Cortical Correlates of Impulsive Aggressive Behavior in Pediatric Bipolar Disorder

Abstract

Background: Impulsive aggression represents a frequent characteristic of pediatric bipolar disorder (PBD). Cortical alterations associated with impulsive aggression and its multiple facets have not been investigated yet in youth with bipolar disorder.Aim: To investigate the relationship between cortical thickness and facets of impulsive aggression in youth with PBD.Materials and Methods: Twenty-three youth with PBD and 23 healthy controls (HC) were administered the aggression questionnaire (AQ) and underwent 3T magnetic resonance imaging scan. Cortical thickness was assessed with FreeSurfer. Canonical correlation analyses were used to investigate the relationship between AQ total and subscale scores and cortical thickness in youth with PBD.Results: Youth with PBD had increased scores in the subscales of AQ-anger and AQ-hostility and cortical thinning in in areas belonging to the affective network (AN), frontoparietal network (FPN) and cingulo-opercular network (CON), i.e., right rostral anterior cingulate, right caudal anterior cingulate, right lateral orbitofrontal, right medial orbitofrontal, left and right inferior parietal, left posterior cingulate, left and right supramarginal left lingual cortices. Greater thickness in these networks positively correlated with the AQ-hostility subscale and negatively correlated with AQ-anger subscale.Conclusions: The opposite patterns observed between areas belonging to AN, FPN, CON, and the two facets of IA, namely anger and hostility, corroborate clinical findings supporting the different nature of these two constructs.

Segmental abnormalities of superior longitudinal fasciculus microstructure in patients with schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder: An automated fiber quantification tractography study

“…This suggested that the partial SLF abnormalities may contribute to manic-hostility symptoms. A previous study reported that greater thickness in the frontoparietal network was positively correlated with hostility score in patients with BD ( 55 ). There was no published literature on the association between manic-hostility symptoms and microstructural changes of SLF in mental disorders.…”

Neural Correlates of Positive Outcome Expectancy for Aggression: Evidence from Voxel-Based Morphometry and Resting-State Functional Connectivity Analysis

“…For example, the PCC, right TPJ, MPFC, and left DLPFC are significantly activated in aggressive responses, and their morphological features can also predict aggressive tendencies [20,55,56,72,73]. Moreover, brain structural characteristics in these regions positively correlate with some negative traits that promote aggression, such as Machiavellianism [20,21,74]. These findings imply that the PCC, right TPJ, MPFC, and left DLPFC represent important components of the neural basis for the approach system of aggression.…”

Altered dynamic amplitude of low-frequency fluctuation between bipolar type I and type II in the depressive state

“…Offspring of BD I were reported to have a thinner cortex in the right supramarginal gyrus ( Hanford et al, 2016 ), and a higher level of neuroinflammation was observed to be related to a lower volume in the right supramarginal gyrus in BD I ( Tsai et al, 2021 ). Simonetti et al proposed reduced thickness in the right supramarginal gyrus and a correlation with the subscales (anger and hostility) of aggression questionnaire in pediatric BD ( Simonetti et al, 2021 ), the type of which was not divided, although majorities were BD I. Therefore, this may explain why BD I has a higher impulsivity rate than BD II ( Izci et al, 2016 ).…”