Background

Conduct disorder (CD) is characterized by severe aggressive and antisocial behavior. Initial evidence suggests neural deficits and aberrant eye gaze pattern during emotion processing in CD; both concepts, however, have not yet been studied simultaneously. The present study assessed the functional brain correlates of emotional face processing with and without consideration of concurrent eye gaze behavior in adolescents with CD compared to typically developing (TD) adolescents.

Methods

58 adolescents (23CD/35TD; average age = 16 years/range = 14–19 years) underwent an implicit emotional face processing task. Neuroimaging analyses were conducted for a priori-defined regions of interest (insula, amygdala, and medial orbitofrontal cortex) and using a full-factorial design assessing the main effects of emotion (neutral, anger, fear), group and the interaction thereof (cluster-level, p < .05 FWE-corrected) with and without consideration of concurrent eye gaze behavior (i.e., time spent on the eye region).

Results

Adolescents with CD showed significant hypo-activations during emotional face processing in right anterior insula compared to TD adolescents, independent of the emotion presented. In-scanner eye-tracking data revealed that adolescents with CD spent significantly less time on the eye, but not mouth region. Correcting for eye gaze behavior during emotional face processing reduced group differences previously observed for right insula.

Conclusions

Atypical insula activation during emotional face processing in adolescents with CD may partly be explained by attentional mechanisms (i.e., reduced gaze allocation to the eyes, independent of the emotion presented). An increased understanding of the mechanism causal for emotion processing deficits observed in CD may ultimately aid the development of personalized intervention programs.

中文翻译：

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行为障碍青少年情绪面部处理过程中的眼睛注视模式和功能性大脑反应

 背景

行为障碍（CD）的特点是严重的攻击性和反社会行为。初步证据表明 CD 情绪处理过程中存在神经缺陷和异常的眼睛注视模式；然而，这两个概念尚未同时得到研究。本研究评估了患有 CD 的青少年与典型发育中 (TD) 青少年相比，在考虑或不考虑同时眼睛注视行为的情况下，大脑功能与情绪面部处理的相关性。

 方法

58 名青少年（23CD/35TD；平均年龄 = 16 岁/范围 = 14-19 岁）接受了内隐情绪面部处理任务。对先验定义的感兴趣区域（岛叶、杏仁核和内侧眶额皮质）进行神经影像分析，并使用全因子设计评估情绪（中性、愤怒、恐惧）、群体及其相互作用（集群）的主要影响。 -水平， p < .05 FWE 校正），考虑或不考虑并发眼睛注视行为（即花在眼睛区域的时间）。

 结果

与 TD 青少年相比，患有 CD 的青少年在右前岛情绪面部处理过程中表现出明显的低激活，与所呈现的情绪无关。扫描仪内的眼球追踪数据显示，患有 CD 的青少年花在眼睛上的时间明显减少，但花在嘴部区域的时间却明显减少。在情绪面部处理过程中纠正眼睛注视行为可以减少之前观察到的右脑岛的群体差异。

 结论

患有克罗恩病的青少年在情绪面部处理过程中的非典型岛叶激活可能部分是通过注意机制来解释的（即，减少对眼睛的注视分配，与所呈现的情绪无关）。加深对 CD 中观察到的情绪处理缺陷的因果机制的了解可能最终有助于个性化干预计划的制定。