Brain structure and internalizing and externalizing behavior in typically developing children and adolescents

  • Quinn R. Andre
  • Bryce L. Geeraert
  • Catherine LebelEmail author
Original Article


Mental health problems often emerge in adolescence and are associated with reduced gray matter thickness or volume in the prefrontal cortex (PFC) and limbic system and reduced fractional anisotropy (FA) and increased mean diffusivity (MD) of white matter linking these regions. However, few studies have investigated whether internalizing and externalizing behavior are associated with brain structure in children and adolescents without mental health disorders, which is important for understanding the progression of symptoms. 67 T1-weighted and diffusion tensor imaging datasets were obtained from 48 typically developing participants aged 6–16 years (37M/30F; 19 participants had two visits). Volume was calculated in the prefrontal and limbic structures, and diffusion parameters were assessed in limbic white matter. Linear mixed effects models were used to compute associations between brain structure and internalizing and externalizing behavior, assessed using the Behavioral Assessment System for Children (BASC-2) Parent Rating Scale. Internalizing behavior was positively associated with MD of the bilateral cingulum. Gender interactions were found in the cingulum, with stronger positive relationships between MD and internalizing behavior in females. Externalizing behavior was negatively associated with FA of the left cingulum, and the left uncinate fasciculus showed an age–behavior interaction. No relationships between behavior and brain volumes survived multiple comparison correction. These results show altered limbic white matter FA and MD related to sub-clinical internalizing and externalizing behavior and further our understanding of neurological markers that may underlie risk for future mental health disorders.


Structural magnetic resonance imaging Diffusion tensor imaging (DTI) Mental health Internalizing Externalizing Pediatric neuroimaging 



This work was supported by the Natural Sciences and Engineering Research Council (NSERC) (CL), NSERC CREATE International and Industrial Imaging Training (I3T) Program, Queen Elizabeth II Graduate Scholarship, and Alberta Children’s Hospital Research Institute (ACHRI) Graduate Scholarship (QA).

Compliance with ethical standards

Conflict of interest

CL’s spouse is an employee of General Electric Healthcare. The authors report no other biomedical financial interests or potential conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Calgary Conjoint Health Research Ethics Board [REB13-1346] and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent and assent were obtained from all guardians and individual participants included in the study.

Supplementary material

429_2019_1973_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medical Science Graduate ProgramUniversity of CalgaryCalgaryCanada
  2. 2.Biomedical Engineering Graduate ProgramUniversity of CalgaryCalgaryCanada
  3. 3.Department of RadiologyUniversity of CalgaryCalgaryCanada
  4. 4.Alberta Children’s Hospital Research InstituteUniversity of CalgaryCalgaryCanada
  5. 5.Hotchkiss Brain InstituteUniversity of CalgaryCalgaryCanada
  6. 6.Alberta Children’s HospitalCalgaryCanada

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