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.
Highlights
Aggression is defined as behaviors in which physical force is used with the intent to harm or damage [1]
The aim of this study is to evaluate the relationship between cortical thickness, impulsive aggression (IA), and its facets in youth with pediatric bipolar disorder (PBD)
Given the transdiagnostic nature of IA, and its relationship with thinning in areas belonging to the affective network and to the control network, we expected youth with PBD to show inverse correlations between the several facets of IA and the cortical thickness of areas belonging to these networks
Summary
Aggression is defined as behaviors in which physical force is used with the intent to harm or damage [1]. Hostility is a cognitive construct defined as an attitude that involves the dislike and the negative evaluation of others and others’ intentions [4]. Such attitudinal trait predisposes individuals to respond to external cues with frequent and intense angry feelings and related behavior [4]. Hostility preludes anger, i.e., a multifaceted construct consisting of physiological (general sympathetic arousal), cognitive (irrational beliefs, automatic thoughts, inflammatory imagery), phenomenological (subjective awareness and labeling of angry feelings) and behavioral (facial expressions and verbal/ behavioral anger expression strategies) facets [5,6,7] Anger in turn serves as a cue for developing physical or verbal aggression [8]. Cortical alterations associated with impulsive aggression and its multiple facets have not been investigated yet in youth with bipolar disorder
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