Sunnybrook Research Institute, Canada; and Hospital Sirio-Libanes, Brazil
Jürgen Germann
University Health Network; and CIC, Douglas Mental Health University Institute, McGill University, Canada
Gabriel A. Devenyi
CIC, Douglas Mental Health University Institute, McGill University; and Department of Psychiatry, McGill University, Canada
Rosa M. C. B. Morais
Hospital Sirio-Libanes; and Department of Psychiatry, University of Sao Paulo, Medical School, Brazil
Ana Paula M. Santos
Department of Psychiatry, University of Sao Paulo, Medical School, Brazil
Erich T. Fonoff
Department of Neurology, Division of Functional Neurosurgery of the Institute of Psychiatry, University of Sao Paulo, Medical School, Brazil
Clement Hamani
Sunnybrook Research Institute; Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre; and Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Canada
Helena Brentani
Department of Psychiatry, University of Sao Paulo, Medical School, Brazil
M. Mallar Chakravarty
CIC, Douglas Mental Health University Institute, McGill University, Canada; Department of Psychiatry, McGill University, Canada; and Department of Biological and Biomedical Engineering, McGill University, Canada
Raquel C. R. Martinez
Hospital Sirio-Libanes; and Department of Psychiatry, University of Sao Paulo, Medical School, Brazil
Aggressive behaviour is a highly prevalent and devastating condition in autism spectrum disorder resulting in impoverished quality of life. Gold-standard therapies are ineffective in about 30% of patients leading to greater suffering. We investigated cortical thickness in individuals with autism spectrum disorder with pharmacological-treatment-refractory aggressive behaviour compared with those with non-refractory aggressive behaviour and observed a brain-wide pattern of local increased thickness in key areas related to emotional control and overall decreased cortical thickness in those with refractory aggressive behaviour, suggesting refractoriness could be related to specific morphological patterns. Elucidating the neurobiology of refractory aggressive behaviour is crucial to provide insights and potential avenues for new interventions.
