Brain structure abnormalities in adolescent girls with conduct disorder

Department of Psychiatry, University of Cambridge, Cambridge, UK School of Psychology, University of Southampton, Southampton, UK Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK Consiglio Nazionale delle Ricerche, Unità di Ricerca Neuroimmagini, Catanzaro, Italy.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 10/2012; 54(1). DOI: 10.1111/j.1469-7610.2012.02617.x
Source: PubMed


Conduct disorder (CD) in female adolescents is associated with a range of negative outcomes, including teenage pregnancy and antisocial personality disorder. Although recent studies have documented changes in brain structure and function in male adolescents with CD, there have been no neuroimaging studies of female adolescents with CD. Our primary objective was to investigate whether female adolescents with CD show changes in grey matter volume. Our secondary aim was to assess for sex differences in the relationship between CD and brain structure.

Female adolescents with CD (n = 22) and healthy control participants matched in age, performance IQ and handedness (n = 20) underwent structural magnetic resonance imaging. Group comparisons of grey matter volume were performed using voxel-based morphometry. We also tested for sex differences using archive data obtained from male CD and control participants.

Female adolescents with CD showed reduced bilateral anterior insula and right striatal grey matter volumes compared with healthy controls. Aggressive CD symptoms were negatively correlated with right dorsolateral prefrontal cortex volume, whereas callous-unemotional traits were positively correlated with bilateral orbitofrontal cortex volume. The sex differences analyses revealed a main effect of diagnosis on right amygdala volume (reflecting reduced amygdala volume in the combined CD group relative to controls) and sex-by-diagnosis interactions in bilateral anterior insula.

We observed structural abnormalities in brain regions involved in emotion processing, reward and empathy in female adolescents with CD, which broadly overlap with those reported in previous studies of CD in male adolescents.

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    • "This pattern of results was recently replicated in a female incarcerated sample (Cope et al. 2014b). However, also in female participants , Fairchild et al. (2013) found that CU traits were positively (rather than negatively) associated with bilateral OFC volumes. Furthermore, some studies have found no associations between brain structure and CU traits; for example Fairchild et al. (2011) found no relationship between GM volumes and CU traits in males, although CD symptoms were negatively associated with right insula volume and the CD sample size was large (N = 63). "
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    ABSTRACT: Genetic, behavioural and functional neuroimaging studies have revealed that different vulnerabilities characterise children with conduct problems and high levels of callous-unemotional traits (CP/HCU) compared with children with conduct problems and low callous-unemotional traits (CP/LCU). We used voxel-based morphometry to study grey matter volume (GMV) in 89 male participants (aged 10-16), 60 of whom exhibited CP. The CP group was subdivided into CP/HCU (n = 29) and CP/LCU (n = 31). Whole-brain and regional GMV were compared across groups (CP vs. typically developing (TD) controls (n = 29); and CP/HCU vs. CP/LCU vs. TD). Whole-brain analyses showed reduced GMV in left middle frontal gyrus in the CP/HCU group compared with TD controls. Region-of-interest analyses showed reduced volume in bilateral orbitofrontal cortex (OFC) in the CP group as a whole compared with TD controls. Reduced volume in left OFC was found to be driven by the CP/HCU group only, with significant reductions relative to both TD controls and the CP/LCU group, and no difference between these latter two groups. Within the CP group left OFC volume was significantly predicted by CU traits, but not conduct disorder symptoms. Reduced right anterior cingulate cortex volume was also found in CP/HCU compared with TD controls. Our results support previous findings indicating that GMV differences in brain regions central to decision-making and empathy are implicated in CP. However, they extend these data to suggest that some of these differences might specifically characterise the subgroup with CP/HCU, with GMV reduction in left OFC differentiating children with CP/HCU from those with CP/LCU.
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    • "Our data showed meanness was also associated with GMV increase in the lateral OFC and striatum. This is consistent with prior research showing an association between callousunemotional traits and OFC volume in a sample of disordered youth (Fairchild et al., 2013). It is also in line with reports of augmented caudate body volume as a function of the affectiveinterpersonal factor or the PCL-R (Glenn et al., 2010). "
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    • "In other clinical cohorts such as in those with anxiety and attention disorders, behavioral and conduct disorders have been linked with abnormal structure and activity of subcortical regions such as the caudate , striatum, amygdala, and the hippocampus. Lower functional activity of the amygdala, hippocampus, and the striatum has been seen in youth with conduct disorders [Crowley et al., 2010; Fairchild et al., 2013; Marsh et al., 2013], while smaller thalamus are found in children with ADHD [Xia et al., 2012]. In contrast, negative or nonsignificant relationships in brain-behavior relationships have been reported previously both in typical children [Lebel et al., 2010] and in typical older populations [Gautam et al., 2011]. "
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