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Executive dysfunction occurs in most psychiatric disorders among youth

Recent findings indicated overall psychopathology was associated with both abnormal patterns of activation and failure to activate executive regions in youth with various psychiatric disorders.

“Many studies have investigated the neural basis of executive impairments in individual psychiatric disorders. Working memory is one of the most commonly studied components of executive function,” Sheila Shanmugan, BA, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues wrote. “Taken together, these studies suggest there likely are overlapping effects across disorders, with hypoactivation of the executive system being a common underlying brain phenotype. However, evidence also exists for dissociable abnormalities among psychiatric disorders.”

To assess executive system deficits associated with dimensions of psychiatric symptoms in youth, researchers evaluated 1,129 adolescents from the Philadelphia Neurodevelopmental Cohort. Participants completed the fractal n-back task during functional MRI. Multivariate and mass-univariate analyses determined the effect of psychopathology dimensions on behavioral performance and executive system recruitment.

Overall psychopathology was associated with abnormal multivariate patterns of activation and failure to activate executive regions within the cingulo-opercular control network, including the frontal pole, cingulate cortex and anterior insula.

Psychosis symptoms were associated with hypoactivation of the left dorsolateral prefrontal cortex, while behavioral symptoms were associated with hypoactivation of the frontoparietal cortex and cerebellum.

Conversely, anxious-misery symptoms were associated with widespread hyperactivation of the executive network.

“The results emphasize that executive dysfunction is present in association with overall psychopathology across traditional categorical psychiatric diagnoses, underscoring this system’s central relevance for circuit-based conceptualizations of neuropsychiatric disorders such as the National Institute of Mental Health’s Research Domain Criteria,” Shanmugan and colleagues wrote. “These results may suggest that interventions seeking to enhance executive function may not fit well within the existing categorical diagnostic framework and may be beneficial to individuals across diverse clinical syndromes where executive deficits are present.” – by Amanda Oldt

Disclosure: Shanmugan reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.