Department of Psychiatry, University of Colorado Denver School of Medicine, 12469 E. 17th Place, Aurora, CO 80045, USA.
Drug Alcohol Depend. 2011 Nov 1;118(2-3):295-305. doi: 10.1016/j.drugalcdep.2011.04.006. Epub 2011 May 17.
Boys with serious conduct and substance problems (Antisocial Substance Dependence (ASD)) repeatedly make impulsive and risky decisions in spite of possible negative consequences. Because prefrontal cortex (PFC) is involved in planning behavior in accord with prior rewards and punishments, structural abnormalities in PFC could contribute to a person's propensity to make risky decisions.
We acquired high-resolution structural images of 25 male ASD patients (ages 14-18 years) and 19 controls of similar ages using a 3T MR system. We conducted whole-brain voxel-based morphometric analysis (p<0.05, corrected for multiple comparisons at whole-brain cluster-level) using Statistical Parametric Mapping version-5 and tested group differences in regional gray matter (GM) volume with analyses of covariance, adjusting for total GM volume, age, and IQ; we further adjusted between-group analyses for ADHD and depression. As secondary analyses, we tested for negative associations between GM volume and impulsivity within groups and separately, GM volume and symptom severity within patients using whole-brain regression analyses.
ASD boys had significantly lower GM volume than controls in left dorsolateral PFC (DLPFC), right lingual gyrus and bilateral cerebellum, and significantly higher GM volume in right precuneus. Left DLPFC GM volume showed negative association with impulsivity within controls and negative association with substance dependence severity within patients.
ASD boys show reduced GM volumes in several regions including DLPFC, a region highly relevant to impulsivity, disinhibition, and decision-making, and cerebellum, a region important for behavioral regulation, while they showed increased GM in precuneus, a region associated with self-referential and self-centered thinking.
男孩严重的行为和物质问题（反社会物质依赖（ASD）），尽管可能有负面后果，反复作出冲动和冒险的决定。因为前额叶皮层（PFC）参与规划行为，根据事先的奖励和惩罚，PFC 的结构异常可能导致一个人有冒险的倾向作出决定。
我们使用 3T MR 系统获得了 25 名男性 ASD 患者（年龄 14-18 岁）和 19 名年龄相匹配的对照者的高分辨率结构图像。我们使用统计参数映射版本-5 进行了全脑基于体素的形态计量分析（p<0.05，在全脑聚类水平上校正了多重比较），并使用协方差分析测试了区域灰质（GM）体积的组间差异，调整了总 GM 体积、年龄和智商；我们进一步调整了 ADHD 和抑郁之间的组间分析。作为二次分析，我们测试了 GM 体积与组内冲动性之间的负相关关系，以及 GM 体积与患者内症状严重程度之间的负相关关系，使用全脑回归分析。
ASD 男孩的左侧背外侧前额叶皮层（DLPFC）、右侧舌回和双侧小脑的 GM 体积明显低于对照组，右侧楔前叶的 GM 体积明显高于对照组。DLPFC 的 GM 体积与对照组的冲动性呈负相关，与患者的物质依赖严重程度呈负相关。
ASD 男孩表现出包括 DLPFC 在内的几个区域的 GM 体积减少，DLPFC 是一个与冲动、抑制和决策高度相关的区域，小脑是一个与行为调节相关的区域，而他们在楔前叶表现出 GM 增加，楔前叶与自我参照和自我中心思维有关。
