Disrupted Reinforcement Signaling in the Orbitofrontal Cortex and Caudate in Youths With Conduct Disorder or Oppositional Defiant Disorder and a High Level of Psychopathic Traits

• Published in: The American journal of psychiatry Vol. 168; no. 2; pp. 152 - 162
• Main Authors: Finger, Elizabeth C., Marsh, Abigail A., Blair, Karina S., Reid, Marguerite E., Sims, Courtney, Ng, Pamela, Pine, Daniel S., Blair, R. James R.
• Format: Journal Article
• Language: English
• Published: Arlington, VA American Psychiatric Publishing 01.02.2011; American Psychiatric Association
• Subjects: Adolescent; Adult and adolescent clinical studies; Amygdala - physiopathology; Antisocial Personality Disorder - diagnosis; Antisocial Personality Disorder - physiopathology; Antisocial Personality Disorder - psychology; Association Learning - physiology; Attention Deficit and Disruptive Behavior Disorders - diagnosis; Attention Deficit and Disruptive Behavior Disorders - physiopathology; Attention Deficit and Disruptive Behavior Disorders - psychology; Avoidance Learning - physiology; Behavior disorders; Biological and medical sciences; Brain; Brain Mapping; Caudate Nucleus - physiopathology; Child & adolescent psychiatry; Child clinical studies; Conduct disorder; Conduct Disorder - diagnosis; Conduct Disorder - physiopathology; Conduct Disorder - psychology; Decision making; Decision Making - physiology; Feedback, Psychological; Female; Frontal Lobe - physiopathology; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical sciences; Mental health; Motivation; Nerve Net - physiopathology; Oxygen Consumption - physiology; Pattern Recognition, Visual - physiology; Personality disorders; Pharmacology; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance - physiology; Psychopathology; Psychopathology. Psychiatry; Reference Values; Reinforcement, Psychology; Signal Transduction - physiology; Social behavior disorders; Human; Orbitofrontal cortex; Oppositional defiant disorder; Central nervous system; Conduct disorder; Basal ganglion; Experimental study; Metabolism; Nuclear magnetic resonance imaging; Personality disorder; Encephalon; Learning; Signal transduction; Acquisition process; School age; Caudate nucleus; Psychopathia; Adolescent; Reinforcement; Social behavior disorder; Child; Avoidance; Functional imaging; Psychopathic personality
• ISSN: 0002-953X; 1535-7228; 1535-7228
• DOI: 10.1176/appi.ajp.2010.10010129

Objective:Dysfunction in the amygdala and orbitofrontal cortex has been reported in youths and adults with psychopathic traits. The specific nature of the functional irregularities within these structures remains poorly understood. The authors used a passive avoidance task to examine the responsiveness of these systems to early stimulus-reinforcement exposure, when prediction errors are greatest and learning maximized, and to reward in youths with psychopathic traits and comparison youths. Method:While performing the passive avoidance learning task, 15 youths with conduct disorder or oppositional defiant disorder plus a high level of psychopathic traits and 15 healthy subjects completed a 3.0-T fMRI scan. Results:Relative to the comparison youths, the youths with a disruptive behavior disorder plus psychopathic traits showed less orbitofrontal responsiveness both to early stimulus-reinforcement exposure and to rewards, as well as less caudate response to early stimulus-reinforcement exposure. There were no group differences in amygdala responsiveness to these two task measures, but amygdala responsiveness throughout the task was lower in the youths with psychopathic traits. Conclusions:Compromised sensitivity to early reinforcement information in the orbitofrontal cortex and caudate and to reward outcome information in the orbitofrontal cortex of youths with conduct disorder or oppositional defiant disorder plus psychopathic traits suggests that the integrated functioning of the amygdala, caudate, and orbitofrontal cortex may be disrupted. This provides a functional neural basis for why such youths are more likely to repeat disadvantageous decisions. New treatment possibilities are raised, as pharmacologic modulations of serotonin and dopamine can affect this form of learning.