M A Bertocci1, G Bebko1, T Olino1, J Fournier1, A K Hinze1, L Bonar1, J R C Almeida1, S B Perlman1, A Versace1, M Travis1, M K Gill1, C Demeter2, V A Diwadkar3, R White3, C Schirda1, J L Sunshine2, L E Arnold4, S K Holland5, R A Kowatch6, B Birmaher1, D Axelson4, E A Youngstrom7, R L Findling2, S M Horwitz8, M A Fristad4, M L Phillips1. 1. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA. 2. University Hospitals Case Medical Center/Case Western Reserve University,Cleveland, OH,USA. 3. Department of Psychiatry and Behavioral Neuroscience,Wayne State University,Detroit, MI,USA. 4. Department of Psychiatry,Ohio State University,Columbus, OH,USA. 5. Cincinnati Children's Hospital Medical Center,University of Cincinnati,Cincinnati, OH,USA. 6. The Research Institute at Nationwide Children's Hospital,Columbus, OH,USA. 7. Department of Psychology,University of North Carolina at Chapel Hill,Chapel Hill, NC,USA. 8. Department of Child Psychiatry,New York University School of Medicine,New York, NY,USA.
Abstract
BACKGROUND: Neuroimaging measures of behavioral and emotional dysregulation can yield biomarkers denoting developmental trajectories of psychiatric pathology in youth. We aimed to identify functional abnormalities in emotion regulation (ER) neural circuitry associated with different behavioral and emotional dysregulation trajectories using latent class growth analysis (LCGA) and neuroimaging. METHOD: A total of 61 youth (9-17 years) from the Longitudinal Assessment of Manic Symptoms study, and 24 healthy control youth, completed an emotional face n-back ER task during scanning. LCGA was performed on 12 biannual reports completed over 5 years of the Parent General Behavior Inventory 10-Item Mania Scale (PGBI-10M), a parental report of the child's difficulty regulating positive mood and energy. RESULTS: There were two latent classes of PGBI-10M trajectories: high and decreasing (HighD; n=22) and low and decreasing (LowD; n=39) course of behavioral and emotional dysregulation over the 12 time points. Task performance was >89% in all youth, but more accurate in healthy controls and LowD versus HighD (p<0.001). During ER, LowD had greater activity than HighD and healthy controls in the dorsolateral prefrontal cortex, a key ER region, and greater functional connectivity than HighD between the amygdala and ventrolateral prefrontal cortex (p's<0.001, corrected). CONCLUSIONS: Patterns of function in lateral prefrontal cortical-amygdala circuitry in youth denote the severity of the developmental trajectory of behavioral and emotional dysregulation over time, and may be biological targets to guide differential treatment and novel treatment development for different levels of behavioral and emotional dysregulation in youth.
BACKGROUND: Neuroimaging measures of behavioral and emotional dysregulation can yield biomarkers denoting developmental trajectories of psychiatric pathology in youth. We aimed to identify functional abnormalities in emotion regulation (ER) neural circuitry associated with different behavioral and emotional dysregulation trajectories using latent class growth analysis (LCGA) and neuroimaging. METHOD: A total of 61 youth (9-17 years) from the Longitudinal Assessment of Manic Symptoms study, and 24 healthy control youth, completed an emotional face n-back ER task during scanning. LCGA was performed on 12 biannual reports completed over 5 years of the Parent General Behavior Inventory 10-Item Mania Scale (PGBI-10M), a parental report of the child's difficulty regulating positive mood and energy. RESULTS: There were two latent classes of PGBI-10M trajectories: high and decreasing (HighD; n=22) and low and decreasing (LowD; n=39) course of behavioral and emotional dysregulation over the 12 time points. Task performance was >89% in all youth, but more accurate in healthy controls and LowD versus HighD (p<0.001). During ER, LowD had greater activity than HighD and healthy controls in the dorsolateral prefrontal cortex, a key ER region, and greater functional connectivity than HighD between the amygdala and ventrolateral prefrontal cortex (p's<0.001, corrected). CONCLUSIONS: Patterns of function in lateral prefrontal cortical-amygdala circuitry in youth denote the severity of the developmental trajectory of behavioral and emotional dysregulation over time, and may be biological targets to guide differential treatment and novel treatment development for different levels of behavioral and emotional dysregulation in youth.
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