Adolescence, Puberty, and Emotion Regulation

The goal of this project is to use functional magnetic resonance imaging (fMRI) to compare
the degree to which brain regions of adolescents and adults with and without steroid-related
endocrine disorders are engaged by tasks involving processing of emotionally salient stimuli.
In healthy subjects, based on developmental continuities in the relevant psychological
processes, we anticipate considerable similarity across age groups in the topography of brain
regions engaged by relevant tasks. However, we hypothesize that developmental differences in
cortico-limbic circuits of adolescents and adults will be reflected in patterns of fMRI
activation. Specifically, we hypothesize in both adults and adolescents that attention and
memory tasks involving the processing of emotionally salient stimuli will engage the
amygdala, cingulate gyrus, and association cortex of medial/inferior prefrontal cortex and
temporal regions. Nevertheless, height of task-associated activation is hypothesized to
differ between adolescents and adults within these regions. Moreover, prior studies
distinguish puberty vs. age-related aspects of cognitive development: some aspects of
attention or memory development relate to changes in chronological age whereas other aspects,
particularly those involving emotional processes, relate to pubertal status. Therefore, we
expect eventually to use emotion-evoking fMRI tasks to test hypotheses on the presence of
complementary, distinguishable puberty vs. age-related components of brain development. In
patients with endocrine disorders, we expect to identify abnormal brain function related to
defects in steroidogenesis, including in utero hyperandrogenism and hypocortisolism seen in
Congenital Adrenal Hyperplasia (CAH), congenital male hyperandrogenism seen in familial male
precocious puberty (FMPP), and hypercortisolism seen as Cushing's Syndrome (CS).

To meet these initial goals, we developed and tested a number of attention/emotion tasks in
healthy adults and healthy adolescents, tested systematically a few of these tasks in the
fMRI, including a face-emotion processing task, an affective picture- processing task, a
threat bias task, a dot-probe task, a reward-related task, and tasks probing social
processing. We are now entering the 2nd phase of the protocol, in which we are focusing on
endocrine disorders, CAH, FMPP and CS. We hypothesize that both face-emotion processing task,
an affective picture- processing task will engage the amygdala, cingulate gyrus, and
association cortices of the medial/inferior prefrontal and temporal regions differently as a
function of time of occurrence, severity, and type of endocrine abnormalities.

- INCLUSION CRITERIA: HEALTHY SUBJECTS:

Age: 9-25 (adolescents/young adults); 25-35 (adults).

Consent: can give consent/assent. Parents will provide consent for all minors.

IQ: all subjects will have an IQ greater than 70; assessment relies on WASI.

Psychopathology: all subjects will be free of any current psychiatric disorder as well as
lifetime history of psychosis, pervasive developmental disorder, major affective disorder,
panic disorder, obsessive compulsive disorder, conduct disorder, ADHD, and anorexia.
Assessment relies on comprehensive psychiatric interview.

INCLUSION CRITERIA: ENDOCRINE AND CARRIER PATIENTS

Age: 9-25 (adolescents/young adults); 25-35 (adults).

Consent: can give consent/assent. Parents will provide consent for all minors.

IQ: all subjects will have an IQ greater than 70. Assessment relies on WASI

EXCLUSION CRITERIA:

Any medical condition that increases risk for MRI (e.g. pacemaker, metallic foreign body in
eye)

Pregnancy