Abnormal ventromedial prefrontal cortex function in children with psychopathic traits during reversal learning.
BACKGROUND
Children and adults with psychopathic traits and conduct or oppositional defiant disorder demonstrate poor decision making and are impaired in reversal learning. However, the neural basis of this impairment has not previously been investigated. Furthermore, despite high comorbidity of psychopathic traits and attention-deficit/hyperactivity disorder, to our knowledge, no research has attempted to distinguish neural correlates of childhood psychopathic traits and attention-deficit/hyperactivity disorder.


OBJECTIVE
To determine the neural regions that underlie the reversal learning impairments in children with psychopathic traits plus conduct or oppositional defiant disorder.


METHODS
Case-control study.


METHODS
Government clinical research institute.


METHODS
Forty-two adolescents aged 10 to 17 years: 14 with psychopathic traits and oppositional defiant disorder or conduct disorder, 14 with attention-deficit/hyperactivity disorder only, and 14 healthy controls.


METHODS
Blood oxygenation level-dependent signal as measured via functional magnetic resonance imaging during a probabilistic reversal task.


RESULTS
Children with psychopathic traits showed abnormal responses within the ventromedial prefrontal cortex (Brodmann area 10) during punished reversal errors compared with children with attention-deficit/hyperactivity disorder and healthy children (P < .05 corrected for multiple comparisons).


CONCLUSIONS
To our knowledge, this study provides the first evidence of abnormal ventromedial prefrontal cortex responsiveness in children with psychopathic traits and demonstrates this dysfunction was not attributable to comorbid attention-deficit/hyperactivity disorder. These findings suggest that reversal learning impairments in patients with developmental psychopathic traits relate to abnormal processing of reinforcement information.
Finger
Elizabeth C
EC
National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA. elizabeth.finger@lhsc.on.ca
Marsh
Abigail A
AA
Mitchell
Derek G
DG
Reid
Marguerite E
ME
Sims
Courtney
C
Budhani
Salima
S
Kosson
David S
DS
Chen
Gang
G
Towbin
Kenneth E
KE
Leibenluft
Ellen
E
Pine
Daniel S
DS
Blair
James R
JR
D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology*; D012193:Reversal Learning; D012720:Severity of Illness Index; D014697:Ventromedial Hypothalamic Nucleus / Q000503:physiopathology*