McKay Cameron C, Scheinberg Brooke, Xu Ellie P, Kircanski Katharina, Pine Daniel S, Brotman Melissa A, Leibenluft Ellen, Linke Julia O
Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
University of Freiburg, Freiburg, Germany.
J Am Acad Child Adolesc Psychiatry. 2024 Dec;63(12):1239-1250. doi: 10.1016/j.jaac.2024.02.010. Epub 2024 Mar 5.
Irritability, inattention, and hyperactivity, which are common presentations of childhood psychopathology, have been associated with perturbed white matter microstructure. However, similar tracts have been implicated across these phenotypes; such non-specificity could be rooted in their high co-occurrence. To address this problem, we use a bifactor approach parsing unique and shared components of irritability, inattention, and hyperactivity, which we then relate to white matter microstructure.
We developed a bifactor model based on the Conners Comprehensive Behavioral Rating Scale in a sample of youth with no psychiatric diagnosis or a primary diagnosis of attention-deficit/hyperactivity disorder or disruptive mood dysregulation disorder (n = 521). We applied the model to an independent yet sociodemographically and clinically comparable sample (n = 152), in which we tested associations between latent variables and fractional anisotropy (FA).
The bifactor model fit well (comparative fit index = 0.99; root mean square error of approximation = 0.07). The shared factor was positively associated with an independent measure of impulsivity (ρ = 0.88, p < .001) and negatively related to whole-brain FA (r = -0.20), as well as FA of the corticospinal tract (all p < .05). FA increased with age and deviation from this curve, indicating that altered white matter maturation was associated with the hyperactivity-specific factor (r = -0.16, p < .05). Inattention-specific and irritability-specific factors were not linked to FA.
Perturbed white matter microstructure may represent a shared neurobiological mechanism of irritability, inattention, and hyperactivity related to heightened impulsivity. Furthermore, hyperactivity might be uniquely associated with a delay in white matter maturation.
In this study, researchers developed a model identifying shared aspects of key symptoms of disruptive mood dysregulation disorder (DMDD) and attention-deficit hyperactivity disorder (ADHD), more specifically irritability, inattention, and hyperactivity. In 521 participants, impulsivity emerged as a shared factor. Applied to 152 youth with brain imaging data, shared impulsivity, not specific symptoms, related to atypical brain structure. Additionally, hyperactivity was linked to delayed white matter maturation. Study findings suggest this approach might identify mechanisms of these childhood disorders that remain hidden when relying on traditional diagnostic categories.
易怒、注意力不集中和多动是儿童精神病理学的常见表现,与白质微结构紊乱有关。然而,这些表型涉及相似的脑区;这种非特异性可能源于它们的高共现率。为了解决这个问题,我们采用双因素方法解析易怒、注意力不集中和多动的独特和共同成分,然后将其与白质微结构联系起来。
我们基于康纳斯综合行为评定量表,在无精神疾病诊断或主要诊断为注意力缺陷多动障碍或破坏性情绪失调障碍的青少年样本(n = 521)中开发了一个双因素模型。我们将该模型应用于一个独立的、但在社会人口统计学和临床方面具有可比性的样本(n = 152),在该样本中我们测试了潜在变量与分数各向异性(FA)之间的关联。
双因素模型拟合良好(比较拟合指数 = 0.99;近似均方根误差 = 0.07)。共同因素与冲动性的独立测量呈正相关(ρ = 0.88,p <.001),与全脑FA呈负相关(r = -0.20),以及与皮质脊髓束的FA呈负相关(所有p <.05)。FA随年龄增加,偏离该曲线表明白质成熟改变与多动特异性因素相关(r = -0.16,p <.05)。注意力不集中特异性因素和易怒特异性因素与FA无关。
白质微结构紊乱可能代表与冲动性增强相关的易怒、注意力不集中和多动的共同神经生物学机制。此外,多动可能与白质成熟延迟有独特关联。
在本研究中,研究人员开发了一个模型,识别破坏性情绪失调障碍(DMDD)和注意力缺陷多动障碍(ADHD)关键症状的共同方面,更具体地说是易怒、注意力不集中和多动。在521名参与者中,冲动性作为一个共同因素出现。应用于152名有脑成像数据的青少年,共同的冲动性而非特定症状与非典型脑结构有关。此外,多动与白质成熟延迟有关。研究结果表明,这种方法可能识别出这些儿童疾病的机制,而这些机制在依赖传统诊断类别时仍然隐藏着。