Annual Research Review: The contributions of the RDoC research framework on understanding the neurodevelopmental origins, progression and treatment of mental illnesses.

The National Institute of Mental Health (NIMH) proposed the Research Domain Criteria (RDoC) initiative as an alternate way to organize research of mental illnesses, by looking at dimensions of functioning rather than being tied to categorical diagnoses. This paper briefly discusses the motivation for and organization of RDoC, and then explores the NIMH portfolio and recent work to monitor the utility and progress that RDoC has afforded developmental research. To examine how RDoC has influenced the NIMH developmental research portfolio over the last decade, we employed a natural language processing algorithm to identify the number of developmental science grants classified as incorporating an RDoC approach. Additional portfolio analyses examine temporal trends in funded RDoC-relevant grants, publications and citations, and research training opportunities. Reflecting on how RDoC has influenced the focus of grant applications, we highlight examples from research on Attention-Deficit Hyperactivity Disorder (ADHD), childhood irritability, and Autism Spectrum Disorder (ASD). Lastly, we consider how the dimensional and transdiagnostic approaches emphasized in RDoC have facilitated research on personalized intervention for heterogeneous disorders and preventive/early interventions targeting emergent or subthreshold psychopathology.

Neural Basis of Visual Attentional Orienting in Childhood Autism Spectrum Disorders.

We examined spontaneous attention orienting to visual salience in stimuli without social significance using a modified Dot-Probe task during functional magnetic resonance imaging in high-functioning preadolescent children with Autism Spectrum Disorder (ASD) and age- and IQ-matched control children. While the magnitude of attentional bias (faster response to probes in the location of solid color patch) to visually salient stimuli was similar in the groups, activation differences in frontal and temporoparietal regions suggested hyper-sensitivity to visual salience or to sameness in ASD children. Further, activation in a subset of those regions was associated with symptoms of restricted and repetitive behavior. Thus, atypicalities in response to visual properties of stimuli may drive attentional orienting problems associated with ASD.

Functional connectivity of the amygdala and subgenual cingulate during cognitive reappraisal of emotions in children with MDD history is associated with rumination.

Major Depressive Disorder (MDD) is characterized by poor emotion regulation. Rumination, a maladaptive strategy for dealing with negative emotions, is common in MDD, and is associated with impaired inhibition and cognitive inflexibility that may contribute to impaired emotion regulation abilities. However, it is unclear whether rumination is differently associated with emotion regulation in individuals with MDD history (MDD-ever) and healthy individuals. In this study, children (8-15 years old) performed a cognitive reappraisal task in which they attempted to decrease their emotional response to sad images during fMRI scanning. Functional connectivity (FC) between both the amygdala and subgenual anterior cingulate (sACC) increased with cortical control regions during reappraisal as rumination increased in MDD-ever, while connectivity between those regions decreased during reappraisal as rumination increased in healthy controls. As the role of cortical control regions is to down-regulate activity of emotion processing regions during reappraisal, this suggests that rumination in MDD-ever, but not controls, is associated with inefficient regulation. This finding suggests that rumination may be particularly associated with poor emotion regulation in MDD-ever, and may also indicate qualitative group differences in whether rumination is maladaptive. These differences in rumination may provide important insight into depressive risk and potential avenues for treatment.

Do Bilingual advantages in attentional control influence memory encoding during a divided attention task?

The current study examined if bilingual advantages in cognitive control influence memory encoding during a divided attention task. Monolinguals, simultaneous bilinguals, and sequential bilinguals switched between classifying objects and words, then were tested for their recognition memory of stimuli previously seen during the classification task. Compared to bilingual groups, monolinguals made the most errors on the classification task and simultaneous bilinguals committed the fewest errors. On the memory task, however, no differences were found between the three language groups, but significant correlations were found between the number of errors during switch trials on the classification task and recognition memory for both target and non-target stimuli. For bilinguals, their age of second language acquisition partially accounted for the association between attentional control (number of switch errors) and subsequent memory for non-target stimuli only. These results contribute to our understanding of how individual differences in language acquisition influence interactions between cognitive domains.

Neural Activation During Cognitive Emotion Regulation in Previously Depressed Compared to Healthy Children: Evidence of Specific Alterations.

OBJECTIVE: Impairments in cognitive emotion regulation (CER) have been linked to functional neural abnormalities and the pathogenesis of major depressive disorder (MDD). Few functional magnetic resonance imaging (fMRI) studies have investigated the neural underpinnings of CER in samples with depression. As CER develops in childhood, understanding dysfunctional CER-related alterations in brain function during this period could advance knowledge of the developmental psychopathology of MDD. METHOD: This study tested whether neural activity in brain regions known to support cognitive reappraisal differed between healthy 7- to 15-year-old children and same-age peers with a history of MDD (MDD-ever). A total of 64 children participated in this event-related fMRI study, which used a developmentally appropriate and validated fMRI reappraisal task. Children were instructed to passively view sad or neutral images and to decrease negative emotions using cognitive reappraisal. RESULTS: MDD-ever and healthy children showed similar patterns of cortical activation during reappraisal, but with a significant difference found in 1 key CER region, the left inferior frontal gyrus (IFG). In addition, individual differences in CER were associated with left IFG activity during reappraisal. CONCLUSION: Alterations in the neurocircuitry of reappraisal are evident in children with a depression history compared to healthy controls. The finding that MDD-ever children showed reappraisal-related neural responses in many regions similar to healthy controls has clinical implications. Findings suggest that identification of alterations in reappraisal in children with remitted depression, for whom much, although not all, of the neural circuitry remains intact, may be an important window of opportunity for intervention.

Temporal sequencing of brain activations during naturally occurring thermoregulatory events.

Thermoregulatory events are associated with activity in the constituents of the spinothalamic tract. Whereas studies have assessed activity within constituents of this pathway, in vivo functional magnetic resonance imaging (fMRI) studies have not determined if neuronal activity in the constituents of the tract is temporally ordered. Ordered activity would be expected in naturally occurring thermal events, such as menopausal hot flashes (HFs), which occur in physiological sequence. The origins of HFs may lie in brainstem structures where neuronal activity may occur earlier than in interoceptive centers, such as the insula and the prefrontal cortex. To study such time ordering, we conducted blood oxygen level-dependent-based fMRI in a group of postmenopausal women to measure neuronal activity in the brainstem, insula, and prefrontal cortex around the onset of an HF (detected using synchronously acquired skin conductance responses). Rise in brainstem activity occurred before the detectable onset of an HF. Activity in the insular and prefrontal trailed that in the brainstem, appearing following the onset of the HF. Additional activations associated with HF's were observed in the anterior cingulate cortex and the basal ganglia. Pre-HF brainstem responses may reflect the functional origins of internal thermoregulatory events. By comparison insular, prefrontal and striatal activity may be associated with the phenomenological correlates of HFs.

Network dysfunction during associative learning in schizophrenia: Increased activation, but decreased connectivity: an fMRI study.

Schizophrenia (SCZ) is characterized by disordered activation and disordered connectivity, yet few fMRI studies have convergently investigated both. Here, we compared differences in activation and connectivity between SCZ and controls (HC). Twenty-two subjects (18≤age≤35yrs) participated in a paired-associative learning task, a behavioral domain particularly dependent on fronto-hippocampal connectivity and of relevance to the schizophrenia diathesis. Activation differences were assessed using standard approaches. Seed-based connectivity differences were compared using Psychophysiological Interaction (PPI) with a hippocampus-based seed. SCZ evinced significantly increased activation, but significantly decreased connectivity with the hippocampus across a cortical-striatal learning network. These results assess potentially complementary patterns of network dysfunction in schizophrenia: increased activation suggests inefficient responses relating to functional specialization; decreased connectivity suggests impaired integration of functional signals between regions. Inefficiency and dysconnection appear to collectively characterize functional deficits in schizophrenia.

Atypical Functional Connectivity of the Amygdala in Childhood Autism Spectrum Disorders during Spontaneous Attention to Eye-Gaze.

We examined functional connectivity of the amygdala in preadolescent children with Autism Spectrum Disorders (ASDs) during spontaneous attention to eye-gaze in emotional faces. Children responded to a target word ("LEFT/RIGHT") printed on angry or fearful faces looking in a direction that was congruent, incongruent, or neutral with the target word. Despite being irrelevant to the task, gaze-direction facilitated (Congruent > Neutral) or interfered with (Incongruent > Congruent) performance in both groups. Despite similar behavioral performance, amygdala-connectivity was atypical and more widespread in children with ASD. In control children, the amygdala was more strongly connected with an emotional cognitive control region (subgenual cingulate) during interference, while during facilitation, no regions showed greater amygdala connectivity than in ASD children. In contrast, in children with ASD the amygdala was more strongly connected to salience and cognitive control regions (posterior and dorsal cingulate) during facilitation and with regions involved in gaze processing (superior temporal sulcus), cognitive control (inferior frontal gyrus), and processing of viscerally salient information (pregenual cingulate, anterior insula, and thalamus) during interference. These findings showing more widespread connectivity of the amygdala extend past findings of atypical functional anatomy of eye-gaze processing in children with ASD and challenge views of general underconnectivity in ASD.

Hypo-activation in the executive core of the sustained attention network in adolescent offspring of schizophrenia patients mediated by premorbid functional deficits.

Adolescent offspring of schizophrenia patients (SCZ-Off) are vulnerable to psychiatric disorders. Assessing relationships between clinical and biological measures (such as functional magnetic resonance imaging, fMRI) may elucidate pathways of vulnerability in this group. Here we assessed the relationship between clinically assessed premorbid function, and cortico-striatal activity during sustained attention in controls (HC: with no family history of psychosis) and SCZ-Off. Subjects (n=39) were assessed using the Structured Interview for Prodromal Syndromes and the Scale of Prodromal Symptoms. Based on the Global Assessment of Functioning (GAF) score, SCZ-Off were cleaved into "high" or "low" clinically functioning sub-groups (SCZ-Off(HF), SCZ-Off(LF) respectively). During fMRI, subjects participated in a modified continuous performance task (CPT-IP). fMRI was conducted on a Bruker MedSpec 4T system (345 EPI scans; TR=2s; 24 slices; 3.8×3.8×4mm). Results show SCZ-Off(LF) evinced less activation than both HC and SCZ-Off(HF) in the executive core of the brain's attentional system (anterior cingulate, dorsal prefrontal cortex and caudate), but not visuo-spatial regions such as primary visual or superior parietal cortex. Differences were independent of behavioral performance, and reduction in activity was related to GAF score in a dose-dependent manner. Assessing the relationship between clinical measures and brain activity in domains such as attention provides a window into mechanisms of vulnerability in the developing adolescent brain.

Effect of dopamine transporter genotype on caudate volume in childhood ADHD and controls.

Polymorphism of the dopamine transporter genotype (DAT1) confers a small but significant susceptibility to attention deficit hyperactivity disorder (ADHD). We examined whether the volume of the head of caudate, a striatal structure with high DAT expression that is important for inhibitory function, differs by DAT1 in children diagnosed with the disorder relative to age and IQ matched controls. Volume of the head of caudate was delineated in the right and left hemisphere and compared between 7- and 13-year-old children with and without ADHD (combined type) who were carriers of two (10/10) or one (9/10) copy of the 10-repeat DAT1 allele. Caudate volumes were overall smaller in 10/10 than 9/10 children, particularly in the left than right hemisphere. While DAT1 effects did not vary by ADHD diagnosis, overall caudate volumes were smaller in ADHD relative to control children. Altered caudate development associated with 10-repeat homozygosity of DAT1 may contribute susceptibility to ADHD.

Differential processing of metacognitive evaluation and the neural circuitry of the self and others in schizophrenia: a pilot study.

BACKGROUND: Impaired awareness of the self and others (i.e., metacognitive evaluations) are seen in schizophrenia. We compared patterns of activation in schizophrenia (SZ) and nonclinical subjects during a functional magnetic resonance imaging (fMRI) task of metacognitive evaluations that has been demonstrated to engage the neural circuitry of the self in healthy subjects. METHODS: Eleven SZ subjects (7 males, mean age 26.6+/-8) and 10 healthy control subjects (4 males, mean age 29.6+/-8.4) were enrolled. Participants completed two runs of a metacognitive evaluation task (self vs. other vs. word meaning). fMRI data was obtained using a full body Bruker MedSped 4.0Tesla system. Group contrasts were performed using an uncorrected p<0.005 with a 50voxel extent threshold. RESULTS: We observed a significant hypoactivation in the left superior temporal sulcus (STS) during metacognitive evaluations of others (OE) vs. semantic positivity evaluations (SPE) and a trend toward significant hypoactivation in the OE vs. self evaluations (SE) in the SZ group. Significant hypoactivation was also seen in the right inferior temporal gyrus (ITG) in the OE vs. SE contrasts in the SZ group. A trendworthy hypoactivation was seen in the SZ group in the right middle frontal gyrus and pole of the left STS during OE vs. SPE and SE contrasts respectively. CONCLUSIONS: These results extend previous findings of impaired metacognitive evaluative processes in schizophrenia to aberrations of the neural circuitry implicated in self/other awareness among SZ patients. Greater understanding of the neural basis of deficits of self/other awareness in early schizophrenia may contribute to improvements in the identification and treatment of individuals at risk for the illness.