Abstract
The child behavior checklist–dysregulation profile (CBCL–DP) refers to a pattern of elevated scores on the attention problems, aggression, and anxiety/depression subscales of the child behavior checklist. The aim of the present study was to investigate the potential role of GABA inhibitory neurons in children with attention deficit/hyperactivity disorder (ADHD) and dysregulation assessed with a dimensional measure. Brain single photon emission computed tomography (SPECT) was performed in 35 children with ADHD using 123I-iomazenil, which binds with high affinity to benzodiazepine receptors. Iomazenil binding activities were assessed with respect to the presence or absence of a threshold CBCL–DP (a score ≥210 for the sum of the three subscales: Attention Problems, Aggression, and Anxiety/Depression). We then attempted to identify which CBCL–DP subscale explained the most variance with respect to SPECT data, using “age,” “sex,” and “history of maltreatment” as covariates. Significantly higher iomazenil binding activity was seen in the posterior cingulate cortex (PCC) of ADHD children with a significant CBCL–DP. The Anxiety/Depression subscale on the CBCL had significant effects on higher iomazenil binding activity in the left superior frontal, middle frontal, and temporal regions, as well as in the PCC. The present brain SPECT findings suggest that GABAergic inhibitory neurons may play an important role in the neurobiology of the CBCL–DP, in children with ADHD.
Highlights
Severe behavioral and affective dysregulation with symptoms, such as hyperactivity, aggression, irritability, mood instability, and anxiety, contribute to significant academic and psychosocial impairment in children
Each attention deficit hyperactivity disorder (ADHD) rating scale, all subscales of child behavior checklist (CBCL) with the exception of somatic problems, and Child Dissociative Checklist (CDC) score were significantly higher in ADHD children with threshold child behavior checklist-dysregulation profile (CBCL–DP) scores
In ADHD children with a significant CBCL–DP, iomazenil activity was upregulated in the posterior cingulate cortex (PCC)
Summary
Severe behavioral and affective dysregulation with symptoms, such as hyperactivity, aggression, irritability, mood instability, and anxiety, contribute to significant academic and psychosocial impairment in children. Some of these symptoms are consistent with attention deficit hyperactivity disorder (ADHD). ADHD is the most frequent neuropsychiatric disorder in children and often presents with co-occurring disruptive behavior disorders, anxiety disorders, and bipolar disorder. Children with ADHD who had a threshold level CBCL–DP score (≥210) showed higher rates of comorbidity disorders, including oppositional defiant disorder (ODD), conduct disorder (CD), anxiety disorder, bipolar disorder, and depression [9]. The CBCL–DP is associated with mood, anxiety, disruptive behavior disorders, and substance use in adulthood [3]
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