Maladaptive aggression, as present in conduct disorder (CD) and, to a lesser extent, oppositional defiant disorder (ODD), has been associated with structural alterations in various brain regions, such as ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), amygdala, insula and ventral striatum. Although aggression can be subdivided into reactive and proactive subtypes, no neuroimaging studies have yet investigated if any structural brain alterations are associated with either of the subtypes specifically. Here we investigated associations between aggression subtypes, CU traits and ADHD symptoms in predefined regions of interest. T1-weighted magnetic resonance images were acquired from 158 children and adolescents with disruptive behavior (ODD/CD) and 96 controls in a multi-center study (aged 8-18). Aggression subtypes were assessed by questionnaires filled in by participants and their parents. Cortical volume and subcortical volumes and shape were determined using Freesurfer and the FMRIB integrated registration and segmentation tool. Associations between volumes and continuous measures of aggression were established using multilevel linear mixed effects models. Proactive aggression was negatively associated with amygdala volume (b = -10.7, p = 0.02), while reactive aggression was negatively associated with insula volume (b = -21.7, p = 0.01). No associations were found with CU traits or ADHD symptomatology. Classical group comparison showed that children and adolescents with disruptive behavior had smaller volumes than controls in (bilateral) vmPFC (p = 0.003) with modest effect size and a reduced shape in the anterior part of the left ventral striatum (p = 0.005). Our study showed negative associations between reactive aggression and volumes in a region involved in threat responsivity and between proactive aggression and a region linked to empathy. This provides evidence for aggression subtype-specific alterations in brain structure which may provide useful insights for clinical practice.Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.
About The Expert
Jilly Naaijen
Leandra M Mulder
Shahrzad Ilbegi
Sanne de Bruijn
Renee Kleine-Deters
Andrea Dietrich
Pieter J Hoekstra
Jan-Bernard C Marsman
Pascal M Aggensteiner
Nathalie E Holz
Boris Boettinger
Sarah Baumeister
Tobias Banaschewski
Melanie C Saam
Ulrike M E Schulze
Paramala J Santosh
Ilyas Sagar-Ouriaghli
Mathilde Mastroianni
Josefina Castro Fornieles
Nuria Bargallo
Mireia Rosa
Celso Arango
Maria J Penzol
Julia E Werhahn
Susanne Walitza
Daniel Brandeis
Jeffrey C Glennon
Barbara Franke
Marcel P Zwiers
Jan K Buitelaar
References
PubMed