Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego.
San Diego State University, California.
J Am Acad Child Adolesc Psychiatry. 2020 Dec;59(12):1380-1391. doi: 10.1016/j.jaac.2019.09.002. Epub 2019 Sep 19.
Characterizing the pathophysiology of irritability symptoms from a dimensional perspective above and beyond diagnostic boundaries is key to developing mechanism-based interventions that can be applied broadly. Face emotion processing deficits are present in youths with elevated levels of irritability. The present study aimed to identify the neural mechanisms of face emotion processing in a sample enriched for irritability by including youths with high-functioning autism spectrum disorder (HF-ASD).
Youths (N = 120, age = 8.3-19.2 years) completed an implicit face emotion task during functional magnetic resonance imaging. We evaluated how irritability, measured dimensionally, above and beyond diagnostic group, relates to whole-brain neural activation and amygdala connectivity in response to face emotions.
Both neural activation and amygdala connectivity differed as a function of irritability level and face emotion in the prefrontal cortex. Youths with higher irritability levels had decreased activation in response to both fearful and happy faces in the left middle frontal gyrus and to happy faces in the left inferior frontal gyrus. Furthermore, increased irritability levels were associated with altered right amygdala connectivity to the left superior frontal gyrus when viewing fearful and sad faces.
The neural mechanisms of face emotion processing differ in youths with higher irritability compared to their less irritable peers. The findings suggest that these irritability mechanisms may be common to both typically developing and HF-ASD youths. Understanding the neural mechanisms of pediatric irritability symptoms that cut across diagnostic boundaries may be leveraged for future intervention development.
从超越诊断界限的维度角度来描述易激惹症状的病理生理学是开发能够广泛应用的基于机制的干预措施的关键。存在面部情绪处理缺陷在易激惹水平升高的青少年中。本研究旨在通过纳入高功能自闭症谱系障碍（HF-ASD）的青少年来确定易激惹丰富样本中面部情绪处理的神经机制。
共有 120 名青少年（年龄 8.3-19.2 岁）参加了功能磁共振成像期间的隐式面部情绪任务。我们评估了易激惹程度（在维度上测量，超越诊断组）如何与整个大脑的神经激活以及杏仁核连接相关，以响应面部情绪。
在额皮质中，易激惹水平和面部情绪的功能磁共振成像都与神经激活和杏仁核连接有关。易激惹程度较高的青少年在左中额回中对恐惧和快乐面孔以及左下额回中对快乐面孔的反应性激活降低。此外，当观看恐惧和悲伤面孔时，较高的易激惹水平与右杏仁核与左额上回的连接改变有关。
与易激惹程度较低的同龄人相比，易激惹程度较高的青少年的面部情绪处理神经机制有所不同。这些发现表明，这些易激惹机制可能在正常发育和 HF-ASD 青少年中都很常见。了解跨越诊断界限的儿科易激惹症状的神经机制可能会被用于未来的干预措施的发展。
