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Background: Irritability is an important dimension of psychopathology that spans multiple clinical diagnostic categories, yet its relationship to patterns of brain development remains sparsely explored. Here, we examined how trans-diagnostic symptoms of irritability relate to the development of structural brain networks. Methods: All participants (n=144, 87 females) completed structural brain imaging with 3 Tesla MRI at two timepoints (mean age at follow-up: 20.9 years, mean inter-scan interval: 5.1 years). Irritability at follow-up was assessed using the Affective Reactivity Index, and cortical thickness was quantified using Advanced Normalization Tools software. Structural covariance networks were delineated using non-negative matrix factorization, a multivariate analysis technique. Both cross-sectional and longitudinal associations with irritability at follow-up were evaluated using generalized additive models with penalized splines. The False Discovery Rate (q<0.05) was used to correct for multiple comparisons. Results: Cross-sectional analysis of follow-up data revealed that 11 of the 24 covariance networks were associated with irritability, with higher levels of irritability being associated with thinner cortex. Longitudinal analyses further revealed that accelerated cortical thinning within 9 networks was related to irritability at follow-up. Effects were particularly prominent in brain regions implicated in emotion regulation, including the orbitofrontal, lateral temporal, and medial temporal cortex. Conclusions: Collectively, these findings suggest that irritability is associated with widespread cortical thickness reductions and accelerated cortical thinning, particularly within frontal and temporal cortex. Aberrant structural maturation of regions important for emotional regulation may in part underlie symptoms of irritability.

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