Cited by 83Neural and Behavioral Psychology StudiesChild and Adolescent Psychosocial and Emotional DevelopmentNeurotransmitter Receptor Influence on Behavior

Structural Differences in Adult Orbital and Ventromedial Prefrontal Cortex Predicted by Infant Temperament at 4 Months of Age

Open access
Schwartz, Carl E., Kunwar, Pratap S., Greve, Douglas N., Moran, Lyndsey R., Viner, Jane C., Covino, Jennifer M., Kagan, Jerome, Stewart, S. Evelyn +3 more·2010·Archives of General Psychiatry

Abstract

CONTEXT: The term temperament refers to a biologically based predilection for a distinctive pattern of emotions, cognitions, and behaviors first observed in infancy or early childhood. High-reactive infants are characterized at age 4 months by vigorous motor activity and crying in response to unfamiliar visual, auditory, and olfactory stimuli, whereas low-reactive infants show low motor activity and low vocal distress to the same stimuli. High-reactive infants are biased to become behaviorally inhibited in the second year of life, defined by timidity with unfamiliar people, objects, and situations. In contrast, low-reactive infants are biased to develop into uninhibited children who spontaneously approach novel situations. OBJECTIVE: To examine whether differences in the structure of the ventromedial or orbitofrontal cerebral cortex at age 18 years are associated with high or low reactivity at 4 months of age. DESIGN: Structural magnetic resonance imaging in a cohort of 18-year-olds enrolled in a longitudinal study. Temperament was determined at 4 months of age by direct observation in the laboratory. SETTING: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital. PARTICIPANTS: Seventy-six subjects who were high-reactive or low-reactive infants at 4 months of age. MAIN OUTCOME MEASURE: Cortical thickness. RESULTS: Adults with a low-reactive infant temperament, compared with those categorized as high reactive, showed greater thickness in the left orbitofrontal cortex. Subjects categorized as high reactive in infancy, compared with those previously categorized as low reactive, showed greater thickness in the right ventromedial prefrontal cortex. CONCLUSIONS: To our knowledge, this is the first demonstration that temperamental differences measured at 4 months of age have implications for the architecture of human cerebral cortex lasting into adulthood. Understanding the developmental mechanisms that shape these differences may offer new ways to understand mood and anxiety disorders as well as the formation of adult personality.

AI snapshot

Written from the paper’s full text.

TL;DR

In a longitudinal cohort, adults who had been low-reactive infants at 4 months showed a thicker left orbitofrontal region, while those who had been high-reactive infants showed a thicker right ventromedial prefrontal region. These structural differences persisted after excluding mood and anxiety diagnoses, suggesting early temperament may mark lasting cortical architecture.

Key findings

  • Among 76 18-year-olds (34 high reactive, 42 low reactive), the low-reactive group had a thicker left orbitofrontal cortex cluster (225 mm²) than the high-reactive group.
  • The high-reactive group had a thicker right ventromedial prefrontal cortex cluster (169 mm²) than the low-reactive group.
  • No sex differences or temperament-by-sex interactions appeared in these regions; whole-brain vertex-wise analysis found no additional clusters surviving correction, and the posterior visual cortex comparison region showed no significant group difference.
  • The reported thickness differences were about 10%–12% and were not associated with medication use, social anxiety disorder, or major depressive disorder.

Methods

  • Longitudinal design: temperament was classified at 4 months by direct laboratory observation using a standard 45-minute battery, and structural MRI was performed at age 18.
  • Participants were 76 subjects from an 18-year longitudinal study, categorized as high reactive (n=34) or low reactive (n=42) in infancy.
  • Two 3D MPRAGE scans per subject were motion-corrected and averaged, then analyzed with FreeSurfer to model cortical surfaces and compute thickness; vertex-wise general linear models tested temperament, gender, and their interaction, with cluster correction by Monte Carlo simulation (10,000 iterations).

Limitations

  • The paper states that because imaging was not done in infancy, it cannot determine whether the structural differences are primary and detectable earlier or develop later through genetic, environmental, or interactive influences.
  • The paper states that high-resolution MRI cannot identify which cellular components—neurons, inhibitory interneurons, glial cells, or neuropil—account for the thickness differences.
  • Evident from the text: the sample is modest and drawn from temperament extremes in one longitudinal cohort, so causal direction and broader generalizability remain uncertain.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1001/archgenpsychiatry.2009.171

Cites

86 of 86 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 65 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Adults who had a high reactive temperament at 4 months had greater cortical thickness in the right ventromedial prefrontal cortex than adults who had a low reactive temperament.

    “Subjects categorized as high reactive in infancy, compared with those previously categorized as low reactive, showed greater thickness in right ventromedial prefrontal cortex.”
    • Also stated in: § RESULTS · plain
      “whereas high reactives had thicker cortex than low reactives in a region of right ventromedial prefrontal cortex”
    • Also stated in: § RESULTS · plain
      “Figure 2 illustrates the 169 mm2 region of right ventromedial prefrontal cortex (VmPfc) that was thicker in the 18 year olds who had a high reactive temperament in infancy, compared with those subjects who were low reactive infants.”
    Quote in the paperSubstantial claim
  • Findingown data

    The posterior visual cortex comparison region showed no significant difference in cortical thickness between the temperament groups.

    “the posterior comparison region of visual cortex (cuneus, pericalcarine, and lingual gyrus) did not show significant difference in cortical thickness between groups [Left: Low Reactive (LR) (Mean ± SEM) 1.81 ± .015 vs. High Reactive (HR) 1.81± .017, t(74) = 0.05, p= .96; Right: LR 1.87 ± .017 vs. HR 1.86± .016, t(74) = 0.37, p= .71].”
    Quote in the paperSubstantial claim
  • Findingcitation

    The maximum fMRI activation in right medial orbital frontal cortex in a prior face perception study occurred at the same Talairach coordinates as the largest temperament-related thickness difference detected in this study.

    “In that study, the maximum fMRI activation in the right medial orbital frontal cortex occurred at precisely the same Talairach coordinates where we detected the largest temperament-related thickness difference.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [76]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Findingown data

    The structural differences in adult cerebral cortex that correlate with infant temperament remained present when subjects with major depression or social phobia were excluded.

    “These structural differences in the cerebral cortex of adults that correlate with infant temperament are present even when we excluded subjects with major depression or social phobia (Table 4).”
    Quote in the paperSubstantial claim
  • Findingown data

    Analysis of the residual ventral prefrontal cortex after removing the cluster territories showed no evidence of diffuse thickness differences between the temperament groups.

    “Analysis of the residual territory in ventral prefrontal cortex that remained after clipping out the territories of the clusters in Figure 1 & Figure 2 showed no evidence of such diffuse thickness differences between the groups”
    Quote in the paperSubstantial claim
  • May combine two claims. 10
  • Classified as probably not a substantial claim. 19
  • May combine two claims.

    Findingown data

    There was no difference in cortical thickness between genders and no interaction between temperament and gender in the left orbitofrontal or right ventromedial prefrontal regions.

    “There was no difference in cortical thickness between the genders, nor any interaction between temperament and gender in either of these regions.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The thickness differences between the temperament groups were not associated with medication use, social anxiety disorder, or major depressive disorder.

    “The results indicated that the thickness differences between the temperament groups were not associated with any of these factors (Table 4).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    High reactive infants are biased to become behaviorally inhibited in the second year of life, defined by timidity with unfamiliar people, objects, and situations.

    “High reactive infants are biased to become behaviorally inhibited in the second year of life, defined by timidity with unfamiliar people, objects and situations.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [1]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The right ventromedial prefrontal region may play an important role in detecting whether a person, place, or object is novel or familiar.

    “and hence may play an important role in detecting whether a person, place or object is novel or familiar.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    These anatomical features may represent novel endophenotypes for genetic analysis.

    “These anatomical features may represent novel endophenotypes for genetic analysis.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Handedness did not differ between the high reactive and low reactive temperament groups.

    “Handedness, measured with the Edinburgh Inventory33, did not differ between the two temperament groups.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Approximately 20% of Caucasian four-month-old infants demonstrate a high reactive temperament, defined by vigorous limb activity, arching of the back, and crying to unfamiliar visual, olfactory, and auditory stimuli.

    “Approximately 20% of Caucasian four-month old infants demonstrate a high reactive (HR) temperament, which is defined by vigorous limb activity, arching of their back and crying to unfamiliar visual, olfactory, and auditory stimuli.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The flailing arms and legs characteristic of high reactive infants in response to unexpected stimuli are consistent with projections to the ventral striatum.

    “The flailing arms and legs characteristic of high reactive infants in response to unexpected stimuli are consistent with projections to the ventral striatum15, 77, 78, which has a central role in the execution of limb movements.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Data analysts were blind to subject identity and temperamental type during image processing.

    “Data analysts were blind during image processing to subjects identity and temperamental type in infancy.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The frequent distress vocalizations of high reactive infants are mediated by direct projections from the medial prefrontal network to the periaqueductal gray and anterior cingulate.

    “Finally, the frequent distress vocalizations of high reactive infants are mediated by direct projections from the medial prefrontal network to the PAG and anterior cingulate.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The frequent distress vocalizations of high reactive infants are mediated by direct projections from the medial prefrontal network to the periaqueductal gray and anterior cingulate.
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Social anxiety disorder during adolescence is an important predictor of subsequent depressive disorders and social phobia in young adults.

    “Social anxiety disorder during adolescence in turn is an important predictor of subsequent depressive disorders12 and social phobia in young adults13.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    There is rich bi-directional connectivity between the ventral prefrontal cortex and the amygdala.

    “There is rich bi-directional connectivity between the ventral prefrontal cortex and the amygdala15, 16.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [15]

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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Ventral prefrontal cortex, including the orbitofrontal cortex, plays a pivotal role in emotional regulation, reward processing, and the ability to inhibit behaviors.

    “Ventral prefrontal cortex, including the orbitofrontal cortex (OFC) plays a pivotal role in emotional regulation, reward processing, and an ability to inhibit behaviors17–31.”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [17]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Independent prospective studies have shown that an inhibited temperament is a risk factor for anxiety disorder in childhood and adolescence, particularly social anxiety disorder.

    “Independent prospective studies from several laboratories have demonstrated that an inhibited temperament is a risk factor for the development of anxiety disorder in childhood8, 9 and adolescence10, particularly social anxiety disorder10, 11.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The current state of high-resolution MRI cannot address which components-neurons, interneurons, glial cells, or neuropil-contribute to the observed cortical thickness differences.

    “The current state of high resolution MRI cannot address which of these components contribute to the cortical thickness differences observed.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    A study of face perception showed greater activation of right medial orbital frontal cortex, bilateral amygdala, and right inferior parietal cortex when subjects viewed images of unfamiliar individuals compared with viewing images of themselves.

    “A study of face perception showed greater activation of right medial orbital frontal cortex, bilateral amydgala, and right inferior parietal cortex when subjects viewed images of unfamilar individuals, compared with viewing images of themselves76.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [76]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A previous fMRI study from the authors' laboratory supported the hypothesis that differences in physiology and behavior between inhibited and uninhibited temperaments reflect differential amygdalar reactivity to novelty.

    “A previous fMRI study from our laboratory supported the the hypothesis that the differences in physiology and behavior between inhibited and uninhibited temperaments might indeed reflect differential amygdalar reactivity to novelty14.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Patients with major depressive disorder show abnormal reward processing with altered brain activation in a region of left orbitofrontal cortex that overlaps substantially with the temperament-related cluster.

    “Patients with MDD show abnormal reward processing61–63 with altered brain activation in a region of left OFC64 that overlaps substantially with the temperament-related cluster.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [61]

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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Functional neuroimaging studies support a central role for the left orbitofrontal cortex sub-region in hedonic processing and in reappraising negative emotion in a more positive direction.

    “Functional neuroimaging studies support a central role for this sub-region of the left OFC in hedonic processing54, 55 and the reappraisal of negative emotion in a more positive direction56.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [54]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The striatum is activated by aversive, novel, unexpected, or intense stimuli.

    “The striatum is activated by aversive, novel, unexpected or intense stimuli79.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The right ventromedial region is reciprocally connected with the posterior parahippocampal gyrus and receives a unilateral projection from the hippocampus, and may therefore play an important role in detecting novelty or familiarity.

    “Furthermore, this region is reciprocally connected with the posterior parahippocampal gyrus73, 74 and receives a unilateral projection from the hippocampus15, 73, 75, and hence may play an important role in detecting whether a person, place or object is novel or familiar.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
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    Premisecitation

    Direct projections to the hypothalamus from the right ventromedial sub-region can activate the medulla and sympathetic chain, resulting in increases in blood pressure and heart rate seen in inhibited children in response to the unfamiliar.

    “Direct projections to the hypothalamus from this sub-region of VmPfc can also activate the medulla and sympathetic chain72, resulting in the increases in blood pressure and heart rate seen in inhibited children in response to the unfamiliar.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [72]

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  • May combine two claims.

    Premisecitation

    Histopathological studies have identified thinning of 12% to 15% in rostral and central orbitofrontal cortex, and sections of the latter region included the area where the temperament effects were detected.

    “Histopathological studies have identified thinning of 12–15% in rostral and central OFC65; sections of the later region included the area where we detected the effects of temperament66.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [65]

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    Premisecitation

    The intercalated cells gate neuronal traffic and modulate output from the central nucleus of the amygdala that produces bodily sensations interpreted as signs of anxiety.

    “These cells, interposed between the input to the basal complex and the output from the central nucleus, gate neuronal traffic and modulate output from the central nucleus of the amygdala that produces bodily sensations that individuals interpret as signs of anxiety60.”
    Quote in the paperSubstantial claim0 of 1 sources checked
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  • The paper relies on this without support.

    The observed adult cortical thickness differences are attributable to infant temperament rather than to later developmental, genetic, or environmental factors.

    “because imaging data were not collected in infancy, these findings cannot address the question of whether the structural differences we report are primary and could be detected earlier, or whether they develop over time due to genetic factors, environmental influences, or some interaction of the two.”
  • The paper relies on this without support.

    This study provides the first demonstration that temperamental differences measured at 4 months of age have implications for the architecture of human cerebral cortex lasting into adulthood.

    “This is the first demonstration that temperamental differences measured at 4 months of age have implications for the architecture of human cerebral cortex lasting into adulthood.”
  • The paper relies on this without support.

    The lateral column of the periaqueductal gray generates active avoidance and defensive behaviors, including arching of the back, a response seen almost exclusively in 4-month-old high reactive infants.

    “The lateral column of the PAG generates active avoidance and defensive behaviours including a response we called arching of the back, a response seen almost exclusively in 4-month old high reactive infants.”
  • The paper relies on this without support.

    The frequent distress vocalizations of high reactive infants are mediated by direct projections from the medial prefrontal network to the periaqueductal gray and anterior cingulate.

    “Finally, the frequent distress vocalizations of high reactive infants are mediated by direct projections from the medial prefrontal network to the PAG and anterior cingulate.”
4 of 4

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(74) = 0.05reported p = .96 · recomputed p = .960

    “t(74) = 0.05, p = .96”

  • Consistentt(74) = 0.37reported p = .71 · recomputed p = .712

    “t(74) = 0.37, p = .71”

  • Consistentt(74) = 0.83reported p = .41 · recomputed p = .409

    “t(74) = 0.83, p = .41”

  • Consistentt(74) = 0.45reported p = .66 · recomputed p = .654

    “t(74) = 0.45, p = .66”

4 of 4

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

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Authors
Schwartz, C. E., Kunwar, P. S., Greve, D. N., Moran, L. R., Viner, J. C., Covino, J. M., Kagan, J., Stewart, S. E., Snidman, N. C., Vangel, M. G., & Wallace, S. R.
Affiliations
  • Harvard University (US)
  • Massachusetts General Hospital (US)
  • Boston Children's Hospital (US)
Venue
Archives of General Psychiatry
Published
2010-01-01
Volume
67
Issue
1
Pages
78
ISSN
0003-990X (ISSN-L)
OpenAlex
W2131766148
Cited by
82
References
89
Citations by year
2025: 4 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 7 · 2016: 10 · 2015: 5 · 2014: 5 · 2013: 10 · 2012: 7
FWCI
4.65
Type
journal article
Language
en
Open access
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH071467)
  • National Center for Research Resources (UL1RR025758, M01RR001066, P41RR014075, 5P41 RR14075-07)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
infant temperament, orbitofrontal cortex, ventromedial prefrontal cortex, cortical thickness, brain structure, behavioral inhibition, adult personality, mood and anxiety disorders, brain development
MeSH terms
Adolescent, Adult, Age Factors, Cerebral Cortex, Child Development, Humans, Infant, Functional Laterality, Longitudinal Studies, Magnetic Resonance Imaging, Temperament, Biomarkers, Prefrontal Cortex, Infant Behavior, Imaging, Three-Dimensional

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

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