efault mode network activity in male adolescents with conduct nd substance use disorder

Background: Adolescents with conduct disorder (CD) and substance use disorders (SUD) experience difficulty evaluating and regulating their behavior in anticipation of future consequences. Given the role of the brain’s default mode network (DMN) in self-reflection and future thought, this study investigates whether DMN is altered in adolescents with CD and SUD, relative to controls. Methods: Twenty adolescent males with CD and SUD and 20 male controls of similar ages underwent functional magnetic resonance imaging as they completed a risk-taking decision task. We used independent component analysis as a data-driven approach to identify the DMN spatial component in individual subjects. DMN activity was then compared between groups. Results: Compared to controls, patients showed reduced activity in superior, medial and middle frontal gyrus (Brodmann area (BA) 10), retrosplenial cortex (BA 30) and lingual gyrus (BA 18), and bilateral middle temporal gryus (BA 21/22) – DMN regions thought to support self-referential evaluation, memory, foresight, and perspective taking. Furthermore, this pattern of reduced activity in patients remained robust after adjusting for the effects of depression and attention-deficit hyperactivity disorder (ADHD). Conversely, when not adjusting for effects of depression and ADHD, patients demonstrated greater DMN activity than controls solely in the cuneus (BA 19). Conclusions: Collectively, these results suggest that comorbid CD and SUD in adolescents is characterized by atypical activity in brain regions thought to play an important role in introspective processing. These functional imbalances in brain networks may provide further insight into the neural underpinnings of conduct and substance use disorders. Supplementary material can be found by accessing the online version of this paper. S ∗ Corresponding author at: Department of Psychiatry, 12469 East 17th Place, Mail Stop ax: +1 303 724 3178. E-mail addresses: manish.dalwani@ucdenver.edu (M.S. Dalwani), Jason.Tregellas@ucd J.R. Andrews-Hanna), Susan.Mikulich@ucdenver.edu (S.K. Mikulich-Gilbertson), Kristen.R M.T. Banich), Thomas.Crowley@ucdenver.edu (T.J. Crowley), Joseph.Sakai@ucdenver.edu 1 Address: Department of Psychiatry, UCD, Campus Box F546, 13001 East 17th Place, A 2 Address: Institute of Cognitive Science, 344 UCB, Mailing Box: 594 UCB; Boulder, CO 8 3 Address: Department of Psychiatry, 12469 East 17th Place, Mail Stop F478, Room 211 4 Address: Department of Psychiatry, 12469 East 17th Place, Mail Stop F478, Room 201 5 Address: Institute of Cognitive Science, 344 UCB, Mailing Box: 594 UCB; Boulder, CO 8 6 Address: Department of Psychiatry, 12469 East 17th Place, Mail Stop F478, Room 215 7 Address: Department of Psychiatry, 12469 East 17th Place, Mail Stop F478, Room 204 376-8716/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. ttp://dx.doi. org/10.1016/j.drugalcdep. 2013.10. 009 © 2013 Elsevier Ireland Ltd. All rights reserved. ee Appendix A for more details. F478, Room 207, Aurora, CO 80045, United States. Tel. : +1 303 724 3185; enver.edu (J.R. Tregellas), Jessica.andrews-hanna@colorado.edu aymond@ucdenver.edu (K.M. Raymond), Marie.Banich@colorado.edu (J.T. Sakai). urora, CO 80002, United States. Tel. : +1 303 724 6232. 0309-00344, United States. Tel. : +1 617 276 4562. , Aurora, CO 80045, United States. Tel. : +1 303 724 3186; fax: +1 303 724 3178. , Aurora, CO 80045, United States. Tel. : +1 303 761 8122; fax: +1 303 724 3178. 0309-00344, United States. Tel. : +1 303 492 6655; fax: +1 303 492 7177. , Aurora, CO 80045, United States. Tel. : +1 303 724 3181; fax: +1 303 724 3178. , Aurora, CO 80045, United States. Tel. : +1 303 724 3182; fax: +1 303 724 3178.