Altered Emotion Perception Linked to Structural Brain Differences in Youth With Congenital Adrenal Hyperplasia.

CONTEXT: Congenital adrenal hyperplasia (CAH) is a genetic disorder that results in hormonal imbalances and decreased brain volumes in regions important for emotional processing. OBJECTIVE: To examine whether emotion perception differs between youth with CAH and control youth, and if these differences relate to brain volumes. METHODS: In this cross-sectional study of 27 youths with CAH (mean age = 12.63 years, 16 female) and 35 age- and sex-matched controls (mean age = 13.03 years, 20 female), each participant rated picture stimuli and completed a 3T structural brain scan. Valence and arousal ratings and reaction times of 61 affective images were assessed. Gray matter volumes were measured by MRI. RESULTS: Youth with CAH had lower valence ratings for negative (P = .007) and neutral (P = .019) images. Controls showed differences in reaction times and arousal ratings across stimuli conditions, but youth with CAH did not. Brain volumes of the right amygdala (P = .025) and left hippocampus (P = .002) were associated with valence ratings. Left rostral middle frontal (P < .001) and right medial orbitofrontal cortex (P = .002) volumes were negatively related to valence scores only in youth with CAH, whereas left medial orbitofrontal cortex (P < .001) volumes were associated with valence scores positively in youth with CAH and negatively in controls. CONCLUSION: Findings suggest that youth with CAH perceive emotive stimuli as more unpleasant. Decreased brain volumes in the amygdala, hippocampus, and prefrontal cortex are associated with these measures of altered emotion perception in youth with CAH.

Social Adjustment of Problem-Talk Partners Moderates Associations Between Self-Perceived Victimization and Depressive Symptoms.

This paper examines the moderating role of problem-talk partnerships with peers who are rejected, victimized, or unpopular on links between self-perceived victimization by peers and depressive symptoms. Problem-talk partnerships are friendships that involve frequent discussion of problems and personal struggles. 267 adolescents (152 girls; mean age of 14.4 years) participated in a short-term prospective study with identical measures administered in two annual waves. The adolescents completed a battery of self-report questionnaires assessing peer victimization and depression. They also completed a peer nomination inventory and identified friends with whom they frequently discuss problems. High levels of peer nominated victimization, social rejection, and unpopularity among problem-talk partners were linked to elevated associations between self-reported victimization and depressive symptoms. The effects for unpopularity levels among problem-talk partners were moderated by gender. Compared to boys, girls' adjustment was more strongly influenced by unpopularity among problem-talk partners. Conversely, friendships with peers who were not problem-talk partners did not have a consistent moderating role. The full pattern of findings highlights the need to consider the social adjustment of dyadic partners when examining the psychosocial impact of perceived victimization.

Congenital Adrenal Hyperplasia and Brain Health: A Systematic Review of Structural, Functional, and Diffusion Magnetic Resonance Imaging (MRI) Investigations.

BACKGROUND: Congenital adrenal hyperplasia (CAH) is a group of genetic disorders that affects the adrenal glands and is the most common cause of primary adrenal insufficiency in children. In the past few decades, magnetic resonance imaging (MRI) has been implemented to investigate how the brain may be affected by CAH. A systematic review was conducted to evaluate and synthesize the reported evidence of brain findings related to CAH using structural, functional, and diffusion-weighted MRI. METHODS: We searched bibliographical databases through July 2021 for brain MRI studies in individuals with CAH. RESULTS: Twenty-eight studies were identified, including 13 case reports or series, 10 studies that recruited and studied CAH patients vs unaffected controls, and 5 studies without a matched control group. Eleven studies used structural MRI to identify structural abnormalities or quantify brain volumes, whereas 3 studies implemented functional MRI to investigate brain activity, and 3 reported diffusion MRI findings to assess white matter microstructure. Some commonly reported findings across studies included cortical atrophy and differences in gray matter volumes, as well as white matter hyperintensities, altered white matter microstructure, and distinct patterns of emotion and reward-related brain activity. CONCLUSIONS: These findings suggest differences in brain structure and function in patients with CAH. Limitations of these studies highlight the need for CAH neuroimaging studies to incorporate larger sample sizes and follow best study design and MRI analytic practices, as well as clarify potential neurologic effects seen across the lifespan and in relation to clinical and behavioral CAH phenotypes.