National Institute of Mental Health, Bethesda, Maryland.
National Institute of Mental Health, Bethesda, Maryland.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Apr;8(4):436-444. doi: 10.1016/j.bpsc.2022.03.007. Epub 2022 Mar 28.
Psychiatric symptoms are commonly comorbid in childhood. The ability to disentangle unique and shared correlates of comorbid symptoms facilitates personalized medicine. Cognitive control is implicated broadly in psychopathology, including in pediatric disorders characterized by anxiety and irritability. To disentangle cognitive control correlates of anxiety versus irritability, the current study leveraged both cross-sectional and longitudinal data from early childhood into adolescence.
For this study, 89 participants were recruited from a large longitudinal research study on early-life temperament to investigate associations of developmental trajectories of anxiety and irritability symptoms (from ages 2 to 15) as well as associations of anxiety and irritability symptoms measured cross-sectionally at age 15 with neural substrates of conflict and error processing assessed at age 15 using the flanker task.
Results of whole-brain multivariate linear models revealed that anxiety at age 15 was uniquely associated with decreased neural response to conflict across multiple regions implicated in attentional control and conflict adaptation. Conversely, irritability at age 15 was uniquely associated with increased neural response to conflict in regions implicated in response inhibition. Developmental trajectories of anxiety and irritability interacted in relation to neural responses to both error and conflict.
Our findings suggest that neural correlates of conflict processing may relate uniquely to anxiety and irritability. Continued cross-symptom research on the neural correlates of cognitive control could stimulate advances in individualized treatment for anxiety and irritability during child and adolescent development.
儿童期常见精神症状共病。区分共病症状的独特和共同相关因素有助于实现个体化医疗。认知控制广泛涉及精神病理学,包括以焦虑和易怒为特征的儿科疾病。为了区分焦虑与易怒的认知控制相关因素,本研究利用了儿童期到青春期的横断面和纵向数据。
本研究从一项关于生命早期气质的大型纵向研究中招募了 89 名参与者,以调查焦虑和易怒症状(从 2 岁到 15 岁)的发展轨迹之间的关联,以及在 15 岁时测量的焦虑和易怒症状与使用侧翼任务评估的 15 岁时冲突和错误处理的神经基质之间的关联。
全脑多变量线性模型的结果表明,15 岁时的焦虑与多个涉及注意力控制和冲突适应的区域的冲突反应降低有关,这是独特相关的。相反,15 岁时的易怒与涉及反应抑制的区域的冲突反应增加有关。焦虑和易怒的发展轨迹在与错误和冲突相关的神经反应方面相互作用。
我们的研究结果表明,冲突处理的神经相关性可能与焦虑和易怒有独特的关系。对认知控制的神经相关性进行持续的跨症状研究可能会促进在儿童和青少年发展期间针对焦虑和易怒的个体化治疗的进展。