Inhibition-related connectivity predicts irritability risk and resilience across early adolescence.

Elevated irritability may in part arise from altered top-down networks, such as those implicated in inhibitory control, that may help modulate temper outbursts. Studies have linked higher youth irritability with aberrant neural patterns during inhibitory control; however, how these networks may relate to trajectories of irritability across key transitions, such as that from childhood to adolescence, remains unknown. Using data from the Adolescent Brain Cognitive Development Study (N = 5373), four previously identified irritability symptoms trajectories from baseline to 4-year follow-up (low-stable, high-decreasing, low-increasing, and high-chronic) were used to predict neural patterns during the baseline Stop Signal Task. Analyses examined associations between trajectories and whole brain activation and functional connectivity. Amygdala connectivity with insula during successful inhibition was lower in the high-decreasing compared to low-stable and low-increasing trajectories. During failed inhibition, amygdala and strital-prefrontal connectivity was lower in the low-increasing compared to the low-stable and high-chronic irritability trajectories. Results remained after controlling for baseline irritability. Findings indicate that changes in inhibitory control networks in preadolescents may contribute to high-decreasing and low-increasing irritability trajectories across early adolescence. Unexpectedly, differences between the high-chronic and low-stable trajectories were nonsignificant, suggesting inhibitory control may affect changes in irritability symptoms rather than their levels.