Brain structure abnormalities in adolescent girls with conduct disorder

Abstract

Background: Conduct disorder (CD) in female adolescents is associated with a range of negative outcomes, including teenage pregnancy and antisocial personality disorder. Although recent studies have documented changes in brain structure and function in male adolescents with CD, there have been no neuroimaging studies of female adolescents with CD. Our primary objective was to investigate whether female adolescents with CD show changes in grey matter volume. Our secondary aim was to assess for sex differences in the relationship between CD and brain structure.

Methods: Female adolescents with CD (n = 22) and healthy control participants matched in age, performance IQ and handedness (n = 20) underwent structural magnetic resonance imaging. Group comparisons of grey matter volume were performed using voxel-based morphometry. We also tested for sex differences using archive data obtained from male CD and control participants.

Results: Female adolescents with CD showed reduced bilateral anterior insula and right striatal grey matter volumes compared with healthy controls. Aggressive CD symptoms were negatively correlated with right dorsolateral prefrontal cortex volume, whereas callous-unemotional traits were positively correlated with bilateral orbitofrontal cortex volume. The sex differences analyses revealed a main effect of diagnosis on right amygdala volume (reflecting reduced amygdala volume in the combined CD group relative to controls) and sex-by-diagnosis interactions in bilateral anterior insula.

Conclusions: We observed structural abnormalities in brain regions involved in emotion processing, reward and empathy in female adolescents with CD, which broadly overlap with those reported in previous studies of CD in male adolescents.

Figure 1

Bilateral anterior insula and right striatal grey matter volume was reduced in female adolescents with conduct disorder relative to healthy controls. Table 2 provides statistics and coordinates for these group differences. Panel A displays bilateral anterior insula and right striatal volume differences in coronal format, whereas panel B depicts the results in axial format. The colour bar, which ranges from red to white, represents T statistics. Both images are thresholded at p < .005, uncorrected, for display purposes

Figure 2

Right amygdala/extended amygdala grey matter volume was reduced in a group of male and female adolescents with CD (n = 44), relative to a group of male and female healthy control (HC) subjects (n = 40). Panel A shows the amygdala group effect (Montreal Neurological Institute coordinates: x = 24, y = 1, z = −12) in coronal format, whereas panel B displays grey matter volume parameter estimates for the peak voxel in right amygdala for males and females separately. The colour bar represents F statistics. The image is thresholded at p < .005, uncorrected, for display purposes

Figure 3

Sex-by-diagnosis interaction in bilateral anterior insula. Panels A and B depict regions that showed significant interactions between sex and diagnosis in coronal and axial format, respectively. The colour bar represents F statistics. The images in A and B are thresholded at p < .005, uncorrected, for display purposes. Panels C and D show plots of the interaction for left and right anterior insula, respectively, and provide coordinates of peak voxels