Abstract
Purpose: Sex differences in conduct disorder (CD) pathophysiology have yet to be resolved. In this study, we applied the amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) to compare spontaneous brain activity in male versus female adolescents diagnosed with CD in light of the gender paradox hypothesis.Materials and Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) examinations were conducted with 51 CD patients (35 males) and 53 age-matched healthy controls (HCs; 35 males). Pearson analysis was conducted to detect relationship between ALFF/fALFF values in gender-differentiated regions and clinical characteristics.Results: We observed that male CD patients showed significant increased ALFF in the bilateral superior temporal gyrus (STG)/insula, and significant decreased ALFF in the left anterior cingulate cortex (ACC), left middle frontal gyrus (BA8 andBA11), left middle temporal gyrus and left inferior/middle temporal gyrus relative to female CD patients. The fALFF in male CD patients was significantly increased in the right STG/insula, decreased in the right superior frontal gyrus, left middle frontal gyrus, right inferior frontal gyrus, and right postcentral gyrus relative to female CD patients. Considering the sex-by-diagnosis interactions in CD patients, the male CD patients had significantly higher fALFF in the left putamen, lower fALFF in the right postcentral gyrus relative to the female CD patients.Conclusion: The brain regions whose activity index values differed in relation to sex should be further explored in CD pathophysiology studies, particularly with respect to sex differences in clinical symptoms, emotional features, cognitive features, and prevalence rates in CD. The present findings are consistent with the gender paradox hypothesis.
Highlights
Conduct disorder (CD) is a common mental disorder of childhood and adolescence characterized by behaviors that are dismissive of others’ basic rights and societal norms (Segal, 2000)
The four groups were well-matched in terms of age and frame-wise displacement (FD)
No significant correlation results were detected between amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) values in gender-differentiated regions and Barratt Impulsivity Scale-version 11 (BIS-11) scores and CU traits in CD patients subgroups after Bonferroni correction. This is the first rs-fMRI study to use both ALFF and fALFF to investigate the influence of gender on spontaneous
Summary
Conduct disorder (CD) is a common mental disorder of childhood and adolescence characterized by behaviors that are dismissive of others’ basic rights and societal norms (Segal, 2000). Relative to boys diagnosed with CD, girls diagnosed with CD tend to have a greater aggregation of genetic and/or environmental risk factors (Berkout et al, 2011) and may have more severe symptoms, despite a lower prevalence of conduct problems in females (Tiet et al, 2001). These observations fit with the so-called gender paradox hypothesis, which posits that a disorder that has lower occurrence in a particular sex may be associated with more severe symptoms in that sex (Eme, 1992; Loeber and Keenan, 1994). The pathophysiological mechanisms underlying sex differences in CD have not been clarified
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