Neural correlates of reactive aggression in children with attention-deficit/hyperactivity disorder and comorbid disruptive behaviour disorders
Neural correlates of reactive aggression in children with attention-deficit/hyperactivity disorder and comorbid disruptive behaviour disorders
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DOI：
10.1111/acps.12475
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发表时间：
2016-04-01
影响因子：
6.7
通讯作者：
Zepf, F. D.
中科院分区：
文献类型：
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作者：
Bubenzer-Busch, S.;Herpertz-Dahlmann, B.;Zepf, F. D.
目的注意缺陷多动障碍 (ADHD) 通常与冲动和攻击性行为有关，其特点是 ADHD 和破坏性行为障碍 (DBD) 之间的高共病率。本研究旨在利用功能神经影像技术 (fMRI) 调查 ADHD 和共病 DBD 儿童反应性攻击的潜在神经活动。 方法 18 名 ADHD 男孩（9-14 岁，10 名共病 DBD）和 18 名健康对照者接受基于 fMRI 的改良版“点减法攻击游戏”，以引发反应性攻击行为。试验由“攻击阶段”（对虚构对手的惩罚）和“结果阶段”（试验结果的呈现）组成。结果在攻击阶段，对照儿童的较高攻击反应伴随着腹侧前扣带皮层和颞顶交界处的较高激活。患者显示出相反的结果。在结果阶段，各组和条件之间的比较显示，当受试者获得分数时，背侧纹状体和双侧岛叶的激活存在差异。失分伴随着岛叶和颞中沟区域的差异性激活。结论数据支持这样的假设：抑制控制机制缺陷与患有 ADHD 和共病 DBD 的年轻人的冲动攻击行为增加有关。
ObjectiveAttention deficit hyperactivity disorder (ADHD) is often linked with impulsive and aggressive behaviour, indexed by high comorbidity rates between ADHD and disruptive behaviour disorders (DBD). The present study aimed to investigate underlying neural activity of reactive aggression in children with ADHD and comorbid DBD using functional neuroimaging techniques (fMRI).MethodEighteen boys with ADHD (age 9-14years, 10 subjects with comorbid DBD) and 18 healthy controls were administered a modified fMRI-based version of the Point Subtraction Aggression Game' to elicit reactive aggressive behaviour. Trials consisted of an aggression phase' (punishment for a fictitious opponent) and an outcome phase' (presentation of the trial outcome).ResultsDuring the aggression phase, higher aggressive responses of control children were accompanied by higher activation of the ventral anterior cingulate cortex and the temporoparietal junction. Patients displayed inverted results. During the outcome phase, comparison between groups and conditions showed differential activation in the dorsal striatum and bilateral insular when subjects gained points. Losing points was accompanied by differential activation of regions belonging to the insula and the middle temporal sulcus.ConclusionData support the hypothesis that deficient inhibitory control mechanisms are related to increased impulsive aggressive behaviour in young people with ADHD and comorbid DBD.