Emotion processing in youths with conduct problems: an fMRI meta-analysis

Abstract

Functional magnetic resonance imaging (fMRI) studies consistently indicate differences in emotion processing in youth with conduct problems. However, no prior meta-analysis has investigated emotion-specific responses associated with conduct problems. This meta-analysis aimed to generate an up-to-date assessment of socio-affective neural responding among youths with conduct problems. A systematic literature search was conducted in youths (ages 10-21) with conduct problems. Task-specific seed-based d mapping analyses examined responses to threatening images, fearful and angry facial expressions, and empathic pain stimuli from 23 fMRI studies, which included 606 youths with conduct problems and 459 comparison youths. Whole-brain analyses revealed youths with conduct problems relative to typically developing youths, when viewing angry facial expressions, had reduced activity in left supplementary motor area and superior frontal gyrus. Additional region of interest analyses of responses to negative images and fearful facial expressions showed reduced activation in right amygdala across youths with conduct problems. Youths with callous-unemotional traits also exhibited reduced activation in left fusiform gyrus, superior parietal gyrus, and middle temporal gyrus when viewing fearful facial expressions. Consistent with the behavioral profile of conduct problems, these findings suggest the most consistent dysfunction is found in regions associated with empathic responding and social learning, including the amygdala and temporal cortex. Youth with callous-unemotional traits also show reduced activation in the fusiform gyrus, consistent with reduced attention or facial processing. These findings highlight the potential role of empathic responding, social learning, and facial processing along with the associated brain regions as potential targets for interventions.

Fig. 1. PRISMA 2020 flow diagram.

After studies were identified from a database and citation search, duplicate records were removed. Full text records were screened and studies were excluded (837 studies) that summarized the literature and did not report new findings, we not within the age range, did not use task based fMRI to measure emotion processing, did not investigate conduct problems, or were case studies. Additional screening excluded studies that did not report whole brain results (2 studies), reported duplicate findings from an already included study (1 study), did not have a healthy or conduct problems comparison group (9 studies).

Fig. 2. Regions reduced in youths with conduct problems relative to healthy control youths in whole-brain and ROI fMRI meta-analyses by task domain.

A Whole-brain results on angry facial expressions. B Whole-brain findings on empathic pain responses. C Results from the amygdala region of interest analysis on fearful facial expressions. D Results from the amygdala region of interest analysis on negative images. The right side of the image corresponds to the left side of the brain.