The VLPFC-Engaged Voluntary Emotion Regulation: Combined TMS-fMRI Evidence for the Neural Circuit of Cognitive Reappraisal

Modulatory role of the right ventrolateral prefrontal cortex in crowd emotional perception following social exclusion

The right ventrolateral prefrontal cortex (rVLPFC) is a crucial region involved in modulating social exclusion. Although prior studies have focused primarily on how social exclusion influences the perception of single faces, the effect of social exclusion on the crowd emotional perception and the neural mechanisms remain elusive. The current research examined whether social exclusion causes a biased perception of crowd emotions, and whether this effect would be modulated by transcranial magnetic stimulation (TMS) over the rVLPFC. Participants were either socially included or excluded, while TMS stimulation was applied over the rVLPFC or the vertex. Next, they viewed sets of happy or disgusted faces and assessed the mean emotions of each set. Socially excluded participants overestimated the mean emotions for disgusted crowd faces compared to socially included participants, which was positively correlated with need threat. Compared to the vertex, stimulating the rVLPFC reduced socially excluded participants' biased perception of disgusted crowd faces. Moreover, stimulation of the rVLPFC decreased discrimination performance for crowd faces expressing disgust but increased it for happy crowd faces. The results provide a causal test for the role of rVLPFC in alleviating the biased perception of negative crowd emotions following social exclusion.

Abnormal resting-state brain networks and their relationship with cognitive reappraisal preferences in depressive tendencies

OBJECTIVE

Currently, the neural mechanisms underlying the topological changes in the brains of individuals with depressive tendencies and the decline in their emotion regulation abilities remain largely unknown. Therefore, this study investigates resting-state brain network characteristics in college students with depressive tendencies (DT) and their preference to cognitive reappraisal strategies.

METHOD

A group of 38 DT students and 41 healthy controls (HCs) were assessed using questionnaires on cognitive reappraisal sub-strategies, followed by alpha and beta frequency band EEG feature extraction.

RESULTS

Through complex network analysis, DT participants showed significantly reduced preferences for positive reappraisal and detached reappraisal compared to HCs, while exhibiting higher preferences for involved reappraisal and negative reappraisal. Additionally, abnormalities in brain network centrality were observed, particularly in the frontal and limbic lobes across various frequency bands. A significant correlation was found between the preference for cognitive reappraisal sub-strategies in DT participants and significant changes in graph indices.

CONCLUSIONS

The findings highlight substantial alterations in the resting-state brain networks of DT individuals, closely associated with cognitive reappraisal strategy preferences. These alterations may affect emotion regulation strategy choices, offering insights into the neural mechanisms of emotional regulation difficulties in DT.

Reliability of brain localization using task-based fMRI for late-life depression with suicidal risk

Late-life depression (LLD) is a heterogeneous mental disorder with a high risk of suicide, often linked to abnormalities in brain networks, particularly the prefrontal cortex. While transcranial magnetic stimulation targeting the dorsal and ventral lateral prefrontal cortex (DLPFC and VLPFC) has shown promise, its treatment efficacy may be compromised by the imprecise group-level standard methods. Although a personalized localization approach using fMRI is available, no study has yet systematically evaluated its reliability in LLD. This study evaluated the reliability of functional magnetic resonance imaging (fMRI) for targeting DLPFC and VLPFC using numerical Stroop and face/shape matching tasks in LLD patients with varying degrees of suicidality, the disorder's most devastating consequence. A total of 103 LLD patients, including 42 with non-suicidal risk (NS), 37 with suicidal ideation or plans (IP), and 24 with past suicide attempts (SA), underwent task-based fMRI. We performed both voxel-wise statistical analyses and the success rate of DLFPC/VLPFC localization in each subgroup by detecting significant brain activity within predefined masks. The numerical Stroop task reliably localized the bilateral DLPFC in all subgroups and the VLPFC in two-thirds. Success rates for localizing DLPFC were 98 % (41 out of 42 NS), 100 % (IP), and 100 % (SA), while VLPFC localization rates were 95 %, 97 %, and 88 %, respectively. Conversely, the face/shape matching task localized bilateral DLPFC in two-thirds and failed to detect the VLPFC in any subgroup. These findings underscore the potential of task-based fMRI, particularly the numerical Stroop task, as a reliable method for personalized targeting in LLD patients with different suicidality degrees.

Transdiagnostic and Disorder-specific Neural Correlates of Emotion Processing in Major Depressive Disorder and Borderline Personality Disorder: Coordinate-based and Image-based Comparative Meta-Analyses

BACKGROUND

Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD) involve substantial impairments in negative and positive emotions processing. This meta-analysis aims to identify both transdiagnostic and disorder-specific neural abnormalities during the processing of negative and positive stimuli for MDD and BPD.

METHODS

The current coordinate-based and image-based meta-analyses comprised 42 fMRI studies involving MDD (42 Negative studies vs. 22 Positive studies; 1,532 MDD patients vs. 1,481 healthy controls) and 25 involving BPD (23 Negative studies vs. 7 Positive studies; 522 BPD patients vs. 519 healthy controls).

RESULTS

Compared to healthy controls, MDD patients exhibited hyporeactivity in left precentral gyrus during negative emotion processing, and decreased activation in left temporal lobe, insula, and bilateral anterior cingulate cortex during positive emotion processing, while BPD patients displayed hyperreactivity in left hippocampus and amygdala and hyporeactivity in right inferior frontal gyrus during negative emotion processing. Compared to BPD, MDD exhibited greater hyporeactivity in bilateral anterior cingulate cortex during negative emotion processing and in left middle temporal gyrus during positive emotion processing. The transdiagnostic hyporeactivity of BPD and MDD was mainly located in left inferior and right middle frontal gyrus during negative emotion processing.

CONCLUSIONS

Our findings highlight both distinct and transdiagnostic neural mechanisms of emotion processing for MDD and BPD.

Revealing the distinct impacts of effectiveness recognition and memory retention on the transfer of creative cognitive reappraisal

Previous research has shown that creative cognitive reappraisal is highly effective in regulating negative emotions. We conducted three experiments to explore its transferability. In Experiment 1, we observed that free recall performance was better for creative reappraisal compared to non-creative reappraisal. Memory retention of reappraisals was associated with creativity ratings, but not with perceived effectiveness ratings. In Experiment 2, participants generated reappraisals for newly introduced unpleasant images before (pre-session) and after (post-session) exposure to creative reappraisal, non-creative reappraisal, and descriptive control interpretation. Results showed increased reflective effectiveness of self-generated reappraisals in the post-session. The level of creativity of the self-generated reappraisals was associated with differences in perceived effectiveness between creative and non-creative exposed reappraisals. In Experiment 3, we investigated how two processing approaches (effectiveness-oriented vs. memory-oriented) influenced the transferability of creative reappraisal. We observed creativity levels of self-generated reappraisals increased in both conditions. The reflective effectiveness of the self-generated reappraisals tended to increase only in the effectiveness-oriented processing condition. Our findings demonstrate that recognising the effectiveness of creative reappraisal plays a crucial role in its transfer across different situations.

fNIRS neurofeedback facilitates emotion regulation: Exploring individual differences over the ventrolateral prefrontal cortex

The ventrolateral prefrontal cortex (VLPFC) plays a pivotal role in emotion regulation, yet the effectiveness of neurofeedback (NF) training targeting the VLPFC remains uncertain, suggesting significant individual differences in outcomes. In this study, we aimed to clarify these differences by enrolling 90 participants, randomly assigned to either an experimental group or a sham group (n = 48/42). Participants in the experimental group underwent VLPFCNF training over eight sessions across two consecutive days, while those in the sham group received random signals from functional near-infrared spectroscopy (fNIRS). To investigate individual variability, participants in the experimental group were further categorized as high or low-efficacy groups based on their training efficiency, determined by the regression slope of VLPFC activity over the sessions. Our results revealed a significant reduction in negative emotions and increased VLPFC activity during emotion regulation in the high-efficacy group, compared to both the low-efficacy group and sham group. Importantly, the benefit in emotion regulation, as reflected by decreased negativity ratings, was predicted by NF training efficiency. Furthermore, the enhancement of VLPFC activity during emotion regulation fully mediated the relationship between NF training efficiency and emotion regulation benefits. Participants with higher VLPFCNF training efficiency exhibited greater engagement of the VLPFC during emotion regulation, leading to superior emotional outcomes. Additionally, VLPFCNF training efficiency was linked to the habitual use of reappraisal strategies in daily life. This study provides novel causal evidence that VLPFCNF training can effectively enhance emotion regulation, highlighting the importance of individual differences in training outcomes. Our findings suggest that NF training targeting the VLPFC offers a promising and personalized intervention strategy for improving emotion regulation, with potential applications for treating emotional disorders. This research underscores the potential of personalized NF approaches, offering new avenues for tailored therapeutic interventions in the future.

Attenuation processes in positive social emotion upregulation: Disentangling functional role of ventrolateral prefrontal cortex

Positive emotions determine individual well-being and sustainable social relationships. Here, we examined the neural processes mediating upregulation of positive social emotions using functional magnetic resonance imaging in healthy female volunteers. We identified brain regions engaged in upregulation of positive social emotions and applied a parametric empirical Bayes approach to isolate modulated network connectivity patterns and assess how these effects relate to individual measures of social perception. Our findings indicate that upregulation of positive social emotions shapes the functional interplay between affective valuation and cognitive control functions. We revealed a selective increase of bilateral posterior ventrolateral prefrontal cortex (vlPFC) activity and attenuation of activity in right anterior vlPFC under control influences from more superior prefrontal regions. We also found that individual perception of sociality modulates connectivity between affective and social networks. This study expands our understanding of neural circuits required to balance positive emotions in social situations and their rehabilitative potential.

Positive resonance: Successful interpersonal emotion regulation facilitated relationship closeness by enhanced inter-brain synchronization

Interpersonal emotion regulation (IER) refers to the dynamic process where a regulator employs specific strategies to alleviate a target's distress. It remains unclear whether successful IER could facilitate interpersonal relationship closeness (IRC). The present study aimed to explore whether successful IER, based on two typical strategies-cognitive reappraisal (CR) and expressive suppression (ES)-for down-regulating the target's negative emotions, could enhance IRC among friend dyads, and to identify the underlying neural correlates of this process using functional near-infrared spectroscopy system. Seventy-four female dyads (friends) were randomly assigned to one of two strategy groups (CR vs. ES), with one participant as the target and the other as the regulator. Our findings revealed that both strategies have down-regulated the target's negative emotions, however, CR strategy was associated with more successful IER outcomes (more improvement of the targets' negative emotions; higher IRC) than ES strategy. IER recruited the enhanced interpersonal brain synchronization (IBS) of the prefrontal and temporal areas among friend dyads. CR strategy recruited higher IBS of the above-mentioned brain networks than ES strategy in down-regulating the target's sadness, and the reversed IBS pattern was found in down-regulating the target's anger, inferring that CR was more successive in IER of sadness, and ES was more effective in IER of anger. The increased IBS pattern of these brain regions played a mediational role between the effectiveness of down-regulating targets' negative emotions and the increment of IRC. Our findings revealed a neural coupling mechanism through which successful IER fostered supportive social bonds.

Scarcity mindset facilitates empathy for social pain and prosocial intention: behavioral and neural evidences

Empathy for social pain encompasses both affective and cognitive responses to others' emotional reactions following negative social encounters, facilitating an understanding of their suffering and promoting prosocial behaviors. This study examined how a scarcity mindset affects empathy for social pain and prosocial intentions at behavioral and neural levels. Sixty participants were randomly assigned to either the scarcity or abundance mindset group. They viewed images of social exclusion or neutral scenarios and subsequently rated the perceived unpleasantness of the target person and their willingness to provide comfort during a stage-game paradigm. The results showed that participants in the scarcity mindset group demonstrated greater differentiation in their ratings of unpleasantness and willingness to comfort when exposed to social exclusion images compared to neutral ones, relative to the abundance mindset group. Electrophysiological data revealed that social exclusion images elicited larger late positive potential (LPP) amplitudes in the scarcity mindset group, but not in the abundance mindset group. Additionally, within the scarcity mindset group, affective empathy trait scores moderated the relationship between LPP amplitudes and willingness to comfort ratings. These findings highlight the amplifying effects of a scarcity mindset on empathy for social pain and prosocial intentions, and emphasize the role of affective empathy traits in this dynamic process.

Neurophysiological Markers of Regulation Success in Everyday Life in Depression

BACKGROUND

Self-regulation is often disrupted in depression and is characterized by negative affect and inflexible parasympathetic responses. However, our understanding of brain mechanisms of self-regulatory processes has largely been limited to laboratory contexts. Measuring individual differences in self-regulatory processes in everyday life-and their neural correlates-could inform our understanding of depression phenotypes and reveal novel intervention targets that impact everyday functioning.

METHODS

In individuals with remitted major depressive disorder and healthy comparison participants (N = 74), we measured 2 dimensions of regulation success in everyday life-perceived success with regulating affect and physiological success (parasympathetic augmentation following regulation attempts)-and their neural correlates using a functional magnetic resonance imaging emotion regulation task.

RESULTS

Perceptions of success were weakly associated with physiological success and had partially distinct neural correlates. Perceived success and physiological success in everyday life predicted reduced activity in brain regions involved in emotional salience while reacting to aversive stimuli in the scanner. During reappraisal in the scanner, greater perceived success in everyday life was dimensionally associated with more reappraisal-related activity in regions involved in cognitive control (including the dorsolateral and dorsomedial prefrontal cortices); in contrast, physiological success predicted enhanced downregulation of salience network activity (amygdala, insula).

CONCLUSIONS

Results suggest that linking psychophysiology with behavior in everyday life can provide a window into dissociable dimensions of self-regulatory functioning. Integrating ambulatory and brain-based metrics may elucidate self-regulatory phenotypes with distinct neurophysiological mechanisms and targets for intervention to impact functioning in daily life.

Characterization of neural networks involved in transdiagnostic emotion dysregulation from a pilot randomized controlled trial of a neurostimulation-enhanced behavioral intervention

BACKGROUND

Emotional dysregulation is a serious and impairing mental health problem. We examined functional activity and connectivity of neural networks involved in emotional dysregulation at baseline and following a pilot neurostimulation-enhanced cognitive restructuring intervention in a transdiagnostic clinical adult sample.

METHODS

Neuroimaging data were analyzed from adults who scored 89 or higher on the Difficulties with Emotion Regulation (DERS) scale and had at least one DSM-5 diagnosis. These participants were part of a pilot randomized, double-blind, placebo-controlled trial combining a single therapeutic session of cognitive restructuring with active or sham transcranial magnetic stimulation over the dorsolateral prefrontal cortex. During the study, participants engaged in an emotional regulation task using personalized autobiographical stressors while undergoing functional magnetic resonance imaging (fMRI) before and after the pilot intervention. The fMRI task required participants to either experience the emotions associated with the memories or apply cognitive restructuring strategies to reduce their distress.

RESULTS

Whole-brain fMRI results during regulation at baseline revealed increased activation in the dorsal frontoparietal network but decreased activation in the supplementary motor area, cingulate cortex, insula, and ventrolateral prefrontal cortex (vlPFC). Emotion dysregulation was associated with greater vmPFC and amygdala activation and functional connectivity between these regions. The strength of functional connectivity between the dlPFC and other frontal regions was also a marker of emotional dysregulation. Preliminary findings from a subset of participants who completed the follow-up fMRI scan showed that active neurostimulation improved behavioral indices of emotion regulation more than sham stimulation. A whole-brain generalized psychophysiological interaction analysis indicated that active neurostimulation selectively increased occipital cortex connectivity with both the insula and the dlPFC. Region-of-interest functional connectivity analyses showed that active neurostimulation selectively increased dlPFC connectivity with the insula and orbitofrontal cortex (OFC).

CONCLUSION

Insufficient neural specificity during the emotion regulation process and over-involvement of frontal regions may be a marker of emotional dysregulation across disorders. OFC, vlPFC, insula activity, and connectivity are associated with improved emotion regulation in transdiagnostic adults. In this pilot study, active neurostimulation led to neural changes in the emotion regulation network after a single session; however, the intervention findings are preliminary, given the small sample size. These functional network properties can inform future neuroscience-driven interventions and larger-scale studies.

Review of Emotion Regulation in Late Life Mood Disorders

Emotion regulation (ER), or the ability to modulate the experience and expression of emotion, is critical to adaptive functioning and is a key feature of mood disorders. At the same time, normal aging is associated with changes in ER, though the interaction of aging with the presence of a mood disorder are unclear. Here, we review what is known about ER and its underlying neural mechanisms in late life mood disorders, specifically late life depression and bipolar disorder. We also review behavioral and neuromodulation therapies that seek to reduce negative affect and improve positive affect. We conclude with recommendations for future research into the nature and mechanisms of ER and interventions targeting ER in older adults with mood disorders.

Genetic Vulnerability to Social Anxiety Disorder

Most anxiety disorders 'run within families': people suffering from an anxiety disorder often have family members who are highly anxious as well. In this chapter, we explore recent work devoted to unraveling the complex interplay between genes and environment in the development of anxiety. We review studies focusing on the genetic vulnerability to develop social anxiety disorder (SAD), as SAD is one of the most prevalent anxiety disorders, with an early onset, a chronic course, and associated with significant life-long impairments. More insight into the development of SAD is thus of uttermost importance.First, we will discuss family studies, twin studies, and large-sized population-based registry studies and explain what these studies can reveal about the genetic vulnerability to develop anxiety. Next, we describe the endophenotype approach; in this context, we will summarize results from the Leiden Family Lab study on Social Anxiety Disorder. Subsequently, we review the relationship between the heritable trait 'behavioral inhibition' and the development of SAD, and highlight the relevance of this work for the development and improvement of preventative and therapeutic interventions for socially anxious youth.

Differential effects of trait-like emotion regulation use and situational emotion regulation ability across the affective and anxiety disorders spectrum: a transdiagnostic examination

Here, we investigated the association of different emotion regulation (ER) indices with symptom severity across a large transdiagnostic sample of patients with emotional disorders (cross-sectional approach) and the predictive validity these ER indices have for the outcome of routine care CBT (longitudinal approach). We assessed the trait-like use of adaptive (reappraisal) and maladaptive (suppression, externalizing behaviors) ER strategies via questionnaire as well as the situational ability to regulate emotions with an experimental ER paradigm. Psychopathology was assessed dimensionally using the depression, anxiety, and stress scale. Cross-sectionally symptom severity was predicted by less trait-like use of adaptive and more trait-like use of maladaptive ER strategies, but no associations were found for situational ER ability. This association was more pronounced for depression and stress symptoms rather than anxiety symptoms. In a striking dissociation, the longitudinal analyses revealed the reverse picture: Better situational ER ability, but not trait-like use of ER strategies was associated with less symptom severity after the CBT treatment. Our data argues in favor of a distinction between trait-like and situational ER abilities in individuals with emotional disorders, highlighting challenges in applying adaptive ER strategies in daily life despite demonstrating intact ER skills in experimental settings. Our findings also inform transdiagnostic models of psychopathology and suggest that distress/depression rather than anxiety symptomatology to be driving forces for the occurrence of ER deficits across the depression/anxiety disorders spectrum.

The ventromedial prefrontal cortex plays an important role in implicit emotion regulation: A focality-optimized multichannel tDCS study in anxiety individuals

The regulation of emotions is a crucial facet of well-being and social adaptability, with explicit strategies receiving primary attention in prior research. Recent studies, however, emphasize the role of implicit emotion regulation, particularly implicating the ventromedial prefrontal cortex (VMPFC) in association with its implementation. This study delves into the nuanced role of the VMPFC through focality-optimized multichannel transcranial direct current stimulation (tDCS), shedding light on its causal involvement in implicit reappraisal. The primary goal was to evaluate the effectiveness of VMFPC-targeted tDCS and elucidate its role in individuals with high trait anxiety. Participants engaged in implicit and explicit emotion regulation tasks during multichannel tDCS targeting the VMPFC. The outcome measures encompassed negative emotion ratings, pupillary diameter, and saccade count, providing a comprehensive evaluation of emotion regulation efficiency. The intervention exhibited a notable impact, resulting in significant reductions in negative emotion ratings and pupillary reactions during implicit reappraisal, highlighting the indispensable role of the VMPFC in modulating emotional responses. Notably, these effects demonstrated sustained efficacy up to 1 day postintervention. This study underscores the potency of VMPFC-targeted multichannel tDCS in augmenting implicit emotion regulation. This not only contributes insights into the neural mechanisms of emotion regulation but also suggests innovative therapeutic avenues for anxiety disorders. The findings present a promising trajectory for future mood disorder interventions, bridging the gap between implicit emotion regulation and neural stimulation techniques.

Theta-burst direct electrical stimulation remodels human brain networks

Theta-burst stimulation (TBS), a patterned brain stimulation technique that mimics rhythmic bursts of 3-8 Hz endogenous brain rhythms, has emerged as a promising therapeutic approach for treating a wide range of brain disorders, though the neural mechanism of TBS action remains poorly understood. We investigated the neural effects of TBS using intracranial EEG (iEEG) in 10 pre-surgical epilepsy participants undergoing intracranial monitoring. Here we show that individual bursts of direct electrical TBS at 29 frontal and temporal sites evoked strong neural responses spanning broad cortical regions. These responses exhibited dynamic local field potential voltage changes over the course of stimulation presentations, including either increasing or decreasing responses, suggestive of short-term plasticity. Stronger stimulation augmented the mean TBS response amplitude and spread with more recording sites demonstrating short-term plasticity. TBS responses were stimulation site-specific with stronger TBS responses observed in regions with strong baseline stimulation effective (cortico-cortical evoked potentials) and functional (low frequency phase locking) connectivity. Further, we could use these measures to predict stable and varying (e.g. short-term plasticity) TBS response locations. Future work may integrate pre-treatment connectivity alongside other biophysical factors to personalize stimulation parameters, thereby optimizing induction of neuroplasticity within disease-relevant brain networks.

Enhancing ventrolateral prefrontal cortex activation mitigates social pain and modifies subsequent social attitudes: Insights from TMS and fMRI

Social pain, a multifaceted emotional response triggered by interpersonal rejection or criticism, profoundly impacts mental well-being and social interactions. While prior research has implicated the right ventrolateral prefrontal cortex (rVLPFC) in mitigating social pain, the precise neural mechanisms and downstream effects on subsequent social attitudes remain elusive. This study employed transcranial magnetic stimulation (TMS) integrated with fMRI recordings during a social pain task to elucidate these aspects. Eighty participants underwent either active TMS targeting the rVLPFC (n = 41) or control stimulation at the vertex (n = 39). Our results revealed that TMS-induced rVLPFC facilitation significantly reduced self-reported social pain, confirming the causal role of the rVLPFC in social pain relief. Functional connectivity analyses demonstrated enhanced interactions between the rVLPFC and the dorsolateral prefrontal cortex, emphasizing the collaborative engagement of prefrontal regions in emotion regulation. Significantly, we observed that negative social feedback led to negative social attitudes, whereas rVLPFC activation countered this detrimental effect, showcasing the potential of the rVLPFC as a protective buffer against adverse social interactions. Moreover, our study uncovered the impact role of the hippocampus in subsequent social attitudes, a relationship particularly pronounced during excitatory TMS over the rVLPFC. These findings offer promising avenues for improving mental health within the intricate dynamics of social interactions. By advancing our comprehension of the neural mechanisms underlying social pain relief, this research introduces novel intervention strategies for individuals grappling with social distress. Empowering individuals to modulate rVLPFC activation may facilitate reshaping social attitudes and successful reintegration into communal life.

Distinct neural dynamics of the observed ostracism effect in decision-making under risk and ambiguity

Observational ostracism, as a form of social exclusion, can significantly affect human behavior. However, the effects of observed ostracism on risky and ambiguous decision-making and the underlying neural mechanisms remain unclear. This event-related potential study investigated these issues by involving participants in a wheel-of- fortune task, considering observed ostracism and inclusion contexts. The results showed that the cue-P3 component was more enhanced during the choice phase for risky decisions than for ambiguous decisions in the observed inclusion contexts but not in the observed ostracism contexts. During the outcome evaluation phase, feedback-related negativity amplitudes following both risky and ambiguous decisions were higher in the no-gain condition than in the gain condition in the observed inclusion context. In contrast, this effect was only observed following risky decisions in the observed ostracism context. The feedback-P3 component did not exhibit an observed ostracism effect in risky and ambiguous decision-making tasks. Risk levels further modulated the cue-P3 and feedback-related negativity components, while ambiguity levels further modulated the feedback-P3 components. These findings demonstrate a neural dissociation between risk and ambiguity decision-making during observed ostracism that unfolds from the choice phase to the outcome evaluation phase.

Effects of Stimulant Treatment on Changes in Brain Activation During Reward Notifications in Drug Naïve Youth With ADHD

BACKGROUND

Research examining the potential effects of stimulant exposure in childhood on subsequent development of substance use disorder (SUD) have focused on differences in the brain reward system as a function of risk.

METHODS

18 drug naïve children ages 7 to 12 years (11 High Risk [ADHD + ODD/CD]; 7 Low Risk [ADHD only]), underwent fMRI scans before and after treatment with mixed amphetamine salts, extended release (MAS-XR). We examined correlations between clinical ratings and fMRI activation at baseline and following treatment as a function of risk status.

RESULTS

High Risk children had higher activation than Low Risk children at baseline during both the Reward and Surprising Non-Reward conditions. Treatment produced strong differential effects on brain activation pertinent to group and reward outcome.

CONCLUSIONS

Findings support the hypothesized role of reward mechanisms in SUD risk, and suggest that stimulant treatment may have differential effects on reward processing in relation to SUD risk.