Brain Changes in Children and Adolescents With Behavioral Problems
Condition: Attention Deficit Disorder With Hyperactivity; Mental Disorders Diagnosed in Childhood; Conduct Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity; Mental Disorders; Conduct Disorder; Neurodevelopmental Disorders
Study type: Observational

Summary: 
      Purpose:

      This study will examine brain activity in children age 10-18 with disruptive behavior
      problems, including conduct disorder (CD), oppositional defiant disorder (ODD), and attention
      deficit hyperactivity disorder (ADHD), compared with children without behavioral problems.
      Our goal is to examine differences in how emotions, social situations, and problem-solving
      situations are processed in the brain across these groups of children.
    

Detailed description: 
      OBJECTIVE:

      The goal of this protocol is to investigate the neuro-cognitive underpinnings of the
      emotional dysfunction linked to childhood behavioral disturbance; in particular, Conduct
      Disorder with elevated callous-unemotional (CU) traits (CD+CU), Conduct Disorder with non
      elevated CU traits (CD-CU), but also ADHD. The functional hypotheses that we are testing with
      both neuro-cognitive and neuro-imaging paradigms are that: (1) CD+CU, but not ADHD, is
      associated with dysfunction in the formation and operational use of stimulus-punishment and,
      to a lesser extent, stimulus-reward association information; (2) CD-CU is associated with
      heightened threat sensitivity and impairment in executive systems involved in emotional
      regulation; and (3) that ADHD and CD-CU, is associated with impairment in executive systems
      related to the representation and execution of task demands.

      STUDY POPULATION:

      160 children with Conduct Disorder (CD) and high CU traits (the CD+CU group); 160 children
      with CD and low CU traits (the CD-CU group); 160 children with ADHD; and 160 healthy
      volunteer children. All children will be between the ages of 10 and 17. Both males and
      females will be enrolled.

      DESIGN:

      The current study will have two phases: i) neuropsychological assessment and training in an
      MRI simulator (up to 4 hours); ii) The MRI scanning session (up to 2 hours, no more than 90
      minutes in scanner). Participants, if they are willing, may be invited to participate in more
      than one scanning session (up to a maximum of 3 120 minute sessions) or neuro-cognitive
      testing session.

      OUTCOME MEASURES:

      Behaviorally, we predict that children with CD+CU and children with CD-CU will present with
      impairment on tasks that involve either the formation or operational use of particular
      stimulus-punishment associations (e.g., the subjective value learning task and emotional
      interrupt task). However, the nature of this impairment with be qualitatively different. For
      example, we predict that youth with CD+CU will show reduced interference by emotional
      distracters on the emotional interrupt task but that youth with CD-CU will show decreased
      interference. In contrast, we predict that children with ADHD, but no CD, will show no
      behavioral impairment on such tasks. However, we predict that children with ADHD and children
      with CD-CU will present with impairments on executive function tasks (e.g., the Number Stroop
      paradigm). In contrast, we predict that children with CD+CU will show no impairment on these
      tasks. At the anatomical level, we anticipate reduced activation of emotional related systems
      in children with CD+CU, but increased activation in children with CD-CU, during emotional
      impact tasks (in particular, reduced activation of the amygdala, regions of orbitofrontal
      cortex and anterior cingulate). We anticipate that the neural response of children with ADHD
      during these tasks will be less anomalous. We anticipate that the neural response of children
      with ADHD and children with CD-CU during the performance of response control tasks to be
      anomalous (with considerable greater recruitment of anterior and posterior compensatory
      systems).
    

Keywords: Amygdala; Orbital Frontal Cortex; Serotonin; Orbitofrontal Cortex; Attention Deficit Hyperactivity Disorder; ADHD; Anti-Social Behavior; Healthy Volunteer; HV