letizia Wyss
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Felix Euler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Berlin, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| |
Collapse
|
38
|
Zhang J, Cao W, Wang M, Wang N, Yao S, Huang B. Multivoxel pattern analysis of structural MRI in children and adolescents with conduct disorder. Brain Imaging Behav 2018; 13:1273-1280. [DOI: 10.1007/s11682-018-9953-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
39
|
Towards an animal model of callousness. Neurosci Biobehav Rev 2018; 91:121-129. [DOI: 10.1016/j.neubiorev.2016.12.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/14/2016] [Accepted: 12/23/2016] [Indexed: 01/16/2023]
|
40
|
Brain structure abnormalities in young women who presented conduct disorder in childhood/adolescence. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2018; 17:869-885. [PMID: 28695488 PMCID: PMC5548815 DOI: 10.3758/s13415-017-0519-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The phenotype and genotype of antisocial behavior among females are different from those among males. Previous studies have documented structural brain alterations in males with antisocial behavior, yet little is known about the neural correlates of female antisocial behavior. The present study examined young women who had presented conduct disorder (CDW) prior to age 15 to determine whether brain abnormalities are present in adulthood and whether the observed abnormalities are associated with comorbid disorders or maltreatment that typically characterize this population. Using magnetic resonance imaging and voxel-based morphometry, we compared gray matter volumes (GMV) of 31 women who presented CD by midadolescence and 25 healthy women (HW), age, on average, 23 years. Participants completed structured, validated interviews to diagnose mental disorders, and validated questionnaires to document physical and sexual abuse. Relative to HW, CDW presented increased GMV in the left superior temporal gyrus that was associated with past alcohol and drug dependence, current use of alcohol and drugs, and current anxiety and depression symptoms and maltreatment. Additionally, CDW displayed reduced GMV in lingual gyrus, hippocampus, and anterior cingulate cortex that was associated with past comorbid disorders, current alcohol and drugs use, current anxiety and depression symptoms, and maltreatment. The CDW also presented reduced total GMV that was associated with past comorbid disorders and current anxiety/depression symptoms. Alterations of brain structure were observed among young adult females with prior CD, relative to HW, all of which were associated with internalizing and externalizing disorders and maltreatment that typically accompany CD.
Collapse
|
41
|
Default mode network activity and neuropsychological profile in male children and adolescents with attention deficit hyperactivity disorder and conduct disorder. Brain Imaging Behav 2018; 11:1561-1570. [PMID: 27738997 DOI: 10.1007/s11682-016-9614-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
It is known that patients with Attention Deficit and Hyperactivity disorder (ADHD) and Conduct disorder (CD) commonly shows greater symptom severity than those with ADHD alone and worse outcomes. This study researches whether Default mode network (DMN) is altered in adolescents with ADHD + CD, relative to ADHD alone and controls or not. Ten medication-naïve boys with ADHD + CD, ten medication-naïve boys with ADHD and 10-age-matched typically developing (TD) controls underwent functional magnetic resonance imaging (fMRI) scans in the resting state and neuropsychological tasks such as the Wisconsin Card Sorting Test (WCST), Stroop Test TBAG Form (STP), Auditory Verbal learning Test (AVLT), Visual Auditory Digit Span B (VADS B) were applied to all the subjects included. fMRI scans can be used only nine patients in each groups. The findings revealed group differences between cingulate cortex and primary mortor cortex; cingulate cortex and somatosensory association cortex; angular gyrus (AG) and dorsal posterior cingulate cortex, in these networks increased activity was observed in participants with ADHD + CD compared with the ADHD. We found that lower resting state (rs)-activity was observed between left AG and dorsal posterior cingulate cortex, whereas higher rs-activity connectivity were detected between right AG and somatosensory association cortex in ADHD relative to the ones with ADHD + CD. In neuropsyhcological tasks, ADHD + CD group showed poor performance in WISC-R, WCST, Stroop, AVLT tasks compared to TDs. The ADHD + CD group displayed rs-functional abnormalities in DMN. Our results suggest that abnormalities in the intrinsic activity of resting state networks may contribute to the etiology of CD and poor prognosis of ADHD + CD.
Collapse
|
42
|
Cheetham A, Allen NB, Whittle S, Simmons J, Yücel M, Lubman DI. Amygdala volume mediates the relationship between externalizing symptoms and daily smoking in adolescence: A prospective study. Psychiatry Res Neuroimaging 2018; 276:46-52. [PMID: 29661490 DOI: 10.1016/j.pscychresns.2018.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 01/31/2018] [Accepted: 03/07/2018] [Indexed: 11/28/2022]
Abstract
The current study examined amygdala and orbitofrontal cortex (OFC) volumes as mediators of the relationship between externalizing symptoms and daily smoking in adolescence. Externalizing behaviors are among the most robust predictors of adolescent smoking, and there is emerging evidence that volume reductions in the amygdala and OFC are associated with risk for substance misuse as well as aggressive, impulsive, and disinhibited tendencies. Using a prospective longitudinal design, we recruited 109 adolescents who provided data on brain volume and externalizing behaviors at age 12, and on smoking at age 18. Daily smoking at age 18 (n = 27) was predicted by externalizing behaviors (measured by the self-report Child Behavior Checklist, CBCL) as well as smaller right amygdala volumes. Right amygdala volumes mediated the relationship between externalizing symptoms and later smoking. These findings provide important insight into the neurobiological risk factors associated with adolescent smoking, and, more generally, into factors that may be associated with vulnerability to substance use disorders and related psychopathology.
Collapse
Affiliation(s)
- Ali Cheetham
- Turning Point, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia
| | - Nicholas B Allen
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Australia; Department of Psychology, University of Oregon, USA
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Australia
| | - Julian Simmons
- Melbourne School of Psychological Sciences, University of Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Australia
| | - Murat Yücel
- Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry, Monash University, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia.
| |
Collapse
|
43
|
Zhang J, Liu W, Zhang J, Wu Q, Gao Y, Jiang Y, Gao J, Yao S, Huang B. Distinguishing Adolescents With Conduct Disorder From Typically Developing Youngsters Based on Pattern Classification of Brain Structural MRI. Front Hum Neurosci 2018; 12:152. [PMID: 29740296 PMCID: PMC5925967 DOI: 10.3389/fnhum.2018.00152] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/04/2018] [Indexed: 01/04/2023] Open
Abstract
Background: Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents antisocial behaviors, and is associated with structural alterations in brain. However, whether these structural alterations can distinguish CD from healthy controls (HCs) remains unknown. Here, we quantified these structural differences and explored the classification ability of these quantitative features based on machine learning (ML). Materials and Methods: High-resolution 3D structural magnetic resonance imaging (sMRI) was acquired from 60 CD subjects and 60 age-matched HCs. Voxel-based morphometry (VBM) was used to assess the regional gray matter (GM) volume difference. The significantly different regional GM volumes were then extracted as features, and input into three ML classifiers: logistic regression, random forest and support vector machine (SVM). We trained and tested these ML models for classifying CD from HCs by using fivefold cross-validation (CV). Results: Eight brain regions with abnormal GM volumes were detected, which mainly distributed in the frontal lobe, parietal lobe, anterior cingulate, cerebellum posterior lobe, lingual gyrus, and insula areas. We found that these ML models achieved comparable classification performance, with accuracy of 77.9 ∼ 80.4%, specificity of 73.3 ∼ 80.4%, sensitivity of 75.4 ∼ 87.5%, and area under the receiver operating characteristic curve (AUC) of 0.76 ∼ 0.80. Conclusion: Based on sMRI and ML, the regional GM volumes may be used as potential imaging biomarkers for stable and accurate classification of CD.
Collapse
Affiliation(s)
- Jianing Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Weixiang Liu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jing Zhang
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiong Wu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yidian Gao
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Jiang
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Junling Gao
- Centre of Buddhist Studies, The University of Hong Kong, Pokfulam, Hong Kong
| | - Shuqiao Yao
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Bingsheng Huang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
44
|
Puiu AA, Wudarczyk O, Goerlich KS, Votinov M, Herpertz-Dahlmann B, Turetsky B, Konrad K. Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review. Neurosci Biobehav Rev 2018; 90:231-246. [PMID: 29689282 DOI: 10.1016/j.neubiorev.2018.04.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/13/2018] [Accepted: 04/17/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although impulsive aggression (IA) and dysfunctional response inhibition (RI) are hallmarks of attention-deficit/hyperactivity disorder (ADHD) and disrupted behavioral disorders (DBDs), little is known about their shared and distinct deviant neural mechanisms. AIMS AND METHODS Here, we selectively reviewed s/fMRI ADHD and DBD studies to identify disorder-specific and shared IA and RI aberrant neural mechanisms. RESULTS In ADHD, deviant prefrontal and cingulate functional activity was associated with increased IA. Structural alterations were most pronounced in the cingulate cortex. Subjects with DBDs showed marked cortico-subcortical dysfunctions. ADHD and DBDs share similar cortico-limbic structural and functional alterations. RI deficits in ADHD highlighted hypoactivity in the dorso/ventro-lateral PFC, insula, and striatum, while the paralimbic system was primarily dysfunctional in DBDs. Across disorders, extensively altered cortico-limbic dysfunctions underlie IA, while RI was mostly associated with aberrant prefrontal activity. CONCLUSION Control network deficits were evidenced across clinical phenotypes in IA and RI. Dysfunctions at any level within these cortico-subcortical projections lead to deficient cognitive-affective control by ascribing emotional salience to otherwise irrelevant stimuli. The clinical implications of these findings are discussed.
Collapse
Affiliation(s)
- Andrei A Puiu
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Olga Wudarczyk
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Katharina S Goerlich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany; Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany; JARA-Institute Brain Structure-Function Relationship, Research Center Jülich and RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine 10, Research Center Jülich, Aachen, Germany.
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Bruce Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| |
Collapse
|
45
|
van Donkelaar MMJ, Hoogman M, Pappa I, Tiemeier H, Buitelaar JK, Franke B, Bralten J. Pleiotropic Contribution of MECOM and AVPR1A to Aggression and Subcortical Brain Volumes. Front Behav Neurosci 2018; 12:61. [PMID: 29666571 PMCID: PMC5891600 DOI: 10.3389/fnbeh.2018.00061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/15/2018] [Indexed: 11/16/2022] Open
Abstract
Reactive and proactive subtypes of aggression have been recognized to help parse etiological heterogeneity of this complex phenotype. With a heritability of about 50%, genetic factors play a role in the development of aggressive behavior. Imaging studies implicate brain structures related to social behavior in aggression etiology, most notably the amygdala and striatum. This study aimed to gain more insight into the pathways from genetic risk factors for aggression to aggression phenotypes. To this end, we conducted genome-wide gene-based cross-trait meta-analyses of aggression with the volumes of amygdala, nucleus accumbens and caudate nucleus to identify genes influencing both aggression and aggression-related brain volumes. We used data of large-scale genome-wide association studies (GWAS) of: (a) aggressive behavior in children and adolescents (EAGLE, N = 18,988); and (b) Magnetic Resonance Imaging (MRI)-based volume measures of aggression-relevant subcortical brain regions (ENIGMA2, N = 13,171). Second, the identified genes were further investigated in a sample of healthy adults (mean age (SD) = 25.28 (4.62) years; 43% male) who had genome-wide genotyping data and questionnaire data on aggression subtypes available (Brain Imaging Genetics, BIG, N = 501) to study their effect on reactive and proactive subtypes of aggression. Our meta-analysis identified two genes, MECOM and AVPR1A, significantly associated with both aggression risk and nucleus accumbens (MECOM) and amygdala (AVPR1A) brain volume. Subsequent in-depth analysis of these genes in healthy adults (BIG), including sex as an interaction term in the model, revealed no significant subtype-specific gene-wide associations. Using cross-trait meta-analysis of brain measures and psychiatric phenotypes, this study generated new hypotheses about specific links between genes, the brain and behavior. Results indicate that MECOM and AVPR1A may exert an effect on aggression through mechanisms involving nucleus accumbens and amygdala volumes, respectively.
Collapse
Affiliation(s)
- Marjolein M J van Donkelaar
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Irene Pappa
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Karakter Child and Adolescent Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| |
Collapse
|
46
|
Keyes KM, Gary DS, Beardslee J, Prins SJ, O’Malley PM, Rutherford C, Schulenberg J. Joint Effects of Age, Period, and Cohort on Conduct Problems Among American Adolescents From 1991 Through 2015. Am J Epidemiol 2018; 187:548-557. [PMID: 28679165 DOI: 10.1093/aje/kwx268] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/23/2017] [Indexed: 12/17/2022] Open
Abstract
Although arrest rates among juveniles have substantially decreased since the 1990s, US national trends in conduct problems are unknown. Population variation in conduct problems would imply changes in the social environment, which would include emergent or receding risk factors. In the present study, we separated age, period, and cohort effects on conduct problems using nationally representative surveys of 375,879 US students conducted annually (1991-2015). The summed score of 7 items measuring the frequency of conduct problems was the outcome. Conduct problems have decreased during the past 25 years among boys; the total amount of the decrease was approximately 0.4 standard deviations (P < 0.01), and by item prevalence, the total amount of the decrease was 8%-11%. Declines are best explained by period effects beginning approximately in 2008, and a declining cohort effect beginning among those born after 1992, which suggests not only declines in population levels, but more rapid declines among younger cohorts of boys. Trends were also consistent with age-period-cohort effects on evenings spent out, which suggest a possible mechanism. Conduct problems among girls were lower than boys and did not demonstrate trends across time. These changes may reflect the changing nature of adolescence toward less unsupervised interaction.
Collapse
Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Dahsan S Gary
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Jordan Beardslee
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Seth J Prins
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Patrick M O’Malley
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
- Department of Psychology and Center for Growth and Human Development, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
47
|
Coccaro EF, Cremers H, Fanning J, Nosal E, Lee R, Keedy S, Jacobson KC. Reduced frontal grey matter, life history of aggression, and underlying genetic influence. Psychiatry Res Neuroimaging 2018; 271:126-134. [PMID: 29174436 DOI: 10.1016/j.pscychresns.2017.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 11/28/2022]
Abstract
Physically healthy, adult, same-sexed twins (n = 287) from a population-based twin cohort underwent high-resolution magnetic resonance imaging (MRI) to identify fronto-limbic brain regions significantly associated with lifetime history of aggression. MRI scans used a 3D magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) sequence, for voxel-based morphometry (VBM) and history of aggressive behavior was assessed using the Life History of Aggression measure. Aggression had modest, inverse associations with grey matter volume (GMV) in medial prefrontal cortex (mPFC, b = -0.20, se = 0.05, p < 0.001) and lateral prefrontal cortex (lPFC, b = -0.23, se = 0.06, p < 0.001). These associations were not confounded by other demographic, psychiatric, or personality factors. Biometrical twin analyses revealed significant heritabilities of 0.57 for GMV in the mPFC cluster and 0.36 for GMV in the lPFC cluster. Genetic factors accounted for the majority of the phenotypic correlations between aggression and mPFC GMV (85.3%) and between aggression and lPFC GMV (63.7%). Reduced GMV of prefrontal brain regions may be a neuronal characteristic of individuals with substantial histories of aggressive behavior regardless of psychiatric diagnosis. As such, these data suggest an anatomical correlate, with a possible genetic etiology, associated with functional deficits in social-emotional information processing.
Collapse
Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Henk Cremers
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Jennifer Fanning
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Eryka Nosal
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Royce Lee
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Sarah Keedy
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Kristen C Jacobson
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| |
Collapse
|
48
|
Sarkar S, Clark BS, Deeley Q. Differences between psychopathy and other personality disorders: evidence from neuroimaging. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.107.004747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryICD-10 and DSM-IV-TR diagnostic guidelines do not list psychopathy as a distinct psychiatric entity. However, there are significant overlaps between psychopathy and DSM-IV-TR Cluster B personality disorders. Neuroimaging studies implicate deficits in structure and function of frontal and limbic regions in this group of personality disorders, while highlighting both distinctions and overlaps between syndromes. Here, these data are reviewed and implications for diagnosis and clinical practice are discussed.
Collapse
|
49
|
Raschle NM, Menks WM, Fehlbaum LV, Steppan M, Smaragdi A, Gonzalez-Madruga K, Rogers J, Clanton R, Kohls G, Martinelli A, Bernhard A, Konrad K, Herpertz-Dahlmann B, Freitag CM, Fairchild G, De Brito SA, Stadler C. Callous-unemotional traits and brain structure: Sex-specific effects in anterior insula of typically-developing youths. NEUROIMAGE-CLINICAL 2017. [PMID: 29527490 PMCID: PMC5842751 DOI: 10.1016/j.nicl.2017.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Callous-unemotional traits are characterized by a lack of empathy, a disregard for others' feelings and shallow or deficient affect, such as a lack of remorse or guilt. Neuroanatomical correlates of callous-unemotional traits have been demonstrated in clinical samples (i.e., adolescents with disruptive behavior disorders). However, it is unknown whether callous-unemotional traits are associated with neuroanatomical correlates within normative populations without clinical levels of aggression or antisocial behavior. Here we investigated the relationship between callous-unemotional traits and gray matter volume using voxel-based morphometry in a large sample of typically-developing boys and girls (N = 189). Whole-brain multiple regression analyses controlling for site, total intracranial volume, and age were conducted in the whole sample and in boys and girls individually. Results revealed that sex and callous-unemotional traits interacted to predict gray matter volume when considering the whole sample. This interaction was driven by a significant positive correlation between callous-unemotional traits and bilateral anterior insula volume in boys, but not girls. Insula gray matter volume explained 19% of the variance in callous-unemotional traits for boys. Our results demonstrate that callous-unemotional traits are related to variations in brain structure beyond psychiatric samples. This association was observed for boys only, underlining the importance of considering sex as a factor in future research designs. Future longitudinal studies should determine whether these findings hold over childhood and adolescence, and whether the neuroanatomical correlates of callous-unemotional traits are predictive of future psychiatric vulnerability. General scientific summary This study suggests that callous-unemotional traits have a neuroanatomical correlate within typically developing boys, but not girls. Bilateral anterior insula volume explains up to 19% of the variance in callous-unemotional traits in boys. Sex-specific correlations between callous-unemotional (CU) traits and insula volume. CU-traits are positively linked to anterior insula in typically-developing boys. Variations in insula volume explained 19% of the variance in CU-traits in boys. Accounting for sex in neuroanatomical studies of individual differences is important.
Collapse
Affiliation(s)
- Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland.
| | - Willeke Martine Menks
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Martin Steppan
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Areti Smaragdi
- Academic Unit of Psychology, University of Southampton, Southampton, England, UK
| | | | - Jack Rogers
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Roberta Clanton
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Gregor Kohls
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of the RWTH, Aachen, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | | | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| |
Collapse
|
50
|
Lu FM, Zhou JS, Zhang J, Wang XP, Yuan Z. Disrupted small-world brain network topology in pure conduct disorder. Oncotarget 2017; 8:65506-65524. [PMID: 29029449 PMCID: PMC5630349 DOI: 10.18632/oncotarget.19098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/06/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Conduct disorder (CD) is characterized by the violation of the rights of others or basic social rules and a repetitive, persistent pattern of antisocial and aggressive behaviors. A large number of functional and structural neuroimaging studies have identified widely abnormalities in specific brain regions in CD, but the alterations in the topological organization of functional networks among them remain largely unknown. METHODS Resting-state functional magnetic resonance imaging was applied to investigate the intrinsic functional connectivity in 18 pure CD patients and eighteen typically developing healthy controls. We first constructed the functional networks and then examined the CD-related alteration in topology properties using graph theoretical analysis. RESULTS Both the CD group and healthy controls exhibited small-world topology. However, the CD group showed decreased global and local efficiency. Changes in the nodal characteristics in CD group were found predominantly in the default-mode network, visual, and striatum regions. In addition, altered fronto-limbic-striatum network topology was found to have a relationship with clinical scores. CONCLUSIONS Our findings indicate the altered nodal topology of brain functional connectivity networks in CD. SIGNIFICANCE The results provide unequivocal evidence of a topological disruption in the brain networks that suggest some possible pathophysiological mechanisms underlying CD.
Collapse
Affiliation(s)
- Feng-Mei Lu
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Jian-Song Zhou
- Mental Health Institute, Second Xiangya Hospital, Central South University, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Jiang Zhang
- School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Xiao-Ping Wang
- Mental Health Institute, Second Xiangya Hospital, Central South University, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Zhen Yuan
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau SAR, China
| |
Collapse
|