title: Abnormal ventromedial prefrontal cortex function in children with psychopathic traits during reversal learning.
abstract: 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.
authors.affiliation: National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA. elizabeth.finger@lhsc.on.ca
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Finger
authors.forename: Abigail A
authors.initials: AA
authors.lastname: Marsh
authors.forename: Derek G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: Marguerite E
authors.initials: ME
authors.lastname: Reid
authors.forename: Courtney
authors.initials: C
authors.lastname: Sims
authors.forename: Salima
authors.initials: S
authors.lastname: Budhani
authors.forename: David S
authors.initials: DS
authors.lastname: Kosson
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Towbin
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: James R
authors.initials: JR
authors.lastname: Blair
mesh_terms: 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*