Importance Understanding the neurodevelopmental trajectory of psychiatric symptoms is important for improving early identification, intervention, and prevention of mental disorders. Objective To test whether the strength of the coupling of activation between specific brain regions, as measured by resting-state functional magnetic resonance imaging (fMRI), predicted individual children's developmental trajectories in terms of attentional problems characteristic of attention-deficit/hyperactivity disorder and internalizing problems characteristics of major depressive disorder (MDD). Design, Setting, and Participants A community cohort of 94 children was recruited from Vanderbilt University between 2010 and 2013. They were followed up longitudinally for 4 years and the data were analyzed from 2016 to 2019. Based on preregistered hypotheses and an analytic plan, we examined whether specific brain connectivity patterns would be associated with longitudinal changes in scores on the Child Behavior Checklist (CBCL), a parental-report assessment used to screen for emotional, behavioral, and social problems and to predict psychiatric illnesses. Main Outcomes and Measures We used the strength of resting-state fMRI connectivity at age 7 years to predict subsequent changes in CBCL measures 4 years later and investigated the mechanisms of change by associating brain connectivity changes with changes in the CBCL. Results We analyzed data from a longitudinal brain development study involving children assessed at age 7 years (n = 94; 41 girls [43.6%]) and 11 years (n = 54; 32 girls [59.3%]). As predicted, less positive coupling at age 7 years between the medial prefrontal cortex and dorsolateral prefrontal cortex (DLPFC) was associated with a decrease in attentional symptoms by age 11 years (t49 = 2.38; P = .01; β = 0.32). By contrast, a less positive coupling between a region implicated in mood, the subgenual anterior cingulate cortex (sgACC), and DLPFC at age 7 years was associated with an increase in internalizing (eg, anxiety/depression) behaviors by age 11 years (t49 = -2.4; P = .01; β = -0.30). Logistic regression analyses revealed that sgACC-DLPFC connectivity was a more accurate predictor than baseline CBCL measures for progression to a subclinical score on internalization (t50 = -2.61; P = .01; β = -0.29). We then replicated and extended the sgACC-DLPFC result in an independent sample of children with (n = 25) or without (n = 18) familial risk for MDD. Conclusions and Relevance These resting-state fMRI metrics are promising biomarkers for the early identification of children at risk of developing MDD or attention-deficit/hyperactivity disorder.

中文翻译：

---

内在大脑结构与发育过程中注意和情绪症状变化的关联。

重要性了解精神症状的神经发育轨迹对于改善早期识别，干预和预防精神障碍很重要。目的通过静息状态功能磁共振成像（fMRI）测试特定大脑区域之间激活耦合的强度是否通过注意缺陷/多动障碍和内在化的注意问题预测了单个儿童的发展轨迹主要抑郁症（MDD）的问题特征。设计，环境和参与者2010年至2013年间，从范德比尔特大学（Vanderbilt University）招募了94名儿童的社区队列。对他们进行了纵向随访，为期4年，并对2016年至2019年的数据进行了分析。基于预先注册的假设和分析计划，我们检查了特定的大脑连接模式是否会与儿童行为清单（CBCL）得分的纵向变化相关联，儿童行为清单（CBCL）是一项用于筛查情绪，行为和社会问题的父母报告评估，预测精神疾病。主要结果和措施我们利用7岁时的静止状态功能磁共振成像连通性的强度来预测4年后CBCL措施的后续变化，并通过将大脑连通性变化与CBCL的变化相关联来研究变化的机制。结果我们分析了一项纵向脑发育研究的数据，该研究涉及在7岁（n = 94； 41岁的女孩[43.6％]）和11岁（n = 54； 32岁的女孩[59.3％]）进行评估的儿童。如预期的那样 到7岁时，内侧前额皮层和背外侧前额叶皮层（DLPFC）之间的正耦合较少，到11岁时注意力症状的减少相关（t49 = 2.38； P = 0.01；β= 0.32）。相比之下，在7岁时涉及情绪的区域，膝下扣带前皮层（sgACC）和DLPFC之间的正耦合程度较低，则与11岁时内在化（例如，焦虑/抑郁）行为的增加相关（t49 ＝ -2.4； P ＝ 0.01；β＝ -0.30）。Logistic回归分析显示，sgACC-DLPFC连通性比基线CBCL指标更能准确预测内在化亚临床评分的进展（t50 = -2.61； P = 0.01；β= -0.29）。然后，我们将sgACC-DLPFC结果复制并扩展到具有（n = 25）或无（n = 18）患MDD家族风险的儿童的独立样本中。结论和相关性这些静息功能磁共振成像指标是有希望的生物标记物，可用于早期识别有发展为MDD或注意力缺陷/多动障碍风险的儿童。