Objective

Childhood irritability, operationalized as disproportionate and frequent temper tantrums and low frustration tolerance relative to peers, is a transdiagnostic symptom across many pediatric disorders. Studies using task-dependent functional magnetic resonance imaging (fMRI) to probe neural dysfunction in irritability have increased. However, an integrated review summarizing the published methods and synthesized fMRI results remains lacking.

Method

We conducted a systematic search using irritability terms and task functional neuroimaging in key databases in March 2021, and identified 30 studies for our systematic review. Sample characteristics and fMRI methods were summarized. A subset of 28 studies met the criteria for extracting coordinate-based data for quantitative meta-analysis. Ten activation-likelihood estimations were performed to examine neural convergence across irritability measures and fMRI task domains.

Results

Systematic review revealed small sample sizes (median = 58, mean age range = 8-16 years) with heterogeneous sample characteristics, irritability measures, tasks, and analytical procedures. Meta-analyses found no evidence for neural activation convergence of irritability across neurocognitive functions related to emotional reactivity, cognitive control, and reward processing, or within each domain. Sensitivity analyses partialing out variances driven by heterogeneous tasks, irritability measures, stimulus types, and developmental ages all yielded null findings. Results were compared with a review on irritability-related structural anomalies from 11 studies.

Conclusion

The lack of neural convergence suggests a need for common, standardized irritability assessments and more homogeneous fMRI tasks. Thoughtfully designed fMRI studies probing commonly defined neurocognitive functions may be more fruitful to elucidate the neural mechanisms of irritability. Open science practices, data mining in large neuroscience databases, and standardized analytical methods promote meaningful collaboration in irritability research.

中文翻译：

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系统评价和荟萃分析：针对易怒青少年的基于任务的功能磁共振成像研究

 客观的

童年期的烦躁，表现为与同龄人相比不成比例且频繁的发脾气以及较低的挫折承受能力，是许多儿科疾病的跨诊断症状。使用任务依赖性功能磁共振成像（fMRI）来探测易激惹的神经功能障碍的研究有所增加。然而，仍然缺乏总结已发表的方法和合成的功能磁共振成像结果的综合综述。

 方法

2021 年 3 月，我们使用烦躁术语和任务功能神经影像在关键数据库中进行了系统检索，并确定了 30 项研究进行系统评价。总结了样本特征和功能磁共振成像方法。 28 项研究的子集符合提取基于坐标的数据进行定量荟萃分析的标准。进行了十次激活似然估计，以检查烦躁性测量和功能磁共振成像任务领域的神经收敛。

 结果

系统审查显示样本量较小（中位数 = 58，平均年龄范围 = 8-16 岁），样本特征、烦躁性测量、任务和分析程序均不同。荟萃分析没有发现任何证据表明与情绪反应、认知控制和奖励处理相关的神经认知功能或每个领域内的烦躁情绪的神经激活趋同。敏感性分析排除了由异质任务、烦躁性测量、刺激类型和发育年龄驱动的差异，所有结果均无效。结果与 11 项研究中与烦躁相关的结构异常的综述进行了比较。

 结论

神经收敛的缺乏表明需要共同的、标准化的烦躁评估和更均匀的功能磁共振成像任务。精心设计的功能磁共振成像研究探索通常定义的神经认知功能可能更有效地阐明烦躁的神经机制。开放科学实践、大型神经科学数据库中的数据挖掘以及标准化分析方法促进了烦躁研究中有意义的合作。