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Behavioral and emotional dysregulation trajectories marked by prefrontal–amygdala function in symptomatic youth

Published online by Cambridge University Press:  27 January 2014

M. A. Bertocci ,
G. Bebko ,
T. Olino ,
J. Fournier ,
A. K. Hinze ,
L. Bonar ,
J. R. C. Almeida ,
S. B. Perlman ,
A. Versace  and
M. Travis
...Show all authors
M. A. Bertocci*
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
G. Bebko
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
T. Olino
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
J. Fournier
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
A. K. Hinze
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
L. Bonar
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
J. R. C. Almeida
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA Alpert Medical School, Brown University, Providence, RI, USA
S. B. Perlman
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
A. Versace
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
M. Travis
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
M. K. Gill
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
C. Demeter
Affiliation:
University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
V. A. Diwadkar
Affiliation:
Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
R. White
Affiliation:
Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
C. Schirda
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
J. L. Sunshine
Affiliation:
University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
L. E. Arnold
Affiliation:
Department of Psychiatry, Ohio State University, Columbus, OH, USA
S. K. Holland
Affiliation:
Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
R. A. Kowatch
Affiliation:
The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
B. Birmaher
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
D. Axelson
Affiliation:
Department of Psychiatry, Ohio State University, Columbus, OH, USA
E. A. Youngstrom
Affiliation:
Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
R. L. Findling
Affiliation:
University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
S. M. Horwitz
Affiliation:
Department of Child Psychiatry, New York University School of Medicine, New York, NY, USA
M. A. Fristad
Affiliation:
Department of Psychiatry, Ohio State University, Columbus, OH, USA
M. L. Phillips
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
*
*Address for correspondence: M. A. Bertocci, Ph.D., Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Loeffler Building, Room 203, Pittsburgh, PA 15213, USA. (Email: [email protected])
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Abstract

Background

Neuroimaging measures of behavioral and emotional dysregulation can yield biomarkers denoting developmental trajectories of psychiatric pathology in youth. We aimed to identify functional abnormalities in emotion regulation (ER) neural circuitry associated with different behavioral and emotional dysregulation trajectories using latent class growth analysis (LCGA) and neuroimaging.

Method

A total of 61 youth (9–17 years) from the Longitudinal Assessment of Manic Symptoms study, and 24 healthy control youth, completed an emotional face n-back ER task during scanning. LCGA was performed on 12 biannual reports completed over 5 years of the Parent General Behavior Inventory 10-Item Mania Scale (PGBI-10M), a parental report of the child's difficulty regulating positive mood and energy.

Results

There were two latent classes of PGBI-10M trajectories: high and decreasing (HighD; n = 22) and low and decreasing (LowD; n = 39) course of behavioral and emotional dysregulation over the 12 time points. Task performance was >89% in all youth, but more accurate in healthy controls and LowD versus HighD (p < 0.001). During ER, LowD had greater activity than HighD and healthy controls in the dorsolateral prefrontal cortex, a key ER region, and greater functional connectivity than HighD between the amygdala and ventrolateral prefrontal cortex (p's < 0.001, corrected).

Conclusions

Patterns of function in lateral prefrontal cortical–amygdala circuitry in youth denote the severity of the developmental trajectory of behavioral and emotional dysregulation over time, and may be biological targets to guide differential treatment and novel treatment development for different levels of behavioral and emotional dysregulation in youth.

Keywords

Behavioral and emotional dysregulationemotion regulationemotional n-backfunctional magnetic resonance imaginglatent class growth analysisyouth
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 12 , September 2014 , pp. 2603 - 2615
Copyright
Copyright © Cambridge University Press 2014 

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