Mapping the Brain Network of Conduct Disorder: Heterogeneous fMRI findings converge on a Common Brain Circuit

Conduct disorder (CD) is among the most prevalent and burdensome disorders in early adolescence. Over the past decade, there has been growing interest in identifying reliable and localized neurobiological markers of conduct disorder (CD). However, recent meta-analyses have highlighted the weak reliability of these so-called markers, thereby limiting the ability to draw firm conclusions. Using normative network mapping (598 healthy subjects), we rather sought to investigate whether the heterogeneous findings across studies may map unto a common brain network. A meta-analysis of 38 fMRI studies involving adolescents with a CD (932 cases, 975 controls) was first conducted and showed only a very weak spatial convergence in brain activity alterations in the anterior temporal lobe (5 out of 38 studies). In turn, network mapping revealed that findings across studies show a consistent connectivity pattern across the whole brain, with regional overlap reaching up to 94.7% (36 out of 38 studies). This network was primarily driven by functional connectivity of brainstem nuclei, subcortical structures (i.e., thalamus, ventral striatum), cingulate cortex (i.e., anterior to posterior midcingulate), superior temporal sulcus, and visual cortices. We further describe the neurochemicals and genetic markers of this CD-Network with emphasis on midbrain serotoninergic, dopaminergic and cholinergic projections. Our findings suggest that our understanding of the neurobiological markers of CD could be enhanced by viewing the brain as a complex interconnected system rather than reducing its complexity to a limited number of brain structures. More importantly, this CD-Network may serve as evidence that the various theories of CD can be reconciled rather than seen as conflicting.