White matter microstructural integrity correlates of emotion dysregulation in children with ADHD: A diffusion imaging tractography study

Chia-Jui Tsai; Hsiang-Yuan Lin; Isaac Wen-Yih Tseng; Susan Shur-Fen Gau

doi:10.1016/j.pnpbp.2021.110325

White matter microstructural integrity correlates of emotion dysregulation in children with ADHD: A diffusion imaging tractography study

Prog Neuropsychopharmacol Biol Psychiatry. 2021 Aug 30:110:110325. doi: 10.1016/j.pnpbp.2021.110325. Epub 2021 Apr 20.

Authors

Chia-Jui Tsai¹, Hsiang-Yuan Lin², Isaac Wen-Yih Tseng³, Susan Shur-Fen Gau⁴

Affiliations

¹ Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Azrieli Adult Neurodevelopmental Centre and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
³ Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: wytseng@ntu.edu.tw.
⁴ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences and Department of Psychology, National Taiwan University, Taipei, Taiwan. Electronic address: gaushufe@ntu.edu.tw.

PMID: 33857524
DOI: 10.1016/j.pnpbp.2021.110325

Abstract

Background: Emotion dysregulation (ED) is prevalent in youths with attention-deficit hyperactivity disorder (ADHD) and causes more social impairment and poor adaptive function. Alterations in the integrity of white matter (WM) tracts might have important implications for affective processing related to ED. However, little is known about the WM correlates underpinning ED in ADHD.

Methods: Using diffusion spectrum image tractography, we obtained generalized fractional anisotropy (GFA) values of 76 WM tracts in 77 children with ADHD and 105 typically developing controls (TDC). ED severity was defined by the dysregulation profile from the child behavior checklist. Canonical correlation analysis (CCA) was performed to identify modes that relate WM microstructural property to ED severity and cognitive measures.

Results: The application of CCA identified one significant mode (r = 0.638, FWE-corrected p = 0.046) of interdependencies between WM property patterns and diagnosis, ADHD total symptom levels, dysregulation by diagnosis interaction, and full-scale intellectual quotient (FIQ). GFA values of 19 WM tracts that were linked to affective-processing, sensory-processing and integration, and cognitive control circuitry were positively correlated with ED severity in TDC but negatively correlated with ED severity in ADHD. ADHD symptom severity and diagnosis were negatively associated with the GFA patterns of this set of tract bundles. In contrast, FIQ was positively correlated with this set of tract bundles.

Conclusions: This study used the CCA to show that children with ADHD and TDC had distinct multivariate associations between ED severity (diagnosis by ED interaction) and microstructural property in a set of WM tracts. These tracts interconnect the cortical regions that are principally involved in emotion processing, integration, and cognitive control in multiple brain systems. The WM microstructure integrity impairment might be an essential correlate of emotion dysregulation in ADHD.

Trial registration: ClinicalTrials.gov NCT00916851.

Keywords: Attention-deficit hyperactivity disorder; Diffusion spectrum image; Emotion dysregulation; White matter microstructural integrity.

MeSH terms

Adolescent
Affective Symptoms / diagnostic imaging*
Affective Symptoms / epidemiology
Affective Symptoms / psychology
Attention Deficit Disorder with Hyperactivity / diagnostic imaging*
Attention Deficit Disorder with Hyperactivity / epidemiology
Attention Deficit Disorder with Hyperactivity / psychology
Brain / diagnostic imaging*
Child
Cross-Sectional Studies
Diffusion Tensor Imaging / methods*
Emotional Regulation* / physiology
Female
Humans
Male
White Matter / diagnostic imaging*

Associated data

ClinicalTrials.gov/NCT00916851