Skip to main content Accessibility help

Abnormalities of cortical structures in adolescent-onset conduct disorder

  • Y. Jiang (a1), X. Guo (a1), J. Zhang (a1), J. Gao (a2) (a3) (a4), X. Wang (a1), W. Situ (a5), J. Yi (a1), X. Zhang (a1), X. Zhu (a1) (a6) (a7), S. Yao (a1) (a6) (a7) and B. Huang (a1) (a8) (a9)...



Converging evidence has revealed both functional and structural abnormalities in adolescents with early-onset conduct disorder (EO-CD). The neurological abnormalities underlying EO-CD may be different from that of adolescent-onset conduct disorder (AO-CD) patients. However, the cortical structure in AO-CD patients remains largely unknown. The aim of the present study was to investigate the cortical alterations in AO-CD patients.


We investigated T1-weighted brain images from AO-CD patients and age-, gender- and intelligence quotient-matched controls. Cortical structures including thickness, folding and surface area were measured using the surface-based morphometric method. Furthermore, we assessed impulsivity and antisocial symptoms using the Barratt Impulsiveness Scale (BIS) and the Antisocial Process Screening Device (APSD).


Compared with the controls, we found significant cortical thinning in the paralimbic system in AO-CD patients. For the first time, we observed cortical thinning in the precuneus/posterior cingulate cortex (PCC) in AO-CD patients which has not been reported in EO-CD patients. Prominent folding abnormalities were found in the paralimbic structures and frontal cortex while diminished surface areas were shown in the precentral and inferior temporal cortex. Furthermore, cortical thickness of the paralimbic structures was found to be negatively correlated with impulsivity and antisocial behaviors measured by the BIS and APSD, respectively.


The present study indicates that AO-CD is characterized by cortical structural abnormalities in the paralimbic system, and, in particular, we highlight the potential role of deficient structures including the precuneus and PCC in the etiology of AO-CD.


Corresponding author

* Addresses for correspondence: S. Yao, Medical Psychological Institute, the Second Xiangya Hospital of Central South University, no. 139, Middle Renmin Road, Changsha, Hunan 410011, People's Republic of China; B. Huang, Department of Biomedical Engineering, School of Medicine, Shenzhen University, no. 3688, Nanhai Avenue, Shenzhen, Guangdong 518060, People's Republic of China. (Email: [S.Y.] (Email: [B.H.]


Hide All
APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Publishing: Washington, DC.
APA (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Publishing: Washington, DC.
Armstrong, E, Schleicher, A, Omran, H, Curtis, M, Zilles, K (1995). The ontogeny of human gyrification. Cerebral Cortex 5, 5663.
Blair, RJ (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. Brain and Cognition 55, 198208.
Blair, RJ, Cipolotti, L (2000). Impaired social response reversal. A case of ‘acquired sociopathy’. Brain 123, 11221141.
Boes, AD, Tranel, D, Anderson, SW, Nopoulos, P (2008). Right anterior cingulate: a neuroanatomical correlate of aggression and defiance in boys. Behavioral Neuroscience 122, 677684.
Bush, G, Luu, P, Posner, MI (2000). Cognitive and emotional influences in anterior cingulate cortex. Trends in Cognitive Science 4, 215222.
Casanova, MF, El-Baz, AS, Giedd, J, Rumsey, JM, Switala, AE (2010). Increased white matter gyral depth in dyslexia: implications for corticocortical connectivity. Journal of Autism and Developmental Disorders 40, 2129.
Crossley, NA, Mechelli, A, Scott, J, Carletti, F, Fox, PT, McGuire, P, Bullmore, ET (2014). The hubs of the human connectome are generally implicated in the anatomy of brain disorders. Brain 137, 23822395.
Dale, AM, Fischl, B, Sereno, MI (1999). Cortical surface-based analysis. I. Segmentation and surface reconstruction. NeuroImage 9, 179194.
Dalwani, MS, Tregellas, JR, Andrews-Hanna, JR, Mikulich-Gilbertson, SK, Raymond, KM, Banich, MT, Crowley, TJ, Sakai, JT (2014). Default mode network activity in male adolescents with conduct and substance use disorder. Drug and Alcohol Dependence 134, 242250.
De Brito, SA, Mechelli, A, Wilke, M, Laurens, KR, Jones, AP, Barker, GJ, Hodgins, S, Viding, E (2009). Size matters: increased grey matter in boys with conduct problems and callous–unemotional traits. Brain 132, 843852.
Dum, RP, Strick, PL (1991). The origin of corticospinal projections from the premotor areas in the frontal lobe. Journal of Neuroscience 11, 667689.
Elliott, R, Deakin, B (2005). Role of the orbitofrontal cortex in reinforcement processing and inhibitory control: evidence from functional magnetic resonance imaging studies in healthy human subjects. International Review of Neurobiology 65, 89116.
Eyler, LT, Prom-Wormley, E, Panizzon, MS, Kaup, AR, Fennema-Notestine, C, Neale, MC, Jernigan, TL, Fischl, B, Franz, CE, Lyons, MJ, Grant, M, Stevens, A, Pacheco, J, Perry, ME, Schmitt, JE, Seidman, LJ, Thermenos, HW, Tsuang, MT, Chen, CH, Thompson, WK, Jak, A, Dale, AM, Kremen, WS (2011). Genetic and environmental contributions to regional cortical surface area in humans: a magnetic resonance imaging twin study. Cerebral Cortex 21, 23132321.
Fahim, C, He, Y, Yoon, U, Chen, J, Evans, A, Pérusse, D (2011). Neuroanatomy of childhood disruptive behavior disorders. Aggressive Behavior 37, 326337.
Fairchild, G, Passamonti, L, Hurford, G, Hagan, CC, von dem Hagen, EA, van Goozen, SH, Goodyer, IM, Calder, AJ (2011). Brain structure abnormalities in early-onset and adolescent-onset conduct disorder. American Journal of Psychiatry 168, 624633.
Fairchild, G, Toschi, N, Hagan, CC, Goodyer, IM, Calder, AJ, Passamonti, L (2015). Cortical thickness, surface area, and folding alterations in male youths with conduct disorder and varying levels of callous–unemotional traits. NeuroImage: Clinical 8, 253260.
Fairchild, G, van Goozen, SH, Calder, AJ, Goodyer, IM (2013). Research review: evaluating and reformulating the developmental taxonomic theory of antisocial behaviour. Journal of Child Psychology and Psychiatry, and Allied Disciplines 54, 924940.
Fairchild, G, Van Goozen, SH, Stollery, SJ, Goodyer, IM (2008). Fear conditioning and affective modulation of the startle reflex in male adolescents with early-onset or adolescence-onset conduct disorder and healthy control subjects. Biological Psychiatry 63, 279285.
Fairchild, G, Van Goozen, SHM, Calder, AJ, Stollery, SJ, Goodyer, IM (2009 a). Deficits in facial expression recognition in male adolescents with early-onset or adolescence-onset conduct disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines 50, 627636.
Fairchild, G, van Goozen, SHM, Stollery, SJ, Aitken, MRF, Savage, J, Moore, SC, Goodyer, IM (2009 b). Decision making and executive function in male adolescents with early-onset or adolescence-onset conduct disorder and control subjects. Biological Psychiatry 66, 162168.
Finger, EC, Marsh, AA, Blair, KS, Reid, ME, Sims, C, Ng, P, Pine, DS, Blair, RJ (2011). Disrupted reinforcement signaling in the orbitofrontal cortex and caudate in youths with conduct disorder or oppositional defiant disorder and a high level of psychopathic traits. American Journal of Psychiatry 168, 152162.
First, M, Spitzer, R, Gibbon, M, Williams, J (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders–Patient Edition (SCID-I/P, 11/2002 revision). New York State Psychiatric Institute: New York.
Fischl, B, Liu, A, Dale, AM (2001). Automated manifold surgery: constructing geometrically accurate and topologically correct models of the human cerebral cortex. IEEE Transactions on Medical Imaging 20, 7080.
Fischl, B, Sereno, MI, Dale, AM (1999). Cortical surface-based analysis. II: inflation, flattening, and a surface-based coordinate system. NeuroImage 9, 195207.
Frick, PJ, Hare, RD (2001). Antisocial Process Screening Device: APSD. Multi-Health Systems: Toronto.
Frye, RE, Liederman, J, Malmberg, B, McLean, J, Strickland, D, Beauchamp, MS (2010). Surface area accounts for the relation of gray matter volume to reading-related skills and history of dyslexia. Cerebral Cortex 20, 26252635.
Gavita, OA, Capris, D, Bolno, J, David, D (2012). Anterior cingulate cortex findings in child disruptive behavior disorders. A meta-analysis. Aggression and Violent Behavior 17, 507513.
Ghosh, SS, Kakunoori, S, Augustinack, J, Nieto-Castanon, A, Kovelman, I, Gaab, N, Christodoulou, JA, Triantafyllou, C, Gabrieli, JDE, Fischl, B (2010). Evaluating the validity of volume-based and surface-based brain image registration for developmental cognitive neuroscience studies in children 4 to 11 years of age. NeuroImage 53, 8593.
Giedd, JN, Blumenthal, J, Jeffries, NO, Castellanos, FX, Liu, H, Zijdenbos, A, Paus, T, Evans, AC, Rapoport, JL (1999). Brain development during childhood and adolescence: a longitudinal MRI study. Nature Neuroscience 2, 861863.
Gong, YX, Cai, TS (1993). Wechsler Intelligence Scale for Children, Chinese Revision (C-WISC). Map Press: Hunan, China.
Hagler, DJ, Saygin, AP, Sereno, MI (2006). Smoothing and cluster thresholding for cortical surface-based group analysis of fMRI data. NeuroImage 33, 10931103.
Herpertz, SC, Huebner, T, Marx, I, Vloet, TD, Fink, GR, Stoecker, T, Shah, NJ, Konrad, K, Herpertz-Dahlmann, B (2008). Emotional processing in male adolescents with childhood-onset conduct disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines 49, 781791.
Hornak, J, Bramham, J, Rolls, ET, Morris, RG, O'Doherty, J, Bullock, PR, Polkey, CE (2003). Changes in emotion after circumscribed surgical lesions of the orbitofrontal and cingulate cortices. Brain 126, 16911712.
Hu, M, Wang, M, Cai, L, Zhu, X, Yao, S (2012). Development of subjective socioeconomic status scale for Chinese adolescents. Chinese Journal of Clinical Psychology 20, 155161.
Huebner, T, Vloet, TD, Marx, I, Konrad, K, Fink, GR, Herpertz, SC, Herpertz-Dahlmann, B (2008). Morphometric brain abnormalities in boys with conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry 47, 540547.
Hyatt, CJ, Haney-Caron, E, Stevens, MC (2012). Cortical thickness and folding deficits in conduct-disordered adolescents. Biological Psychiatry 72, 207214.
Kruesi, MJ, Casanova, MF, Mannheim, G, Johnson-Bilder, A (2004). Reduced temporal lobe volume in early onset conduct disorder. Psychiatry Research 132, 111.
Moffitt, TE, Arseneault, L, Jaffee, SR, Kim-Cohen, J, Koenen, KC, Odgers, CL, Slutske, WS, Viding, E (2008). Research review: DSM-V conduct disorder: research needs for an evidence base. Journal of Child Psychology and Psychiatry, and Allied Disciplines 49, 333.
Northoff, G, Bermpohl, F (2004). Cortical midline structures and the self. Trends in Cognitive Science 8, 102107.
Odgers, CL, Caspi, A, Broadbent, JM, Dickson, N, Hancox, RJ, Harrington, H, Poulton, R, Sears, MR, Thomson, WM, Moffitt, TE (2007). Prediction of differential adult health burden by conduct problem subtypes in males. Archives of General Psychiatry 64, 476484.
O'Doherty, J, Kringelbach, ML, Rolls, ET, Hornak, J, Andrews, C (2001). Abstract reward and punishment representations in the human orbitofrontal cortex. Nature Neuroscience 4, 95102.
O'Doherty, JP (2004). Reward representations and reward-related learning in the human brain: insights from neuroimaging. Current Opinion in Neurobiology 14, 769776.
Oldfield, RC (1971). The assessment and analysis of handedness: the Edinburgh Inventory. Neuropsychologia 9, 97113.
Olsson, M (2009). DSM diagnosis of conduct disorder (CD) – a review. Nordic Journal of Psychiatry 63, 102112.
Panizzon, MS, Fennema-Notestine, C, Eyler, LT, Jernigan, TL, Prom-Wormley, E, Neale, M, Jacobson, K, Lyons, MJ, Grant, MD, Franz, CE, Xian, H, Tsuang, M, Fischl, B, Seidman, L, Dale, A, Kremen, WS (2009). Distinct genetic influences on cortical surface area and cortical thickness. Cerebral Cortex 19, 27282735.
Passamonti, L, Fairchild, G, Goodyer, IM, Hurford, G, Hagan, CC, Rowe, JB, Calder, AJ (2010). Neural abnormalities in early-onset and adolescence-onset conduct disorder. Archives of General Psychiatry 67, 729738.
Paus, T, Petrides, M, Evans, AC, Meyer, E (1993). Role of the human anterior cingulate cortex in the control of oculomotor, manual, and speech responses: a positron emission tomography study. Journal of Neurophysiology 70, 453469.
Radloff, LS (1977). The CES-D scale: a self report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.
Raine, A, Yang, Y (2006). Neural foundations to moral reasoning and antisocial behavior. Social Cognitive and Affective Neuroscience 1, 203213.
Richman, DP, Stewart, RM, Hutchinson, JW, Caviness, VS Jr (1975). Mechanical model of brain convolutional development. Science 189, 1821.
Roisman, GI, Monahan, KC, Campbell, SB, Steinberg, L, Cauffman, E; National Institute of Child Health and Human Development Early Child Care Research Network (2010). Is adolescence-onset antisocial behavior developmentally normative? Development and Psychopathology 22, 295311.
Rubia, K (2011). “Cool” inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus “hot” ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review. Biological Psychiatry 69, e69e87.
Rubia, K, Halari, R, Smith, AB, Mohammed, M, Scott, S, Giampietro, V, Taylor, E, Brammer, MJ (2008). Dissociated functional brain abnormalities of inhibition in boys with pure conduct disorder and in boys with pure attention deficit hyperactivity disorder. American Journal of Psychiatry 165, 889897.
Rubia, K, Smith, AB, Halari, R, Matsukura, F, Mohammad, M, Taylor, E, Brammer, MJ (2009). Disorder-specific dissociation of orbitofrontal dysfunction in boys with pure conduct disorder during reward and ventrolateral prefrontal dysfunction in boys with pure ADHD during sustained attention. American Journal of Psychiatry 166, 8394.
Schaer, M, Cuadra, MB, Schmansky, N, Fischl, B, Thiran, JP, Eliez, S (2012). How to measure cortical folding from MR images: a step-by-step tutorial to compute local gyrification index. Journal of Visualized Experiments: JoVE e3417.
Schaer, M, Cuadra, MB, Tamarit, L, Lazeyras, F, Eliez, S, Thiran, JP (2008). A surface-based approach to quantify local cortical gyrification. IEEE Transactions on Medical Imaging 27, 161170.
Shaw, P, Eckstrand, K, Sharp, W, Blumenthal, J, Lerch, JP, Greenstein, D, Clasen, L, Evans, A, Giedd, J, Rapoport, JL (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences of the United States of America 104, 1964919654.
Shaw, P, Kabani, NJ, Lerch, JP, Eckstrand, K, Lenroot, R, Gogtay, N, Greenstein, D, Clasen, L, Evans, A, Rapoport, JL, Giedd, JN, Wise, SP (2008). Neurodevelopmental trajectories of the human cerebral cortex. Journal of Neuroscience 28, 35863594.
Shokouhi, M, Williams, JH, Waiter, GD, Condon, B (2012). Changes in the sulcal size associated with autism spectrum disorder revealed by sulcal morphometry. Autism Research 5, 245252.
Silberg, J, Moore, AA, Rutter, M (2014). Age of onset and the subclassification of conduct/dissocial disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines 56, 826833.
Silberg, JL, Rutter, M, Eaves, L (2001). Genetic and environmental influences on the temporal association between earlier anxiety and later depression in girls (vol 49, pg 1040, 2001). Biological Psychiatry 50, 393393.
Stadler, C, Sterzer, P, Schmeck, K, Krebs, A, Kleinschmidt, A, Poustka, F (2007). Reduced anterior cingulate activation in aggressive children and adolescents during affective stimulation: association with temperament traits. Journal of Psychiatric Research 41, 410417.
Sterzer, P, Stadler, C, Krebs, A, Kleinschmidt, A, Poustka, F (2005). Abnormal neural responses to emotional visual stimuli in adolescents with conduct disorder. Biological Psychiatry 57, 715.
Sterzer, P, Stadler, C, Poustka, F, Kleinschmidt, A (2007). A structural neural deficit in adolescents with conduct disorder and its association with lack of empathy. NeuroImage 37, 335342.
van den Heuvel, MP, Sporns, O (2011). Rich-club organization of the human connectome. Journal of Neuroscience 31, 1577515786.
Van Essen, DC (1997). A tension-based theory of morphogenesis and compact wiring in the central nervous system. Nature 385, 313318.
Wallace, GL, White, S, Robustelli, B, Sinclair, S, Hwang, S, Martin, A, Blair, R (2014). Cortical and subcortical abnormalities in youths with conduct disorder and elevated callous unemotional traits. Journal of the American Academy of Child and Adolescent Psychiatry 53, 456465.
White, T, Su, S, Schmidt, M, Kao, CY, Sapiro, G (2010). The development of gyrification in childhood and adolescence. Brain and Cognition 72, 3645.
Winkler, AM, Kochunov, P, Blangero, J, Almasy, L, Zilles, K, Fox, PT, Duggirala, R, Glahn, DC (2010). Cortical thickness or grey matter volume? The importance of selecting the phenotype for imaging genetics studies. NeuroImage 53, 11351146.
Winkler, AM, Sabuncu, MR, Yeo, BT, Fischl, B, Greve, DN, Kochunov, P, Nichols, TE, Blangero, J, Glahn, DC (2012). Measuring and comparing brain cortical surface area and other areal quantities. NeuroImage 61, 14281443.
Winston, JS, Henson, RN, Fine-Goulden, MR, Dolan, RJ (2004). fMRI-adaptation reveals dissociable neural representations of identity and expression in face perception. Journal of Neurophysiology 92, 18301839.
Wismueller, A, Vietze, F, Dersch, DR, Leinsinger, GL, Ritter, H, Hahn, K (1999). Adaptive self-organized template matching of the gray-level feature space for automatic segmentation of multispectral MRI data of the human brain. Radiology 213, 364364.
Yang, Y, Raine, A (2009). Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a meta-analysis. Psychiatry Research 174, 8188.
Yao, S, Yang, H, Zhu, X, Auerbach, RP, Abela, JR, Pulleyblank, RW, Tong, X (2007 a). An examination of the psychometric properties of the Chinese version of the Barratt Impulsiveness Scale, 11th version in a sample of Chinese adolescents. Perceptual and Motor Skills 104, 11691182.
Yao, S, Zhang, C, Zhu, X, Jing, X, McWhinnie, CM, Abela, JR (2009). Measuring adolescent psychopathology: psychometric properties of the Self-Report Strengths and Difficulties Questionnaire in a sample of Chinese adolescents. Journal of Adolescent Health 45, 5562.
Yao, S, Zou, T, Zhu, X, Abela, JR, Auerbach, RP, Tong, X (2007 b). Reliability and validity of the Chinese version of the Multidimensional Anxiety Scale for children among Chinese secondary school students. Child Psychiatry and Human Development 38, 116.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Jiang supplementary material
Figures S1-S6 and Table S1

 Word (985 KB)
985 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed