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Association of the Anterior Cingulate Volume and Emotion Regulation in Girls but Not Boys with Autism Spectrum Disorder
Children with autism spectrum disorder (ASD) have been observed to experience challenges with controlling emotional responses that are often expressed as aggression, self-injurious behavior and mood dysregulation. Previous literature has looked at the amygdala, anterior cingulate cortex (ACC) and prefrontal cortex (PFC) as essential brain regions involved in emotional regulation (ER). While influences of sex based differences on ER have been well established, there is still a lack of investigation at the brain and behavior level looking at ER in ASD children with the impact of sex.
Objectives:
To examine brain-behavior associations underlying emotion dysregulation in boys and girls with ASD, as compared with their typically developing (TD) peers.
Methods:
104 ASD (16 girls, 88 boys) and 163 TD (32 girls, 132 boys) participants were balanced on age, sex, socioeconomic status and IQ score. The emotion lability (EL) t-score from the Conners parent rating scale was used to assess ER. Volumes of cortical regions (amygdala, ACC, dorsolateral PFC) were derived from high resolution T1-weighted images using FreeSurfer version 6.0. Multiple regression analyses were performed to investigate: 1) the effect of diagnosis, sex, and interaction thereof (diagnosis*sex) on EL scores, and 2) associations of cortical regions with EL t-scores and effects of diagnosis, sex, and diagnosis*sex on the relationship between cortical regions and EL t-scores; significant associations were followed-up with Pearson correlations.
Results:
Multiple regression revealed a statistically significant effect of diagnosis (F(1,263) = 5.213, p = 0.023), sex (F(1,263) = 96.457, p < 0.001), and interaction of diagnosis*sex (F(1,263) = 4.029, p=0.046). Follow up post hoc analyses tests revealed elevated EL t-scores in children with ASD compared to TD children. Significant interactions were found such that both girls and boys with ASD showed higher EL scores compared to TD peers, although it was significantly stronger in girls (M=66.19, SD=14.232) than boys (M=59.39, SD=11.165). Regression analyses of brain-behavior associations revealed that there was a marginal diagnosis*sex interaction (F(7,259) = 22.266, p=0.094) for the relationship between the left ACC volume and the EL t-score. Specifically, as figure 1 indicates, the left ACC volume showed significant correlations with the EL t-scores in ASD but not TD girls. Lower left ACC volumes were negatively correlated with higher EL t-scores in ASD girls (r=-.579, p=0.019). No significance was found with the amygdala and PFC regions.
Conclusions:
Findings reveal that children with ASD face difficulty with ER when compared to TD peers but this may be a problem that is more present in girls with ASD. Furthermore, ASD girls show a unique association with the left ACC volume; therefore, the dysfunction of the left ACC may contribute to the emotional challenges experienced by girls with ASD.