| Abstract No.: | A-C1117 |
| Country: | Canada |
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| Title: | CINGULATE-FRONTO-INSULAR CORTICAL THINNING AND DECREASED GRAY MATTER DENSITY IN 8 YEAR-OLD CHILDREN WITH DISRUPTIVE BEHAVIOR DISORDERS |
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| Authors/Affiliations: | 4 Cherine Fahim*; 2 Uicheul Yoon; 2 John Chen; 1 J-Sebastian Muehlboeck; 2 Alan Evans; 3 Daniel Perusse;
1 McConnell Brain Imaging Centre, Montreal Neurological Institute; 2 McGill University; McConnell Brain Imaging Centre, Montreal Neurological Institute; 3 Sainte-Justine Hospital Research Centre, University of Montreal; 4 Sainte-Justine Hospital Research Centre, University of Montreal; Mcgill University; QC, Canada
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| Content: | Background: Among the group of disruptive behavior disorders (DBDs), most neuroimaging research has been based entirely on attention-deficit/hyperactivity disorder (ADHD). Sparse research targets directly the DBDs as grouped into the DSM-IV. Such approach limits the generalizability, cause literature discrepancies and compromise the validity of study findings.
Objectives: The objectives of this study was (1) to examine possible neuroanatomical abnormalities associated with DBDs; (2) assess possible characteristic neuroanatomical deficits in each of the DBDs separately.
Materials and Methods: Cortical thickness in conjunction with voxel-based morphometry were analyzed from 47 eight year-old children (22 DBDs and 25 healthy controls) 1.5T Siemens Magnetom Vision magnetic resonance imgaing brain scans. DBDs symptoms were measured using the Dominic-R Interactive.
Results: We report two main findings. First, significant thinning of the cingulate, prefrontal and insular cortices in conjunction with decreased gray matter density in the same regions. Thinning and decreased gray matter density of the insula. Second, each of the DBDs was associated with specific cortical thinning in regions which accord with its symptomatology profile [i.e., attention deficit disorder correlated with thinning of the anterior cingulate cortex (which is heavily connected with the dorsolateral prefrontal cortex and implicated in high executive functions); conduct disorder with thinning of the medial prefrontal (aggression and cruelty) and oppositional defiance thinning of the orbitofrontal cortex (impulsivity)].
Conclusion: While in normal individuals these brain regions act to constrain the expression of affect, deficits in this circuit increase a person's inclination towards vulnerability to aggressive behavior. Thinning and decreased gray matter density of the insula disorganizes prefrontal circuits, diminishing the inhibitory influence of the prefrontal cortex on anger, aggression, cruelty and impulsivity. These findings have implications for pathophysiologic models of DBDs, diagnostic classification systems and for designing more effective interventions. Clinical practice with the heterogeneous group of children with DBDs may benefit from improved formats for diagnostic subtyping. Determination of the clinical significance of potential DBDs subtyping could yield better diagnostic decision-making, treatment planning, and treatment outcomes.
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