12 Dec Brains of Troubled Youth Demonstrate Key Grey Matter Changes
Dr. De Brito
MedicalResearch.com Interview with:
Stephane De Brito, PhD
Birmingham Fellow
School of Psychology
Robert Aitken Building, Room 337a
University of Birmingham UK
Medical Research: What is the background for this study? What are the main findings?
Dr. De Brito: In the last decade, an increasing number of neuroimaging studies have used structural magnetic resonance imaging (sMRI) to examine the brains of youths who show behavioural problems that include antisocial and aggressive behaviour. Those studies have mostly relied on a method called voxel-based morphometry (or VBM), which is a whole-brain and automated technique that allows researchers to objectively assess the local composition of brain tissue, such as grey matter volume. The main problem is that the findings from those sMRI studies have been quite disparate and few have been replicated, partly due to differences in sample sizes and characteristics across studies. Therefore, we set out to carry out a meta-analysis of the available data to provide a clearer account of the literature on this topic. A particular strength of our meta-analysis is that we used the original brain imaging maps (also referred to as statistical parametric maps) from 11 of the 13 studies, which makes our analysis more accurate and reliable. The final sample comprised of 394 youths with behavioural problems and 350 typically developing youths, making it the largest study on this topic to date.
Our results showed that, compared to typically developing youths, those with behavioural problems show reduced grey matter volume in the amygdala, the insula, and the prefrontal cortex. These brain areas have been shown to be important for decision-making, empathic responses, processing facial expressions and emotion regulation; key cognitive and affective processes that are shown to be deficient in youths with behavioural problems.
Medical Research: What should clinicians and patients take away from your report?
Dr. De Brito: As discussed below, in the context of the current evidence base, it is difficult to formulate clear clinical implications for our work, but we know that the brain is plastic and follows a protracted development which continues well into the mid-twenties. This definitely leaves open the possibility that positive inputs could influence observed brain differences and the cognitive and affective processes they subsume.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. De Brito: Because all of the existing neuroimaging studies have used a cross-sectional design, it is unclear if those differences are a cause or a consequence of the disorders and if they persist over time. Also, despite the fact that not all children with behavioural problems will go on to show poor outcomes as adults, how neurobiological and environmental factors interact to promote positive long-term outcomes is still poorly understood. So, there is a pressing need for prospective longitudinal studies starting earlier in childhood and following up these individuals as they enter adolescence and adulthood. Future studies will also need to include large samples and systematically examine the influence of substance misuse during pregnancy and childhood maltreatment. Indeed, these are well known environmental risk factors for behavioural problems that influence grey matter volume in some of the brain regions we identified in our study. Finally, we know that youths with behavioural problems with and without callous-unemotional traits (identified as ‘with limited prosocial emotions’ in the DSM-5) present with distinct neurobiological vulnerabilities and different response to interventions. Hence, future neuroimaging studies should also investigate the influence of these traits on observed results and how they might be related to treatment outcomes.
Citation:
Jack C. Rogers, Stéphane A. De Brito. Cortical and Subcortical Gray Matter Volume in Youths With Conduct Problems. JAMA Psychiatry, 2015; 1 DOI: 10.1001/jamapsychiatry.2015.2423
Stephane De Brito, PhD (2015). Brains of Troubled Youth Demonstrate Key Brain Grey Matter Changes
Last Updated on December 12, 2015 by Marie Benz MD FAAD