Huebner Thomas, Vloet Timo D, Marx Ivo, Konrad Kerstin, Fink Gereon R, Herpertz Sabine C, Herpertz-Dahlmann Beate
Drs. Herpertz-Dahlmann and Vloet and Mr. Huebner are with the Department of Child and Adolescent Psychiatry and Psychotherapy and Dr. Konrad is with the Child and Neuropsychology Section of the Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, RWTH Aachen; Dr. Fink is with the Brain Imaging Center West, Institute of Neuroscience and Biophysics, Research Center Juelich; and Mr. Marx and Dr. Herpertz are with the Department of Psychiatry and Psychotherapy, University of Rostock.
Drs. Herpertz-Dahlmann and Vloet and Mr. Huebner are with the Department of Child and Adolescent Psychiatry and Psychotherapy and Dr. Konrad is with the Child and Neuropsychology Section of the Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, RWTH Aachen; Dr. Fink is with the Brain Imaging Center West, Institute of Neuroscience and Biophysics, Research Center Juelich; and Mr. Marx and Dr. Herpertz are with the Department of Psychiatry and Psychotherapy, University of Rostock..
J Am Acad Child Adolesc Psychiatry. 2008 May;47(5):540-547. doi: 10.1097/CHI.0b013e3181676545.
Children with the early-onset type of conduct disorder (CD) are at high risk for developing an antisocial personality disorder. Although there have been several neuroimaging studies on morphometric differences in adults with antisocial personality disorder, little is known about structural brain aberrations in boys with CD.
Magnetic resonance imaging and voxel-based morphometry were used to assess abnormalities in gray matter volumes in 23 boys ages 12 to 17 years with CD (17 comorbid for attention-deficit/hyperactivity disorder) in comparison with age- and IQ-matched controls.
Compared with healthy controls, mean gray matter volume was 6% smaller in the clinical group. Compared with controls, reduced gray matter volumes were found in the left orbitofrontal region and bilaterally in the temporal lobes, including the amygdala and hippocampus on the left side in the CD group. Regression analyses in the clinical group indicated an inverse association of hyperactive/impulsive symptoms and widespread gray matter abnormalities in the frontoparietal and temporal cortices. By contrast, CD symptoms correlated primarily with gray matter reductions in limbic brain structures.
The data suggest that boys with CD and comorbid attention-deficit/hyperactivity disorder show brain abnormalities in frontolimbic areas that resemble structural brain deficits, which are typically observed in adults with antisocial behavior.
早发型品行障碍（CD）儿童发展为反社会人格障碍的风险很高。虽然已有多项关于反社会人格障碍成年患者形态学差异的神经影像学研究，但对于患有品行障碍的男孩的脑结构异常却知之甚少。
采用磁共振成像和基于体素的形态测量法，评估23名年龄在12至17岁之间患有品行障碍（其中17名合并注意力缺陷多动障碍）的男孩与年龄及智商匹配的对照组之间的灰质体积异常情况。
与健康对照组相比，临床组的平均灰质体积小6%。与对照组相比，品行障碍组左侧眶额区域以及双侧颞叶（包括左侧杏仁核和海马体）的灰质体积减少。临床组的回归分析表明，多动/冲动症状与额顶叶和颞叶皮质广泛的灰质异常呈负相关。相比之下，品行障碍症状主要与边缘脑结构的灰质减少相关。
数据表明，患有品行障碍且合并注意力缺陷多动障碍的男孩在前额叶边缘区域存在脑异常，类似于通常在有反社会行为的成年人中观察到的脑结构缺陷。
