Functional Magnetic Resonance Imaging Brain Study in Children with Conduct Disorder: An Observational Case-Control Study

Abstract

Background: Conduct disorder (CD) is a psychological condition characterized by a persistent and recurrent pattern of violating the basic rights of others, along with disregarding important social norms or rules during the developmental stages of childhood or adolescence. This study aimed to compare functional magnetic resonance imaging (FMRI) brain scans of children diagnosed with conduct disorder to those of a matched control group, to determine whether any observed changes correlate with developmental or sociodemographic factors, and to explore the relationship between these changes and the symptom profiles of the patients. 

Methods: This Observational Case-Control Study involved 50 male participants, comprising 25 children with conduct disorder and 25 controls, all aged between 7 and 12 years, who were recruited consecutively. The subjects were categorized into two equal groups: the Conduct Disorder group, children without comorbidities, specifically those exhibiting at least one symptom indicative of CD prior to reaching the age of 10, while the control group consisted of healthy children who had no previous occurrences of neurological or psychiatric conditions.

Results: Comparison patients with control showed that degree of activation in the regions of interest (ROI) showed significant increase activation in Bilateral Amygdala and Rt insula while Lt insular was non-significant. Additionally, there was significant increase in activations in ROI while both orbitofrontal cortex activities were non-significant. Fractional Anisotropy (FA) of examined tracts showed significant (P< 0.05) decrease in all examined tracts. Multiple linear regression analysis was done to test if the changes in brain activation and the tract integrity could predict the degree of callous unemotional traits. Both amygdala, insula, prefrontal cortex (both ventromedial and dorsolateral) and anterior cingulate cortex activities exhibited strong negative correlations with the severity of Callous Unemotional traits. Regarding DTI, both uncinate fasciculus integrity measured by FA affection showed strong negative correlations with the severity of Callous unemotional traits.

Conclusions: A positive correlation between Callous Unemotional Traits scores and duration of illness was found in patients’ group. The higher callous unemotional traits were, the less brain activity in Regions of Interest and the less tracts integrity were detected.