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


METHODS
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.
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
M A
MA
Bertocci
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
G
G
Bebko
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
T
T
Olino
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
J
J
Fournier
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
A K
AK
Hinze
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
L
L
Bonar
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
J R C
JR
Almeida
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
S B
SB
Perlman
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
A
A
Versace
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
M
M
Travis
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
M K
MK
Gill
University Hospitals Case Medical Center/Case Western Reserve University,Cleveland, OH,USA.
C
C
Demeter
Department of Psychiatry and Behavioral Neuroscience,Wayne State University,Detroit, MI,USA.
V A
VA
Diwadkar
Department of Psychiatry and Behavioral Neuroscience,Wayne State University,Detroit, MI,USA.
R
R
White
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
C
C
Schirda
University Hospitals Case Medical Center/Case Western Reserve University,Cleveland, OH,USA.
J L
JL
Sunshine
Department of Psychiatry,Ohio State University,Columbus, OH,USA.
L E
LE
Arnold
Cincinnati Children's Hospital Medical Center,University of Cincinnati,Cincinnati, OH,USA.
S K
SK
Holland
The Research Institute at Nationwide Children's Hospital,Columbus, OH,USA.
R A
RA
Kowatch
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
B
B
Birmaher
Department of Psychiatry,Ohio State University,Columbus, OH,USA.
D
D
Axelson
Department of Psychology,University of North Carolina at Chapel Hill,Chapel Hill, NC,USA.
E A
EA
Youngstrom
University Hospitals Case Medical Center/Case Western Reserve University,Cleveland, OH,USA.
R L
RL
Findling
Department of Child Psychiatry,New York University School of Medicine,New York, NY,USA.
S M
SM
Horwitz
Department of Psychiatry,Ohio State University,Columbus, OH,USA.
M A
MA
Fristad
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center,University of Pittsburgh,Pittsburgh, PA,USA.
M L
ML
Phillips
D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology*; D000342:Affective Symptoms / Q000503:physiopathology*; D000679:Amygdala / Q000503:physiopathology*; D001526:Behavioral Symptoms / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology*