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具有品行障碍的青少年的白质微观结构:冷酷特质的性别和变化的影响。

White Matter Microstructure in Youths With Conduct Disorder: Effects of Sex and Variation in Callous Traits.

机构信息

School of Psychology, University of Birmingham, UK.

University of Southampton, UK.

出版信息

J Am Acad Child Adolesc Psychiatry. 2019 Dec;58(12):1184-1196. doi: 10.1016/j.jaac.2019.02.019. Epub 2019 Apr 25.

Abstract

OBJECTIVE

Studies using diffusion tensor imaging (DTI) to investigate white matter (WM) microstructure in youths with conduct disorder (CD) have reported disparate findings. We investigated WM alterations in a large sample of youths with CD, and examined the influence of sex and callous-unemotional (CU) traits.

METHOD

DTI data were acquired from 124 youths with CD (59 female) and 174 typically developing (TD) youths (103 female) 9 to 18 years of age. Tract-based spatial statistics tested for effects of diagnosis and sex-by-diagnosis interactions. Associations with CD symptoms, CU traits, a task measuring impulsivity, and the impact of comorbidity, and age- and puberty-related effects were examined.

RESULTS

Youths with CD exhibited higher axial diffusivity in the corpus callosum and lower radial diffusivity and mean diffusivity in the anterior thalamic radiation relative to TD youths. Female and male youths with CD exhibited opposite changes in the left hemisphere within the internal capsule, fornix, posterior thalamic radiation, and uncinate fasciculus. Within the CD group, CD symptoms and callous traits exerted opposing influences on corpus callosum axial diffusivity, with callous traits identified as the unique clinical feature predicting higher axial diffusivity and lower radial diffusivity within the corpus callosum and anterior thalamic radiation, respectively. In an exploratory analysis, corpus callosum axial diffusivity partially mediated the association between callous traits and impulsive responses to emotional faces. Results were not influenced by symptoms of comorbid disorders, and no age- or puberty-related interactions were observed.

CONCLUSION

WM alterations within the corpus callosum represent a reliable neuroimaging marker of CD. Sex and callous traits are important factors to consider when examining WM in CD.

摘要

目的

使用弥散张量成像(DTI)研究品行障碍(CD)青少年的白质(WM)微观结构的研究报告结果存在差异。我们对大量 CD 青少年的 WM 改变进行了研究,并检查了性别和无情无义(CU)特征的影响。

方法

从 124 名患有 CD(59 名女性)和 174 名典型发育(TD)青少年(103 名女性)9 至 18 岁的青少年中获得 DTI 数据。基于束的空间统计测试了诊断和性别诊断之间的相互作用的影响。检查了与 CD 症状、CU 特征、测量冲动性的任务以及合并症的影响以及与年龄和青春期相关的影响之间的关联。

结果

与 TD 青少年相比,患有 CD 的青少年的胼胝体的轴向弥散度较高,而前丘脑辐射的径向弥散度和平均弥散度较低。患有 CD 的女性和男性青少年在左半球的内囊、穹窿、后丘脑辐射和钩束中表现出相反的变化。在 CD 组中,CD 症状和 CU 特征对胼胝体的轴向弥散度施加了相反的影响,CU 特征被确定为唯一的临床特征,可预测胼胝体和前丘脑辐射的轴向弥散度增加和径向弥散度降低。在一项探索性分析中,胼胝体的轴向弥散度部分介导了 CU 特征与对情绪面孔的冲动反应之间的关联。结果不受合并症症状的影响,也没有观察到与年龄或青春期相关的相互作用。

结论

胼胝体内部的 WM 改变是 CD 的可靠神经影像学标志物。在检查 CD 中的 WM 时,性别和 CU 特征是重要的考虑因素。

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