Sex-related differences in psychopathology are known phenomena, with externalizing and internalizing symptoms typically more common in boys and girls, respectively. However, the neural correlates of these sex-by-psychopathology interactions are underinvestigated, particularly in adolescence.

Participants were 14 years of age and part of the IMAGEN study, a large (N = 1526) community-based sample. To test for sex-by-psychopathology interactions in structural grey matter volume (GMV), we used whole-brain, voxel-wise neuroimaging analyses based on robust non-parametric methods. Psychopathological symptom data were derived from the Strengths and Difficulties Questionnaire (SDQ).

We found a sex-by-hyperactivity/inattention interaction in four brain clusters: right temporoparietal-opercular region (p < 0.01, Cohen's d = −0.24), bilateral anterior and mid-cingulum (p < 0.05, Cohen's d = −0.18), right cerebellum and fusiform (p < 0.05, Cohen's d = −0.20) and left frontal superior and middle gyri (p < 0.05, Cohen's d = −0.26). Higher symptoms of hyperactivity/inattention were associated with lower GMV in all four brain clusters in boys, and with higher GMV in the temporoparietal-opercular and cerebellar-fusiform clusters in girls.

Using a large, sex-balanced and community-based sample, our study lends support to the idea that externalizing symptoms of hyperactivity/inattention may be associated with different neural structures in male and female adolescents. The brain regions we report have been associated with a myriad of important cognitive functions, in particular, attention, cognitive and motor control, and timing, that are potentially relevant to understand the behavioural manifestations of hyperactive and inattentive symptoms. This study highlights the importance of considering sex in our efforts to uncover mechanisms underlying psychopathology during adolescence.

精神病理学中与性别相关的差异是已知现象，外化和内化症状通常分别在男孩和女孩中更常见。然而，这些性别与精神病理学相互作用的神经相关性尚未得到充分研究，尤其是在青春期。

参与者年满 14 岁，是 IMAGEN 研究的一部分，该研究是一个大型 ( N = 1526) 社区样本。为了测试结构灰质体积 (GMV) 中性别与精神病理学的相互作用，我们使用了基于稳健的非参数方法的全脑、体素方面的神经影像学分析。精神病理学症状数据来自优势和困难问卷 (SDQ)。

我们在四个脑群中发现了性行为与多动/注意力不集中的相互作用：右侧颞顶-盖骨区域（p < 0.01，Cohen's d = -0.24），双侧前扣带和中扣带回（p < 0.05，Cohen's d = -0.18） , 右小脑和梭形 ( p < 0.05, Cohen's d = -0.20) 和左额上回和中回 ( p < 0.05, Cohen's d = -0.26)。多动/注意力不集中的较高症状与男孩所有四个脑群中较低的 GMV 相关，而与女孩的颞顶-盖骨和小脑-梭状脑群中较高的 GMV 相关。

我们的研究使用大量的、性别平衡的和基于社区的样本，支持这样一种观点，即多动/注意力不集中的外化症状可能与男性和女性青少年的不同神经结构有关。我们报告的大脑区域与无数重要的认知功能有关，特别是注意力、认知和运动控制以及计时，这些功能可能与理解多动和注意力不集中症状的行为表现有关。这项研究强调了在我们努力揭示青春期精神病理学潜在机制时考虑性的重要性。