Identification of a common neurobiological substrate for XXXX .

@entity1 @entity162 @entity1032 @entity308 @entity146 @entity148 @entity161 @entity3119
IMPORTANCE: Psychiatric diagnoses are currently distinguished based on sets of specific symptoms. However, genetic and clinical analyses find similarities across a wide variety of diagnoses, suggesting that a common neurobiological substrate may exist across @entity1032 . OBJECTIVE: To conduct a meta-analysis of structural neuroimaging studies across multiple @entity146 diagnoses, followed by parallel analyses of 3 large-scale healthy @entity1 data sets to help interpret structural findings in the meta-analysis. DATA SOURCES: PubMed was searched to identify voxel-based morphometry studies through July 2012 comparing @entity146 @entity1 to healthy control individuals for the meta-analysis. The 3 parallel healthy @entity1 data sets included resting-state functional magnetic resonance imaging, a database of activation foci across thousands of neuroimaging experiments, and a data set with structural imaging and cognitive task performance data. DATA EXTRACTION AND SYNTHESIS: Studies were included in the meta-analysis if they reported voxel-based morphometry differences between @entity1 with an @entity146 and control individuals in stereotactic coordinates across the whole brain, did not present predominantly in childhood, and had at least 10 studies contributing to that diagnosis (or across closely related diagnoses). The meta-analysis was conducted on peak voxel coordinates using an activation likelihood estimation approach. MAIN OUTCOMES AND MEASURES: We tested for areas of common gray matter volume increase or decrease across Axis I diagnoses, as well as areas differing between diagnoses. Follow-up analyses on other healthy @entity1 data sets tested connectivity related to regions arising from the meta-analysis and the relationship of gray matter volume to cognition. RESULTS: Based on the voxel-based morphometry meta-analysis of 193 studies comprising 15   892 individuals across 6 diverse diagnostic groups ( @entity161 , @entity162 , @entity308 , addiction, @entity3119 , and @entity148 ), we found that gray matter loss converged across diagnoses in 3 regions: the dorsal anterior cingulate, right insula, and left insula. By contrast, there were few diagnosis-specific effects, distinguishing only @entity161 and @entity308 from other diagnoses. In the parallel follow-up analyses of the 3 independent healthy @entity1 data sets, we found that the common gray matter loss regions formed a tightly interconnected network during tasks and at resting and that lower gray matter in this network was associated with poor executive functioning. CONCLUSIONS AND REVELANCE: We identified a concordance across @entity146 diagnoses in terms of integrity of an anterior insula/dorsal anterior cingulate-based network, which may relate to executive function deficits observed across diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates across psychopathology, despite likely diverse etiologies, which is currently not an explicit component of @entity146 nosology.
