1
|
Jiang Y, Zhou Y, Xie Y, Zhou J, Cai M, Tang J, Liu F, Ma J, Liu H. Functional magnetic resonance imaging alternations in suicide attempts individuals and their association with gene expression. Neuroimage Clin 2024; 43:103645. [PMID: 39059208 PMCID: PMC11326948 DOI: 10.1016/j.nicl.2024.103645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/29/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Functional Magnetic Resonance Imaging (fMRI) has shown brain activity alterations in individuals with a history of attempted suicide (SA) who are diagnosed with depression disorder (DD) or bipolar disorder (BD). However, patterns of spontaneous brain activity and their genetic correlations need further investigation. METHODS A voxel-based meta-analysis of 19 studies including 26 datasets, involving 742 patients with a history of SA and 978 controls (both nonsuicidal patients and healthy controls) was conducted. We examined fMRI changes in SA patients and analyzed the association between these changes and gene expression profiles using data from the Allen Human Brain Atlas by partial least squares regression analysis. RESULTS SA patients demonstrated increased spontaneous brain activity in several brain regions including the bilateral inferior temporal gyrus, hippocampus, fusiform gyrus, and right insula, and decreased activity in areas like the bilateral paracentral lobule and inferior frontal gyrus. Additionally, 5,077 genes were identified, exhibiting expression patterns associated with SA-related fMRI alterations. Functional enrichment analyses demonstrated that these SA-related genes were enriched for biological functions including glutamatergic synapse and mitochondrial structure. Concurrently, specific expression analyses showed that these genes were specifically expressed in the brain tissue, in neurons cells, and during early developmental periods. CONCLUSION Our findings suggest a neurobiological basis for fMRI abnormalities in SA patients with DD or BD, potentially guiding future genetic and therapeutic research.
Collapse
Affiliation(s)
- Yurong Jiang
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yujing Zhou
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 116000 Dalian, Liaoning, China
| | - Yingying Xie
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Junzi Zhou
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Mengjing Cai
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jie Tang
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Feng Liu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Juanwei Ma
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Huaigui Liu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging & Tianjin Institute of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
| |
Collapse
|
2
|
Zhang X, Xu R, Ma H, Qian Y, Zhu J. Brain Structural and Functional Damage Network Localization of Suicide. Biol Psychiatry 2024; 95:1091-1099. [PMID: 38215816 DOI: 10.1016/j.biopsych.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Extensive neuroimaging research on brain structural and functional correlates of suicide has produced inconsistent results. Despite increasing recognition that damage in multiple different brain locations that causes the same symptom can map to a common brain network, there is still a paucity of research investigating network localization of suicide. METHODS To clarify this issue, we initially identified brain structural and functional damage locations in relation to suicide from 63 published studies with 2135 suicidal and 2606 nonsuicidal individuals. By applying novel functional connectivity network mapping to large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we mapped these affected brain locations to 3 suicide brain damage networks corresponding to different imaging modalities. RESULTS The suicide gray matter volume damage network comprised widely distributed brain areas primarily involving the dorsal default mode, basal ganglia, and anterior salience networks. The suicide task-induced activation damage network was similar to but less extensive than the gray matter volume damage network, predominantly implicating the same canonical networks. The suicide resting-state activity damage network manifested as a localized set of brain regions encompassing the orbitofrontal cortex and middle cingulate cortex. CONCLUSIONS Our findings not only may help reconcile prior heterogeneous neuroimaging results, but also may provide insights into the neurobiological mechanisms of suicide from a network perspective, which may ultimately inform more targeted and effective strategies to prevent suicide.
Collapse
Affiliation(s)
- Xiaohan Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China; Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Ruoxuan Xu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China; Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Haining Ma
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China; Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China; Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China.
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China; Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China.
| |
Collapse
|
3
|
Aupperle RL, Kuplicki R, Tsuchiyagaito A, Akeman E, Sturycz-Taylor CA, DeVille D, Lasswell T, Misaki M, Berg H, McDermott TJ, Touthang J, Ballard ED, Cha C, Schacter DL, Paulus MP. Ventromedial prefrontal cortex activation and neurofeedback modulation during episodic future thinking for individuals with suicidal thoughts and behaviors. Behav Res Ther 2024; 176:104522. [PMID: 38547724 PMCID: PMC11103812 DOI: 10.1016/j.brat.2024.104522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/30/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
Individuals experiencing suicidal thoughts and behaviors (STBs) show less specificity and positivity during episodic future thinking (EFT). Here, we present findings from two studies aiming to (1) further our understanding of how STBs may relate to neural responsivity during EFT and (2) examine the feasibility of modulating EFT-related activation using real-time fMRI neurofeedback (rtfMRI-nf). Study 1 involved 30 individuals with major depressive disorder (MDD; half with STBs) who performed an EFT task during fMRI, for which they imagined personally-relevant future positive, negative, or neutral events. Positive EFT elicited greater ventromedial prefrontal cortex (vmPFC) activation compared to negative EFT. Importantly, the MDD + STB group exhibited reduced vmPFC activation across all EFT conditions compared to MDD-STB; although EFT fluency and subjective experience remained consistent across groups. Study 2 included rtfMRI-nf focused on vmPFC modulation during positive EFT for six participants with MDD + STBs. Results support the feasibility and acceptability of the rtfMRI-nf protocol and quantitative and qualitative observations are provided to help inform future, larger studies aiming to examine similar neurofeedback protocols. Results implicate vmPFC blunting as a promising treatment target for MDD + STBs and suggest rtfMRI-nf as one potential technique to explore for enhancing vmPFC engagement.
Collapse
Affiliation(s)
- R L Aupperle
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA; School of Community Medicine, 1215 South Boulder Ave W., The University of Tulsa, Tulsa, OK, 74119, USA.
| | - R Kuplicki
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - A Tsuchiyagaito
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - E Akeman
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - C A Sturycz-Taylor
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - D DeVille
- Department of Psychiatry, University of California San Diego, 4510 Executive Drive, San Diego, CA, 92121, USA
| | - T Lasswell
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - M Misaki
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - H Berg
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - T J McDermott
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - J Touthang
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA
| | - E D Ballard
- Experimental Therapeutics and Pathophysiological Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - C Cha
- Department of Psychology, Columbia University, 428 Horace Mann, New York, NY, 10027, USA
| | - D L Schacter
- Department of Psychology, Harvard University, 33 Kirkland St., William James Hall, Cambridge, MA, 02138, USA
| | - M P Paulus
- Laureate Institute for Brain Research, 6655 S. Yale Ave., Tulsa, OK, 74008, USA; School of Community Medicine, 1215 South Boulder Ave W., The University of Tulsa, Tulsa, OK, 74119, USA
| |
Collapse
|
4
|
Wood S, Booth S, Ko JH. Functional connectivity alterations in PTSD patients with suicidal ideation. Brain Res Bull 2024; 209:110905. [PMID: 38382625 DOI: 10.1016/j.brainresbull.2024.110905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
Post-traumatic stress disorder (PTSD) is a highly prevalent psychological disorder characterized by intense feelings of fear or helplessness after experiencing a traumatic event. PTSD is highly comorbid with mood disorders and patients are at increased risk for suicide. The present study aimed to identify neural connectivity alterations associated with suicidal ideation (SI) in PTSD patients by using resting-state functional magnetic resonance imaging. Voxel-to-voxel intrinsic connectivity was compared between PTSD patients with no (N-SI; N = 26) and high (H-SI; N = 7) SI. Region-to-voxel functional connectivity analysis was performed to identify the regions that contributed to intrinsic connectivity changes. H-SI patients had increased connectivity to various brain regions representing the central executive network, salience network, and default mode network in the frontal, temporal, and occipital lobes as well as subcortical structures involved in executive and limbic functioning, and motor systems. These results suggest SI is associated with large network-level alterations in PTSD patients and is not the result of neuronal abnormalities in any one specific area.
Collapse
Affiliation(s)
- Stephen Wood
- Department of Psychology, Faculty of Arts, University of Manitoba, 66 Chancellors Cir, MB R3T 2N2, Canada
| | - Samuel Booth
- Department of Human Anatomy and Cell Science, University of Manitoba, 744 Bannatyne Ave, Winnipeg, MB R3E 0J9, Canada; PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Science Centre, 710 William Ave, Winnipeg, MB R3E 0Z3, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, University of Manitoba, 744 Bannatyne Ave, Winnipeg, MB R3E 0J9, Canada; PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Science Centre, 710 William Ave, Winnipeg, MB R3E 0Z3, Canada.
| |
Collapse
|
5
|
Li H, Zhang H, Qin K, Yin L, Chen Z, Zhang F, Wu B, Chen T, Sweeney JA, Gong Q, Jia Z. Disrupted small-world white matter networks in patients with major depression and recent suicide plans or attempts. Brain Imaging Behav 2024:10.1007/s11682-024-00870-1. [PMID: 38407738 DOI: 10.1007/s11682-024-00870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
Suicide is a major concern for health, and depression is an established proximal risk factor for suicide. This study aimed to investigate white matter features associated with suicide. We constructed white matter structural networks by deterministic tractography via diffusion tensor imaging in 51 healthy controls, 47 depressed patients without suicide plans or attempts and 56 depressed patients with suicide plans or attempts. Then, graph theory analysis was used to measure global and nodal network properties. We found that local efficiency was decreased and path length was increased in suicidal depressed patients compared to healthy controls and non-suicidal depressed patients; moreover, the clustering coefficient was decreased in depressed patients compared to healthy controls; and the global efficiency and normalized characteristic path length was increased in suicidal depressed patients compared to healthy controls. Similarly, compared with those in non-suicidal depressed patients, nodal efficiency in the thalamus, caudate, medial orbitofrontal cortex, hippocampus, olfactory cortex, supplementary motor area and Rolandic operculum was decreased. In summary, compared with those of non-suicidal depressed patients, the structural connectome of suicidal depressed patients exhibited weakened integration and segregation and decreased nodal efficiency in the fronto-limbic-basal ganglia-thalamic circuitry. These alterations in the structural networks of depressed suicidal brains provide insights into the underlying neurobiology of brain features associated with suicide.
Collapse
Affiliation(s)
- Huiru Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, China
| | - Huawei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China
| | - Li Yin
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Ziqi Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China
| | - Baolin Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China.
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China.
| | - Zhiyun Jia
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China.
- Functional and Molecular Imaging Key Laboratory of Sichuan University, Chengdu, 610041, China.
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Xiang, Chengdu, Sichuan, 610041, PR China.
| |
Collapse
|
6
|
Doruk Camsari D, Lewis CP, Sonmez AI, Ozger C, Fatih P, Yuruk D, Shekunov J, Vande Voort JL, Croarkin PE. Event-Related Potential Markers of Suicidality in Adolescents. Int J Neuropsychopharmacol 2023; 26:566-575. [PMID: 37422891 PMCID: PMC10464930 DOI: 10.1093/ijnp/pyad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/07/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Implicit cognitive markers may assist with the prediction of suicidality beyond clinical risk factors. The aim of this study was to investigate neural correlates associated with the Death/Suicide Implicit Association Test (DS-IAT) via event-related potentials (ERP) in suicidal adolescents. METHODS Thirty inpatient adolescents with suicidal ideations and behaviors (SIBS) and 30 healthy controls from the community were recruited. All participants underwent 64-channel electroencephalography, DS-IAT, and clinical assessments. Hierarchical generalized linear models with spatiotemporal clustering were used to identify significant ERPs associated with the behavioral outcome of DS-IAT (D scores) and group differences. RESULTS Behavioral results (D scores) showed that the adolescents with SIBS had stronger implicit associations between "death" and "self" than the healthy group (P = .02). Within adolescents with SIBS, participants with stronger implicit associations between "death" and "self" reported more difficulty in controllability of suicidal ideation in the past 2 weeks based on the Columbia-Suicide Severity Rating Scale (P = .03). For the ERP data, the D scores and N100 component over the left parieto-occipital cortex had significant correlations. Significant group differences without behavioral correlation were observed for a second N100 cluster (P = .01), P200 (P = .02), and late positive potential (5 clusters, all P ≤ .02). Exploratory predictive models combining both neurophysiological and clinical measures distinguished adolescents with SIBS from healthy adolescents. CONCLUSIONS Our results suggest that N100 may be a marker of attentional resources involved in the distinction of stimuli that are congruent or incongruent to associations between death and self. Combined clinical and ERP measures may have utility in future refinements of assessment and treatment approaches for adolescents with suicidality.
Collapse
Affiliation(s)
- Deniz Doruk Camsari
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Charles P Lewis
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ayse Irem Sonmez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Can Ozger
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Parmis Fatih
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry, Rush University, Chicago, Illinois, USA
| | - Deniz Yuruk
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julia Shekunov
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
7
|
Jagger-Rickels A, Stumps A, Rothlein D, Evans T, Lee D, McGlinchey R, DeGutis J, Esterman M. Aberrant connectivity in the right amygdala and right middle temporal gyrus before and after a suicide attempt: Examining markers of suicide risk. J Affect Disord 2023; 335:24-35. [PMID: 37086805 PMCID: PMC10330566 DOI: 10.1016/j.jad.2023.04.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
Functional neuroimaging has the potential to help identify those at risk for self-injurious thoughts and behaviors, as well as inform neurobiological mechanisms that contribute to suicide. Based on whole-brain patterns of functional connectivity, our previous work identified right amygdala and right middle temporal gyrus (MTG) connectivity patterns that differentiated Veterans with a history of a suicide attempt (SA) from a Veteran control group. In this study, we aimed to replicate and extend our previous findings by examining whether this aberrant connectivity was present prior to and after a SA. In a trauma-exposed Veteran sample (92 % male, mean age = 34), we characterized if the right amygdala and right MTG connectivity differed between a psychiatric control sample (n = 56) and an independent sample of Veterans with a history of SA (n = 17), using fMRI data before and after the SA. Right MTG and amygdala connectivity differed between Veterans with and without a history of SA (replication), while MTG connectivity also distinguished Veterans prior to engaging in a SA (extension). In a second study, neither MTG or amygdala connectivity differed between those with current suicidal ideation (n = 27) relative to matched psychiatric controls (n = 27). These results indicate a potential stable marker of suicide risk (right MTG connectivity) as well as a potential marker of acute risk of or recent SA (right amygdala connectivity) that are independent of current ideation.
Collapse
Affiliation(s)
- Audreyana Jagger-Rickels
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America.
| | - Anna Stumps
- Department of Psychological and Brain Sciences, University of Delaware, United States of America
| | - David Rothlein
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America
| | - Travis Evans
- Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America
| | - Daniel Lee
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, United States of America; Department of Psychiatry, Harvard Medical School, United States of America; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, United States of America
| | - Joseph DeGutis
- Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, United States of America; Boston University Chobanian and Avedisian School of Medicine, Department of Psychiatry, United States of America; Boston Attention and Learning Lab, VA Boston Healthcare System, United States of America; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, United States of America
| |
Collapse
|
8
|
Amico F, De Canditiis D, Castiglione F, Pascarella A, Venerelli N, Fagan JV, Yek JH, Brophy J. A resting state EEG study on depressed persons with suicidal ideation. IBRO Neurosci Rep 2023; 14:346-352. [PMID: 37063608 PMCID: PMC10102403 DOI: 10.1016/j.ibneur.2023.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
Background Major Depressive Disorder (MDD) is a psychiatric illness that is often associated with potentially life-threatening physiological changes and increased risk for suicidal behavior. Electroencephalography (EEG) research suggests an association between depression and specific frequency imbalances in the frontal brain region. Further, while recently developed technology has been proposed to simplify EEG data acquisition, more research is still needed to support its use in patients with MDD. Methods Using the 14-channel EMOTIV EPOC cap, we recorded resting state EEG from 15 MDD patients with and MDD persons with suicidal ideation (SI) vs. 12 healthy controls (HC) to investigate putative power spectral density (PSD) between-group differences at the F3 and F4 electrode sites. Specifically, we explored 1) between-group alpha power asymmetries (AA), 2) between-group differences in delta, theta, alpha and beta power, 3) between PSD data and the scores in the Beck's Depression Inventory-II (BDI-II), Beck's Anxiety Inventory (BAI), Reasons for Living Inventory (RFL), and Self-Disgust Questionnaire (SDS). Results When compared to HC, patients had higher scores on the BAI (p = 0.0018), BDI-II (p = 0.0001) or SDS (p = 0.0142) scale and lower scores in the RFL (p = 0.0006) scale. The PSD analysis revealed no between-group difference or correlation with questionnaire scores for any of the measures considered. Conclusions The present study could not confirm previous research suggesting frequency-specific anomalies in depressed persons with SI but might suggest that frontal EEG imbalances reflect greater anxiety and negative self-referencing. Future studies should confirm these findings in a larger population sample.
Collapse
Affiliation(s)
- Francesco Amico
- Newcastle Hospital, Newcastle, Co. Wicklow, Ireland
- Department of Psychiatry, Trinity Centre for Health Sciences, St. James Hospital, James's Street, Dublin 8, Ireland
- Corresponding author at: Department of Psychiatry, Trinity Centre for Health Sciences, St. James Hospital, James's Street, Dublin 8, Ireland.
| | - Daniela De Canditiis
- Centro Nazionale delle Ricerche (CNR), Istituto per le Applicazioni del Calcolo "M.Picone", Rome, Italy
| | - Filippo Castiglione
- Centro Nazionale delle Ricerche (CNR), Istituto per le Applicazioni del Calcolo "M.Picone", Rome, Italy
| | - Annalisa Pascarella
- Centro Nazionale delle Ricerche (CNR), Istituto per le Applicazioni del Calcolo "M.Picone", Rome, Italy
| | - Noemi Venerelli
- Dipartimento di Matematica G. Castelnuovo, Università La Sapienza, Rome, Italy
| | | | - John, H. Yek
- Newcastle Hospital, Newcastle, Co. Wicklow, Ireland
| | | |
Collapse
|
9
|
Vieira R, Faria AR, Ribeiro D, Picó-Pérez M, Bessa JM. Structural and functional brain correlates of suicidal ideation and behaviors in depression: A scoping review of MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110799. [PMID: 37207727 DOI: 10.1016/j.pnpbp.2023.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Identifying and integrating the neural correlates of suicidal ideation and behaviors is crucial to expand the knowledge and develop targeted strategies to prevent suicide. This review aimed to describe the neural correlates of suicidal ideation, behavior and the transition between them, using different magnetic resonance imaging (MRI) modalities, providing an up-to-date overview of the literature. To be included, the observational, experimental, or quasi-experimental studies must include adult patients currently diagnosed with major depressive disorder and investigate the neural correlates of suicidal ideation, behavior and/or the transition using MRI. The searches were conducted on PubMed, ISI Web of Knowledge and Scopus. Fifty articles were included in this review: 22 on suicidal ideation, 26 on suicide behaviors and two on the transition between them. The qualitative analysis of the included studies suggested alterations in the frontal, limbic and temporal lobes in suicidal ideation associated with deficits in emotional processing and regulation, and in the frontal, limbic, parietal lobes, and basal ganglia in suicide behaviors associated with impairments in decision-making. Gaps in the literature and methodological concerns were identified and might be addressed in future studies.
Collapse
Affiliation(s)
- Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | | | - Diogo Ribeiro
- Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - João M Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
| |
Collapse
|
10
|
Dorsolateral prefrontal activation in depressed young adults with and without suicidal ideation during an emotional autobiographical memory task: A fNIRS study. J Affect Disord 2023; 326:216-224. [PMID: 36736791 DOI: 10.1016/j.jad.2023.01.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Previous studies have proved that there is a strong association between dorsolateral prefrontal cortex and mood symptoms. This study aimed at using functional near-infrared spectroscopy technology to invest brain activity in dlPFC of depressed individuals with and without suicidal ideation during emotional autobiographical memory test, and to understand their differences in brain cognitive mechanisms. It is helpful to improve our ability to predict and subsequently to prevent suicide. METHODS 85 young adults participated in the study by a simple random sampling method, with health control (34participants), depression with suicidal ideation (17participants), and depression without suicidal ideation (34participants). The average oxyhemoglobin in dlPFC of subjects during EAMT was collected by a 53-channel fNIRS imaging device. RESULTS A marginal significant difference was found between three groups in left dlPFC and right dlPFC. Post hoc analysis revealed that: (1) under negative emotion, depression without suicidal ideation group had higher activation than healthy control group in left dlPFC. (2) under positive emotion, depression with suicidal ideation group had lower activation than healthy control in right dlPFC. CONCLUSIONS Results indicated that the depressed individuals with suicidal ideation had some deficits in executive function in right dlPFC, while the depressed adults without suicidal ideation may have mechanism of resource compensatory recruitment in left dlPFC and the dlPFC abnormality involved in the pathophysiology, may localize within left hemisphere. The depressed individuals with and without suicidal ideation had the different mechanisms in dlPFC and fNIRS can be a neuroimaging biomarker characterizing or predicting suicidality in depressed individuals.
Collapse
|
11
|
Dionisio-García DM, Genis-Mendoza AD, González-Castro TB, Tovilla-Zárate CA, Juarez-Rojop IE, López-Narváez ML, Hernández-Díaz Y, Nicolini H, Olvera-Hernández V. DNA Methylation of Genes Involved in the HPA Axis in Presence of Suicide Behavior: A Systematic Review. Brain Sci 2023; 13:brainsci13040584. [PMID: 37190549 DOI: 10.3390/brainsci13040584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
DNA methylation in genes of the hypothalamic–pituitary–adrenal (HPA) axis has been associated with suicide behavior. Through a systematic review, we aimed to evaluate DNA methylation levels of the genes involved in the HPA pathway and their association with suicide behavior. A search of articles was performed using PubMed and Science Direct, EBSCO. The terms included were “DNA methylation”, “suicide”, “epigenetics”, “HPA axis” and “suicide behavior”. This systematic review was performed by the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Six studies comprising 743 cases and 761 controls were included in this systematic review. The studies included individuals with suicide ideation, suicide attempts or completed suicide and childhood trauma, post-traumatic stress disorder (PTSD), or depression. One study reported hypermethylation in GR in childhood trauma, while two studies found hypermethylation of NR3C1 in childhood trauma and major depressive disorder (MDD). Only one study reported hypermethylation in BNDF in people with MDD. FKBP5 was found to be hypermethylated in people with MDD. Another study reported hypermethylation in CRHBP. SKA2 was reported to be hypermethylated in one study and another study found hypomethylated both in populations with PTSD. CRHR1 was found to be hypermethylated in people with MDD, and the last study found hypomethylation in CRH. Our result showed that patients with suicidal behavior showed a DNA methylation state of genes of the HPA axis in association with psychiatric comorbidity and with adverse events. Genes of the HPA axis could play a role in suicidal behavior associated with adverse events and pathologies. As a result, DNA methylation levels, proteins, and genes involved in the HPA axis could be considered for the search for biomarkers for the prevention of suicidal behavior in future studies.
Collapse
|
12
|
Bajaj S, Blair KS, Dobbertin M, Patil KR, Tyler PM, Ringle JL, Bashford-Largo J, Mathur A, Elowsky J, Dominguez A, Schmaal L, Blair RJR. Machine learning based identification of structural brain alterations underlying suicide risk in adolescents. DISCOVER MENTAL HEALTH 2023; 3:6. [PMID: 37861863 PMCID: PMC10501026 DOI: 10.1007/s44192-023-00033-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 10/21/2023]
Abstract
Suicide is the third leading cause of death for individuals between 15 and 19 years of age. The high suicide mortality rate and limited prior success in identifying neuroimaging biomarkers indicate that it is crucial to improve the accuracy of clinical neural signatures underlying suicide risk. The current study implements machine-learning (ML) algorithms to examine structural brain alterations in adolescents that can discriminate individuals with suicide risk from typically developing (TD) adolescents at the individual level. Structural MRI data were collected from 79 adolescents who demonstrated clinical levels of suicide risk and 79 demographically matched TD adolescents. Region-specific cortical/subcortical volume (CV/SCV) was evaluated following whole-brain parcellation into 1000 cortical and 12 subcortical regions. CV/SCV parameters were used as inputs for feature selection and three ML algorithms (i.e., support vector machine [SVM], K-nearest neighbors, and ensemble) to classify adolescents at suicide risk from TD adolescents. The highest classification accuracy of 74.79% (with sensitivity = 75.90%, specificity = 74.07%, and area under the receiver operating characteristic curve = 87.18%) was obtained for CV/SCV data using the SVM classifier. Identified bilateral regions that contributed to the classification mainly included reduced CV within the frontal and temporal cortices but increased volume within the cuneus/precuneus for adolescents at suicide risk relative to TD adolescents. The current data demonstrate an unbiased region-specific ML framework to effectively assess the structural biomarkers of suicide risk. Future studies with larger sample sizes and the inclusion of clinical controls and independent validation data sets are needed to confirm our findings.
Collapse
Affiliation(s)
- Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA.
| | - Karina S Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
- Child and Adolescent Psychiatric Inpatient Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Kaustubh R Patil
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Patrick M Tyler
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jay L Ringle
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Johannah Bashford-Largo
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
- Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Avantika Mathur
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Jaimie Elowsky
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Ahria Dominguez
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Lianne Schmaal
- Center for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, Australia
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| |
Collapse
|
13
|
Zanghì E, Corallo F, Lo Buono V. Diffusion tensor imaging studies on subjects with suicidal thoughts and behaviors: A descriptive literature review. Brain Behav 2022; 12:e2711. [PMID: 35943210 PMCID: PMC9480894 DOI: 10.1002/brb3.2711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/02/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Globally, suicide represents the second leading cause of death in young people aged 15-29 years for both sexes, after traffic accidents. Suicide occurs not only in high-income countries, in high-income countries but it is a global phenomenon in all regions of the world and it represents a serious public health problem. METHOD This review was conducted on studies focused on white matter alterations in people who have attempted or thought about suicide. We searched PubMed and Scopus databases and screened references of included studies and reviewed articles for additional citations. From the initial 21 publications, we included only 12 studies that met search criteria and described the association between white matter alterations and suicide. RESULTS White matter alterations in suicidal behaviors were found in the prefrontal cortex, orbitofrontal cortex, internal capsule, corpus callosum, and default mode networks, which are critical cerebral areas involved in emotion processing and regulation, decision-making, executive functions, and empathy. CONCLUSIONS White matter alteration in cerebral areas involving high cognitive process and emotional regulation to confer a heightened vulnerability for suicidal behavior. Suicide is a complex process ranging from suicidal ideation to planning, attempting, or committing suicide. The identification of abnormalities in underlying neural circuitry may help delineate the neurobiological basis for suicide risk.
Collapse
|
14
|
Walling MA. Suicide Contagion. CURRENT TRAUMA REPORTS 2021; 7:103-114. [PMID: 34931156 PMCID: PMC8674834 DOI: 10.1007/s40719-021-00219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE OF REVIEW Suicide is a serious healthcare concern worldwide. In the USA, suicide was the tenth leading cause of death prior to 2020 when it was displaced as a result of the death toll from COVID-19. RECENT FINDINGS Suicide behavior is the result of the interaction between the individual's predisposing factors and precipitating factors. A recognized precipitating factor is the knowledge of the suicidal act of another, termed suicide contagion. Another precipitating factor is the physiological impact of an acute inflammatory response to disease, for example that seen in patients with COVID-19. SUMMARY Risk identification of persons at increased risk for suicidal actions is an essential goal in medical care so that protective measures can be employed to prevent suicide.
Collapse
|
15
|
Overs BJ, Roberts G, Ridgway K, Toma C, Hadzi-Pavlovic D, Wilcox HC, Hulvershorn LA, Nurnberger JI, Schofield PR, Mitchell PB, Fullerton JM. Effects of polygenic risk for suicide attempt and risky behavior on brain structure in young people with familial risk of bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2021; 186:485-507. [PMID: 34726322 DOI: 10.1002/ajmg.b.32879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/27/2021] [Accepted: 10/11/2021] [Indexed: 01/11/2023]
Abstract
Bipolar disorder (BD) is associated with a 20-30-fold increased suicide risk compared to the general population. First-degree relatives of BD patients show inflated rates of psychopathology including suicidal behaviors. As reliable biomarkers of suicide attempts (SA) are lacking, we examined associations between suicide-related polygenic risk scores (PRSs)-a quantitative index of genomic risk-and variability in brain structures implicated in SA. Participants (n = 206; aged 12-30 years) were unrelated individuals of European ancestry and comprised three groups: 41 BD cases, 96 BD relatives ("high risk"), and 69 controls. Genotyping employed PsychArray, followed by imputation. Three PRSs were computed using genome-wide association data for SA in BD (SA-in-BD), SA in major depressive disorder (SA-in-MDD) (Mullins et al., 2019, The American Journal of Psychiatry, 176(8), 651-660), and risky behavior (Karlsson Linnér et al., 2019, Nature Genetics, 51(2), 245-257). Structural magnetic resonance imaging processing employed FreeSurfer v5.3.0. General linear models were constructed using 32 regions-of-interest identified from suicide neuroimaging literature, with false-discovery-rate correction. SA-in-MDD and SA-in-BD PRSs negatively predicted parahippocampal thickness, with the latter association modified by group membership. SA-in-BD and Risky Behavior PRSs inversely predicted rostral and caudal anterior cingulate structure, respectively, with the latter effect driven by the "high risk" group. SA-in-MDD and SA-in-BD PRSs positively predicted cuneus structure, irrespective of group. This study demonstrated associations between PRSs for suicide-related phenotypes and structural variability in brain regions implicated in SA. Future exploration of extended PRSs, in conjunction with a range of biological, phenotypic, environmental, and experiential data in high risk populations, may inform predictive models for suicidal behaviors.
Collapse
Affiliation(s)
- Bronwyn J Overs
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Kate Ridgway
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Claudio Toma
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid, Spain
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Holly C Wilcox
- Child Psychiatry and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Leslie A Hulvershorn
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John I Nurnberger
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia
| |
Collapse
|
16
|
Liu Y, Wang S, Xue C, Hu X, Zhou G, Zhou Y, Fang D, Ding K. An Exploratory Cohort Study of the Association between the Level of Testosterone and Suicidal Ideation in Hospitalized Adolescent Females with Depression in China. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:3529147. [PMID: 34745279 PMCID: PMC8566051 DOI: 10.1155/2021/3529147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND To date, around 4 per 100,000 adolescents committed suicide within the 29 OECD countries. The suicidal behavior is related to psychological factors, genetics, neurobiology, and other biomarkers. The aim of this study was to examine risk factors for the development of suicidal ideation in adolescent females with depression, focusing on the relationship between different testosterone levels and suicidal ideation, in order to help develop strategies to intervene in suicidal behavior in female adolescents with depression. METHOD In this single-center prospective cohort study, we enrolled adolescent females with depression. We collected information on their baseline data, testosterone levels, symptom self-rating scale scores, suicidal ideation, non-suicidal self-injurious (NSSI) behaviours, and suicide attempts. We used multivariate logistic regression to identify risk factors for the development of suicidal ideation in adolescent females with depression. RESULTS A total of 113 hospitalized adolescent females were enrolled with a mean age of 13.5 (1.20). Among these patients, there were 86 (76.11%) subjects who suffered from suicidal ideation, 59 (52.21%) had NSSI and 23 (20.35%) had suicide attempt behavior. In the final model, higher level of testosterone (p=0.04) and higher age (p=0.02) were associated with the higher odds of having suicidal ideation. CONCLUSION In this exploratory cohort study, the emergence of suicidal ideation was common among adolescent females with depression. This study is consistent with the other studies. It shows that the age is a potential predictor for suicidal ideation in hospitalized adolescent females with depression.
Collapse
Affiliation(s)
- Yan Liu
- Department of Child and Adolescent Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Shaohua Wang
- Department of Child and Adolescent Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Chuang Xue
- Division of Psychological Evaluation, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Xiwen Hu
- Division of Depressive Disorder, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Guoling Zhou
- Department of Child and Adolescent Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Yuanyue Zhou
- Department of Child and Adolescent Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Dan Fang
- Department of Clinical Laboratory, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Kaijing Ding
- Department of Child and Adolescent Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| |
Collapse
|
17
|
Stumps A, Jagger-Rickels A, Rothlein D, Amick M, Park H, Evans T, Fortenbaugh FC, Fortier CB, Fonda JR, Lee D, Milberg W, McGlinchey R, DeGutis J, Esterman M. Connectome-based functional connectivity markers of suicide attempt. J Affect Disord 2021; 283:430-440. [PMID: 33549365 DOI: 10.1016/j.jad.2020.11.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/23/2020] [Accepted: 11/08/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Functional brain markers of suicidality can help identify at-risk individuals and uncover underlying neurocognitive mechanism(s). Although some converging evidence has implicated dysfunction in several brain networks, suicide-related neuroimaging markers are inconsistent across studies, due to heterogeneity of neuroimaging approaches, clinical populations, and experimental methods. METHODS The current study aimed to address these limitations by examining resting-fMRI connectivity in a sample of post-9/11 veterans with a past suicide attempt (SA; n = 16) compared to a psychiatric control group (PC; n = 124) with no SA history but comparable past and present symptomatology, as well as a trauma control group (TC; n = 66) of trauma-exposed healthy controls. We used both a novel graph-analytic and seed-based approach to characterize SA-related connectivity differences across brain networks. RESULTS First, the graph-analytic approach identified the right amygdala and a region in the cognitive control network (right middle temporal gyrus; MTG) as regional SA-related hubs of dysfunction (HoD), or regions that exhibited a high number of SA-related connections. Aberrant SA-related connectivity between these hubs spanned multiple networks, including the cognitive control, default mode and visual networks. Second, the seed-based connectivity analysis that identifies SA-related differences in the strength of neural connections across the whole brain further implicated the right amygdala. LIMITATIONS Small sample size and potential underreporting of SA. CONCLUSIONS These two analytic approaches preliminarily suggest that the right amygdala and right MTG may be specific neural markers of SA that can be differentiated from neural markers of psychopathology more broadly.
Collapse
Affiliation(s)
- Anna Stumps
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Audreyana Jagger-Rickels
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA
| | - David Rothlein
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA
| | - Melissa Amick
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Hannah Park
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Travis Evans
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Francesca C Fortenbaugh
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Jennifer R Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Daniel Lee
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - William Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Regina McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Joseph DeGutis
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Michael Esterman
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, 02130, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA 02130, USA; Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA; Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA.
| |
Collapse
|
18
|
Serafini G, Canepa G, Aguglia A, Amerio A, Bianchi D, Magnani L, Dell'Osso B, Pompili M, Fitzgerald PB, Amore M. Effects of repetitive transcranial magnetic stimulation on suicidal behavior: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:109981. [PMID: 32485190 DOI: 10.1016/j.pnpbp.2020.109981] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 01/29/2023]
Abstract
The efficacy and tolerability of repetitive transcranial magnetic stimulation (rTMS) in major depression is well-known and documented by existing studies. However, whether rTMS may be effective on suicidal behavior is unclear and needs to be further investigated. This systematic review is aimed to investigate the available literature about the effects of rTMS on suicidal behavior and provide a comprehensive overview of the available evidence. A systematic search regarding the association between rTMS and suicidal behavior was carried out. All relevant articles concerning this association were comprehensively searched on PubMed, Scopus, Science Direct, and PsycInfo databases. After a careful search, 16 articles (7 sham-controlled studies, 5 uncontrolled studies, 4 case-series) met inclusion criteria and were selected in this systematic review. Overall, the left dorsolateral prefrontal cortex (DLPFC) was identified as the most frequent stimulation target by most studies. Unfortunately, actually it is not clear whether suicidal behavior reduction may be mediated, at least in some cases, by depression attenuation. While some methodological heterogeneity was found in terms of stimulation parameters (e.g., frequency, number of sessions, intensity of stimulation), most of the analyzed articles showed that rTMS is a safe, applicable, well tolerated and reproducible method in treating suicidal behavior. The most effective treatment seems to be the bilateral rTMS as well as the combination with antidepressants. Further longitudinal studies are required in order to replicate the mentioned study results.
Collapse
Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Giovanna Canepa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA 02111, USA
| | - Davide Bianchi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Magnani
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA; CRC "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy; Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant'Andrea Hospital, University of Rome, Rome, Italy
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash Universitty Department of Psychiatry, Camberwell, VIC, Australia
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| |
Collapse
|
19
|
Zhao Y, Wang L, Edmiston EK, Womer FY, Jiang X, Wu F, Kong L, Zhou Y, Wang F, Tang Y, Wei S. Alterations in gray matter volumes and intrinsic activity in the prefrontal cortex are associated with suicide attempts in patients with bipolar disorder. Psychiatry Res Neuroimaging 2021; 307:111229. [PMID: 33242746 DOI: 10.1016/j.pscychresns.2020.111229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/13/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is associated with increased suicidal behavior. Understanding the neural features of suicide attempts (SA) in patients with BD is critical to preventing suicidal behavior. The prefrontal cortex (PFC) is a key region related to SA. In this study, forty BD patients with a history of SA (BD+SA), 70 BD patients without a history of SA (BD-SA), and 110 individuals in a healthy control (HC) group underwent structural magnetic resonance imaging (MRI) and resting-state functional MRI. We used voxel-based morphometry (VBM) and amplitude of low frequency fluctuations (ALFF) techniques to examine the gray matter volumes (GMVs) and ALFF values in the PFC. Compared with the HC group, both the BD+SA and BD-SA groups had lower GMVs and higher ALFF values in the medial PFC (MPFC), ventral PFC (VPFC), and dorsolateral PFC (DLPFC). The ALFF values in the MPFC, VPFC, and DLPFC in the BD+SA group were significantly higher than those in the BD-SA group. These findings suggest that BD patients with SA have intrinsic activity abnormalities in PFC regions. This provides potentially identifiable neuroimaging markers in BD patients with SA that could be used to increase our understanding of suicidal behavior.
Collapse
Affiliation(s)
- Yimeng Zhao
- Department of Psychiatry, China Medical University, Shenyang, Liaoning, China; Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Lifei Wang
- Department of Psychiatry, China Medical University, Shenyang, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Elliot K Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Feng Wu
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Yifang Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Fei Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China
| | - Yanqing Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China.
| | - Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang, 110001, Liaoning, China.
| |
Collapse
|
20
|
Ho TC, Teresib GI, Ojhac A, Walker JC, Kirshenbaum JS, Singh MK, Gotlib IH. Smaller caudate gray matter volume is associated with greater implicit suicidal ideation in depressed adolescents. J Affect Disord 2021; 278:650-657. [PMID: 33039875 PMCID: PMC9386733 DOI: 10.1016/j.jad.2020.09.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/13/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Objective biomarkers of cognitive vulnerabilities related to suicidal ideation (SI) may assist in early prevention in adolescents. Previously, we found that smaller gray matter volumes (GMVs) of the dorsal striatum prospectively predicted implicit SI, measured using a computerized implicit association test (IAT) assessing associations between "self" and "death," in a community sample of adolescents. Here, we sought to replicate these findings in an independent sample of depressed adolescents. METHODS 53 depressed adolescents who varied in severity of suicidal thoughts and behaviors completed high-resolution structural MRI. Caudate, putamen, and nucleus accumbens GMVs were estimated using FreeSurfer 6.0. Robust linear regressions were used to examine associations between striatal GMVs and implicit and explicit SI, covarying for sex, age, total intracranial volume, medication use, and depression severity. Significance was determined using Bonferroni correction. Finally, LASSO regression was used to identify which striatal GMV contributed most to prediction of implicit SI. RESULTS Smaller bilateral caudate and right nucleus accumbens GMVs were associated with higher IAT scores (all ps<0.001). Smaller putamen and nucleus accumbens GMVs were not associated with implicit or explicit SI. Our LASSO analysis indicated that right caudate GMV contributed most to the prediction of IAT scores. CONCLUSIONS This study is the first to demonstrate that caudate GMVs are significantly associated with implicit self-associations with death in a sample of depressed adolescents. When considered with our previous work, smaller caudate GMVs may be a robust biomarker of implicit SI in adolescents, with clinical implications for early identification of youth at risk for engaging in suicidal behaviors.
Collapse
Affiliation(s)
- Tiffany C. Ho
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA,Corresponding author.
| | | | - Amar Ojhac
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Manpreet K. Singh
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University, Stanford, CA
| |
Collapse
|
21
|
Stange JP, Jenkins LM, Pocius S, Kreutzer K, Bessette KL, DelDonno SR, Kling LR, Bhaumik R, Welsh RC, Keilp JG, Phan KL, Langenecker SA. Using resting-state intrinsic network connectivity to identify suicide risk in mood disorders. Psychol Med 2020; 50:2324-2334. [PMID: 31597581 PMCID: PMC7368462 DOI: 10.1017/s0033291719002356] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the neural substrates of suicide risk in mood disorders. Improving the identification of biomarkers of suicide risk, as indicated by a history of suicide-related behavior (SB), could lead to more targeted treatments to reduce risk. METHODS Participants were 18 young adults with a mood disorder with a history of SB (as indicated by endorsing a past suicide attempt), 60 with a mood disorder with a history of suicidal ideation (SI) but not SB, 52 with a mood disorder with no history of SI or SB (MD), and 82 healthy comparison participants (HC). Resting-state functional connectivity within and between intrinsic neural networks, including cognitive control network (CCN), salience and emotion network (SEN), and default mode network (DMN), was compared between groups. RESULTS Several fronto-parietal regions (k > 57, p < 0.005) were identified in which individuals with SB demonstrated distinct patterns of connectivity within (in the CCN) and across networks (CCN-SEN and CCN-DMN). Connectivity with some of these same regions also distinguished the SB group when participants were re-scanned after 1-4 months. Extracted data defined SB group membership with good accuracy, sensitivity, and specificity (79-88%). CONCLUSIONS These results suggest that individuals with a history of SB in the context of mood disorders may show reliably distinct patterns of intrinsic network connectivity, even when compared to those with mood disorders without SB. Resting-state fMRI is a promising tool for identifying subtypes of patients with mood disorders who may be at risk for suicidal behavior.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Runa Bhaumik
- University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - K. Luan Phan
- University of Illinois at Chicago, Chicago, IL, USA
| | | |
Collapse
|
22
|
Aberrant functional connectivity and graph properties in bipolar II disorder with suicide attempts. J Affect Disord 2020; 275:202-209. [PMID: 32734909 DOI: 10.1016/j.jad.2020.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/10/2020] [Accepted: 07/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The physiological mechanism of suicide attempt (SA) in bipolar II disorder (BD-II) remains only partially understood. The study seeks to identify the dysfunction pattern in suicide brain for BD-II patients. METHODS Graph theory was utilized to explore topological properties at whole-brain, module and region levels based on resting-state functional MRI (rs-fMRI) data, which acquired from 38 un-medicated BD-II patients with at least one SA, 60 none SA (NSA) patients and 69 healthy controls (HCs). Finally, the correlation relationship between graph metrics and clinical variables were estimated. RESULTS Compared with NSA patients and HCs, the functional connectivity strength between limbic/sub-cortical (LIMB/SubC) and frontoparietal network (FPN) were significantly weakened. Nodal strength in left head of caudate nucleus (HCN), raphe nucleus (RN), right nucleus accumbens (NAcc), right subgenual anterior cingulate cortex (sgACC) and nodal efficiency in right sgACC, right HCN for SA patients were significantly reduced relative to NSA and HCs. In particular, nodal strength in RN and nodal efficiency in right sgACC showed a significant negative correlation with Nurses' Global Assessment of Suicide Risk (NGASR) scores. LIMITATIONS This is a single-mode cross-sectional study, the results were not verified by multi-center data. CONCLUSIONS The abnormal disrupted FC between LIMB/SubC and FPN is associated with SA in BD-II patients, which increased the susceptibility of suicide. Especially, the dysfunction in RN and right sgACC predict a higher suicide risk in BD-II patients.The results can help us to understand the suicide mechanism and early judgment of suicidal behaviors for BD-II patients.
Collapse
|
23
|
Brain grey matter abnormalities in first episode non-affective psychosis patients with suicidal behaviours: The role of neurocognitive functioning. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109948. [PMID: 32305356 DOI: 10.1016/j.pnpbp.2020.109948] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of premature death in first-episode psychosis (FEP) patients. The understanding of suicidal behaviour (SB) is limited, and new and integrative approaches focusing on the likely relationship of the biological and cognitive features of SB in the early phases of psychosis are warranted. We aimed to study the relationship of brain grey matter anomalies and cognitive functioning with SB or suicidal risk in a large sample of non-affective FEP patients. METHODS We used a voxel-based morphometry analysis in 145 FEP patients to investigate the pattern of structural brain abnormalities related to SB. In addition, bivariate and multivariate analyses were performed to explore the relationship between cognitive functioning and SB. RESULTS A reduction in grey matter volume in the frontal area, temporal gyrus, precuneus, uncus, amygdala, left cuneus and subcallosal gyrus as well as a marked regional volume reduction in the right hemisphere was linked with the presence of SB. Additionally, worse global cognitive functioning and living in urban areas were identified as suicide risk factors. CONCLUSIONS This study provides some insights about the brain abnormalities associated with SB in FEP patients. Specifically, the areas reported are involved in important functions related to SB, such as impulsivity, problem solving or responses to pain. Thus, the results confirm the relevant role of cognitive functioning on SB.
Collapse
|
24
|
Biological Targets Underlying the Antisuicidal Effects of Lithium. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
|
25
|
Schmaal L, Pozzi E, C Ho T, van Velzen LS, Veer IM, Opel N, Van Someren EJW, Han LKM, Aftanas L, Aleman A, Baune BT, Berger K, Blanken TF, Capitão L, Couvy-Duchesne B, R Cullen K, Dannlowski U, Davey C, Erwin-Grabner T, Evans J, Frodl T, Fu CHY, Godlewska B, Gotlib IH, Goya-Maldonado R, Grabe HJ, Groenewold NA, Grotegerd D, Gruber O, Gutman BA, Hall GB, Harrison BJ, Hatton SN, Hermesdorf M, Hickie IB, Hilland E, Irungu B, Jonassen R, Kelly S, Kircher T, Klimes-Dougan B, Krug A, Landrø NI, Lagopoulos J, Leerssen J, Li M, Linden DEJ, MacMaster FP, M McIntosh A, Mehler DMA, Nenadić I, Penninx BWJH, Portella MJ, Reneman L, Rentería ME, Sacchet MD, G Sämann P, Schrantee A, Sim K, Soares JC, Stein DJ, Tozzi L, van Der Wee NJA, van Tol MJ, Vermeiren R, Vives-Gilabert Y, Walter H, Walter M, Whalley HC, Wittfeld K, Whittle S, Wright MJ, Yang TT, Zarate C, Thomopoulos SI, Jahanshad N, Thompson PM, Veltman DJ. ENIGMA MDD: seven years of global neuroimaging studies of major depression through worldwide data sharing. Transl Psychiatry 2020; 10:172. [PMID: 32472038 PMCID: PMC7260219 DOI: 10.1038/s41398-020-0842-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/09/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023] Open
Abstract
A key objective in the field of translational psychiatry over the past few decades has been to identify the brain correlates of major depressive disorder (MDD). Identifying measurable indicators of brain processes associated with MDD could facilitate the detection of individuals at risk, and the development of novel treatments, the monitoring of treatment effects, and predicting who might benefit most from treatments that target specific brain mechanisms. However, despite intensive neuroimaging research towards this effort, underpowered studies and a lack of reproducible findings have hindered progress. Here, we discuss the work of the ENIGMA Major Depressive Disorder (MDD) Consortium, which was established to address issues of poor replication, unreliable results, and overestimation of effect sizes in previous studies. The ENIGMA MDD Consortium currently includes data from 45 MDD study cohorts from 14 countries across six continents. The primary aim of ENIGMA MDD is to identify structural and functional brain alterations associated with MDD that can be reliably detected and replicated across cohorts worldwide. A secondary goal is to investigate how demographic, genetic, clinical, psychological, and environmental factors affect these associations. In this review, we summarize findings of the ENIGMA MDD disease working group to date and discuss future directions. We also highlight the challenges and benefits of large-scale data sharing for mental health research.
Collapse
Affiliation(s)
- Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Elena Pozzi
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Tiffany C Ho
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
- Department of Psychiatry & Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Laura S van Velzen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ilya M Veer
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Laura K M Han
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lybomir Aftanas
- FSSBI Scientific Research Institute of Physiology & Basic Medicine, Laboratory of Affective, Cognitive & Translational Neuroscience, Novosibirsk, Russia
- Department of Neuroscience, Novosibirsk State University, Novosibirsk, Russia
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Tessa F Blanken
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands
| | - Liliana Capitão
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Kathryn R Cullen
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Christopher Davey
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), University Medical Center Göttingen, Göttingen, Germany
| | - Jennifer Evans
- Experimental Therapeutics Branch, NIMH, NIH, Bethesda, MD, USA
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Cynthia H Y Fu
- School of Psychology, University of East London, London, UK
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), University Medical Center Göttingen, Göttingen, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Nynke A Groenewold
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Geoffrey B Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Sean N Hatton
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Eva Hilland
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Benson Irungu
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rune Jonassen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Sinead Kelly
- Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | | | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - David E J Linden
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- MRC Center for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK
| | - Frank P MacMaster
- Psychiatry and Pediatrics, University of Calgary, Addictions and Mental Health Strategic Clinical Network, Calgary, AB, Canada
| | - Andrew M McIntosh
- Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - David M A Mehler
- Department of Psychiatry, University of Münster, Münster, Germany
- MRC Center for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Marburg University Hospital UKGM, Marburg, Germany
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maria J Portella
- Institut d'Investigació Biomèdica-Sant Pau, Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, location AMC, Amsterdam UMC, Amsterdam, The Netherlands
| | - Miguel E Rentería
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Matthew D Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, location AMC, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kang Sim
- West Region/Institute of Mental Health, Singapore, Singapore
- Yong Loo Lin School of Medicine/National University of Singapore, Singapore, Singapore
| | - Jair C Soares
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dan J Stein
- SA MRC Research Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Leonardo Tozzi
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Nic J A van Der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-José van Tol
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert Vermeiren
- Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena, Germany
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Heather C Whalley
- Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Tony T Yang
- Department of Psychiatry & Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Carlos Zarate
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, Bethesda, MD, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| |
Collapse
|
26
|
Averill LA, Fouda S, Murrough JW, Abdallah CG. Chronic stress pathology and ketamine-induced alterations in functional connectivity in major depressive disorder: An abridged review of the clinical evidence. ADVANCES IN PHARMACOLOGY 2020; 89:163-194. [PMID: 32616206 DOI: 10.1016/bs.apha.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A paradigm shift in the conceptualization of the neurobiology of depression and the serendipitous discovery of ketamine's rapid-acting antidepressant (RAAD) effects has ushered in a new era of innovative research and novel drug development. Since the initial discovery of ketamine's RAAD effects, multiple studies have supported its short-term efficacy for fast-tracked improvements in treatment-resistant depression. Evidence from MRI studies have repeatedly demonstrated functional connectivity alterations in stress- and trauma-related disorders suggesting this may be a viable biomarker of chronic stress pathology (CSP). Human mechanistic studies further support this by coupling functional connectivity to ketamine's RAAD effects including connectivity to glutamate neurotransmission, ketamine to normalized connectivity, and these advantageous normalizations to symptom improvement/ketamine response. This review provides an abridged discussion of the suspected neurobiological underpinnings of ketamine's RAAD effects, highlighting ketamine-induced alterations in prefrontal, striatal, and anterior cingulate cortex functional connectivity in major depressive disorder. We present a model of CSP underscoring the role of synaptic loss and dysconnectivity and discuss how ketamine may be used both as (1) a treatment to restore and normalize these stress-induced neural alterations and (2) a tool to study potential biomarkers of CSP and treatment response. We conclude by noting challenges and future directions including heterogeneity, sex differences, the role of early life stress, and the need for proliferation of new methods, paradigms, and tools that will optimize signal and allow analyses at different levels of complexity, according to the needs of the question at hand, perhaps by thinking hierarchically about both clinical and biological phenotypes.
Collapse
Affiliation(s)
- Lynnette A Averill
- Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
| | - Samar Fouda
- Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - James W Murrough
- Department of Psychiatry, Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine of Mount Sinai, New York, NY, United States; Department of Neuroscience, Icahn School of Medicine of Mount Sinai, New York, NY, United States
| | - Chadi G Abdallah
- Clinical Neurosciences Division, US Department of Veterans Affairs, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
27
|
Cabrera-Mendoza B, Fresno C, Monroy-Jaramillo N, Fries GR, Walss-Bass C, Glahn DC, Ostrosky-Wegman P, Mendoza-Morales RC, García-Dolores F, Díaz-Otañez CE, González-Sáenz EE, Genis-Mendoza AD, Martínez-Magaña JJ, Romero-Pimentel AL, Flores G, Vázquez-Roque RA, Nicolini H. Sex differences in brain gene expression among suicide completers. J Affect Disord 2020; 267:67-77. [PMID: 32063575 DOI: 10.1016/j.jad.2020.01.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/23/2019] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide rates vary substantially by sex. Suicides committed by males significantly outnumber female suicides. Disparities in community and social factors provide a partial explanation for this phenomenon. Thus, the evaluation of sex differences at a biological level might contribute to the elucidation of the factors involved in this imbalance. The aim of the present study was to evaluate sex-specific gene expression patterns in the suicidal brain. METHODS postmortem samples from the dorsolateral prefrontal cortex (DLPFC) of 75 Latino individuals were analyzed. We considered the following groups: i) male suicides (n = 38), ii) female suicides (n = 10), iii) male controls (n = 20), and iv) female controls (n = 7). Gene expression profiles were evaluated by microarrays. Differentially expressed genes among the groups were identified with a linear model. Similarities and differences in the gene sets between the sexes were identified. RESULTS Differentially expressed genes were identified between suicides and controls of each sex: 1,729 genes in females and 1,997 genes in males. Female-exclusive suicide genes were related to cell proliferation and immune response. Meanwhile, male-exclusive suicide genes were associated to DNA binding and ribonucleic protein complex. Sex-independent suicide genes showed enrichment in mitochondrial and vesicular functions. LIMITATIONS Relatively small sample size. Our diagnosis approach was limited to information found on coroner's records. The analysis was limited to a single brain area (DLPFC) and we used microarrays. CONCLUSION Previously unexplored sex differences in the brain gene expression of suicide completers were identified, providing valuable foundation for the evaluation of sex-specific factors in suicide.
Collapse
Affiliation(s)
- Brenda Cabrera-Mendoza
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico; PECEM, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Cristóbal Fresno
- Technological Development Department, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Nancy Monroy-Jaramillo
- Department of Genetics, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Gabriel Rodrigo Fries
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, United States
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, United States
| | - David C Glahn
- Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | | | | | | | | | | | - Alma Delia Genis-Mendoza
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - José Jaime Martínez-Magaña
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Ana Luisa Romero-Pimentel
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Gonzalo Flores
- Neuropsychiatry Laboratory, Institute of Physiology, Meritorious Autonomous University of Puebla, Mexico City, Mexico
| | - Rubén Antonio Vázquez-Roque
- Neuropsychiatry Laboratory, Institute of Physiology, Meritorious Autonomous University of Puebla, Mexico City, Mexico
| | - Humberto Nicolini
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico.
| |
Collapse
|
28
|
Chattun MR, Zhang S, Chen Y, Wang Q, Amdanee N, Tian S, Lu Q, Yao Z. Caudothalamic dysfunction in drug-free suicidally depressed patients: an MEG study. Eur Arch Psychiatry Clin Neurosci 2020; 270:217-227. [PMID: 30552507 DOI: 10.1007/s00406-018-0968-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 12/06/2018] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD), characterized by low mood or anhedonia, is commonly associated with a greater suicidal susceptibility. There are numerous suicide-related findings pertaining to the dorsolateral prefrontal cortex (DLPFC), caudate nucleus and thalamus, which form a cortico-striato-thalamo-cortical (CSTC) circuit responsible for executive function and working memory. An aberrant CSTC circuitry is hypothesized to be implicated in depressed patients with a high suicidal risk. 27 MDD patients were assessed with the Nurses Global Assessment of Suicide Risk (NGASR), following which 14 patients were classified into a high suicide risk group (NGASR ≥ 12) and 13 patients were assigned to a low suicide risk group (NGASR < 6). All 27 patients were enrolled with 25 healthy controls for resting-state magnetoencephalography (MEG). Cross-frequency coupling (CFC) measured the phase of alpha-band (8-13 Hz) as it modulated to cortical gamma-band (30-48 Hz). There was a significantly lower alpha-to-gamma phase-amplitude coupling (PAC) between the right caudate and left thalamus in high-risk suicide group compared to both the low-risk suicide group and healthy controls. The presence of a weaker coupling between the right caudate and left thalamus is indicative of a caudothalamic abnormality in suicidally depressed patients. This implies that a disruption of CSTC loop could result in executive dysfunction and working memory impairment, leading to an increased suicidal risk in MDD patients. In the future, this preliminary study has the possibility of being replicated on a larger scale, and hence validates caudothalamic dysfunction as a reliable neuroimaging biomarker for suicide in depression.
Collapse
Affiliation(s)
- Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China
| | - Siqi Zhang
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China
| | - Yu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China
| | - Qiang Wang
- Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing, 210093, China
| | - Nousayhah Amdanee
- Department of Geriatrics, Jiangsu Province Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, China
| | - Shui Tian
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China. .,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China.
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China. .,Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing, 210093, China.
| |
Collapse
|
29
|
Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, Fornaro M, Valchera A, Tomasetti C, Fraticelli S, Alessandrini M, La Rovere R, Trotta S, Martinotti G, Di Giannantonio M, De Berardis D. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investig 2020; 17:207-221. [PMID: 32209966 PMCID: PMC7113180 DOI: 10.30773/pi.2019.0171] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. METHODS A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of 'Major Depressive Disorder' and 'Suicide' as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. RESULTS Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. CONCLUSION The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.
Collapse
Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy.,Polyedra, Teramo, Italy
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Polyedra, Teramo, Italy.,Department of Psychiatry, Federico II University, Naples, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata" ASL 4, Giulianova, Italy
| | - Silvia Fraticelli
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Marco Alessandrini
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Raffaella La Rovere
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Sabatino Trotta
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy.,Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| |
Collapse
|
30
|
Ballard ED, Gilbert JR, Fields JS, Nugent AC, Zarate CA. Network Changes in Insula and Amygdala Connectivity Accompany Implicit Suicidal Associations. Front Psychiatry 2020; 11:577628. [PMID: 33192714 PMCID: PMC7543650 DOI: 10.3389/fpsyt.2020.577628] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/02/2020] [Indexed: 02/03/2023] Open
Abstract
Limited knowledge exists regarding the neurobiology of suicidal thoughts, given that there are currently no direct probes of the suicidal state. This pilot study used magnetoencephalography (MEG) to evaluate correlates of the implicit association between the self and death compared to the self and life as objective markers of suicide risk. Healthy volunteers (HVs; n=21) completed a modified version of the Suicide Implicit Association Task (S-IAT) during MEG scanning. Gamma power-which is considered a proxy measure of excitation-inhibition balance-was directly compared in the self-death/self-life contrast. As a proof-of-concept, the ability of dynamic causal modeling to categorize HVs versus four individuals with recent suicide crisis (SC) was evaluated. In HVs, enhanced gamma power in both amygdala and anterior insula were found for the self-death compared with self-life contrast. In addition, connectivity estimates between early visual cortex, anterior insula, and amygdala correctly categorized SC participants with 77% to 82% sensitivity and 80% to 85% specificity. These findings, which implicate network-level changes in salience network and amygdala connectivity in mediating suicidal associations, require further replication in larger samples. Direct probing of suicidal thoughts with the S-IAT may provide foundational markers of neural circuits associated with suicide risk.
Collapse
Affiliation(s)
- Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Jessica R Gilbert
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Jessica S Fields
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Allison C Nugent
- MEG Core Facility, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
31
|
Ballard ED, Reed JL, Szczepanik J, Evans JW, Yarrington JS, Dickstein DP, Nock MK, Nugent AC, Zarate CA. Functional Imaging of the Implicit Association of the Self With Life and Death. Suicide Life Threat Behav 2019; 49:1600-1608. [PMID: 30761601 PMCID: PMC6692253 DOI: 10.1111/sltb.12543] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A critical need exists to identify objective markers of suicide ideation. One potential suicide risk marker is the Suicide Implicit Association Task (S-IAT), a behavioral task that uses differential reaction times to compare the implicit association between the self and death to the implicit association between the self and life. Individuals with a stronger association between the self and death on the S-IAT are more likely to attempt suicide in the future. To better understand the neural underpinnings of the implicit association between self and either life or death, a functional magnetic resonance imaging (fMRI) version of the S-IAT was adapted and piloted in healthy volunteers. METHOD An fMRI version of the S-IAT was administered to 28 healthy volunteers (ages 18-65, 14F/14M). RESULTS Behavioral results were comparable to those seen in non-scanner versions of the task. The task was associated with patterns of neural activation in areas relevant to emotional processing, specifically the insula and right ventrolateral prefrontal cortex. CONCLUSIONS Performance on the S-IAT fMRI task may reflect scores obtained outside of the scanner. In future evaluations, this task could help assess whether individuals at increased risk of suicide display a different pattern of neural activation in response to self/death and self/life stimuli.
Collapse
Affiliation(s)
- Elizabeth D. Ballard
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Jessica L. Reed
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Joanna Szczepanik
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Jennifer W. Evans
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Julia S. Yarrington
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Daniel P. Dickstein
- PediMIND Program, Bradley Hospital, Division of Child/Adolescent Psychiatry, Brown University School of Medicine East Providence, RI
| | | | - Allison C. Nugent
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| | - Carlos A. Zarate
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, 20892
| |
Collapse
|
32
|
Bomyea J, Stout DM, Simmons AN. Attenuated prefrontal and temporal neural activity during working memory as a potential biomarker of suicidal ideation in veterans with PTSD. J Affect Disord 2019; 257:607-614. [PMID: 31349177 DOI: 10.1016/j.jad.2019.07.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/05/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Suicide is a significant health concern among veterans, and suicidal ideation is a common and functionally debilitating condition that frequently precedes suicidal behavior. Characterizing neurobiological substrates associated with suicidal ideation in veterans may inform evaluation of risk for this population. Associations between suicidal ideation and functional abnormalities in prefrontal, temporal, and striatal regions supporting cognitive task performance have been documented in individuals with mood and psychotic disorders, suggesting a potential role for neurocognitive vulnerabilities in this condition. To date, however, relatively little research has explored neural correlates of suicidal ideation, particularly among individuals with posttraumatic stress disorder (PTSD). METHODS Twenty three combat veterans diagnosed with PTSD completed an adapted Reading Span (Rspan) working memory task during functional magnetic resonance imaging (fMRI). Participants were classified based on presence of current SI. We evaluated differences between these groups on neural activation in response to interference-based working memory demands within the task. Primary analyses were conducted using a voxel-wise between-group t-test. RESULTS Task-based activations were observed in regions including the cingulate, middle frontal, parietal, and occipital cortex, striatum, and cerebellum. Relative to individuals without SI, individuals with SI demonstrated less activation in a large region spanning the lateral prefrontal cortex and cingulate cortex, as well as the inferior temporal cortex, in response to interference demands. CONCLUSIONS Results are consistent with models proposing that prefrontal neural substrates involved in cognitive regulation are implicated in suicidal ideation. Involvement of temporal functioning may also exist based on current findings. Future research is needed to understand whether disturbances in prefrontal regulatory control reflect a specific profile subtype with distinct neural correlates, and how such neural patterns may be used to improve detection and treatment personalization.
Collapse
Affiliation(s)
- J Bomyea
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States.
| | - D M Stout
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
| | - A N Simmons
- VA San Diego Healthcare System Center of Excellence for Stress and Mental Health, University of California, San Diego, United States
| |
Collapse
|
33
|
Chang C, Yeh M, Chien W, Chung C, Li T, Lai EC. Interactions between psychiatric and physical disorders and their effects on the risks of suicide: a nested case–control study. Ann N Y Acad Sci 2019; 1462:79-91. [DOI: 10.1111/nyas.14216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/24/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Ching‐Feng Chang
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Ming‐kung Yeh
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- School of Pharmacy, Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
| | - Wu‐Chien Chien
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Chi‐Hsiang Chung
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Tzu‐Ting Li
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Edward Chia‐Cheng Lai
- School of Pharmacy, College of Medicine, Institute of Clinical Pharmacy and Pharmaceutical SciencesNational Cheng Kung University Tainan Taiwan
- Department of PharmacyNational Cheng Kung University Hospital Tainan Taiwan
| |
Collapse
|
34
|
Santamarina-Perez P, Romero S, Mendez I, Leslie SM, Packer MM, Sugranyes G, Picado M, Font E, Moreno E, Martinez E, Morer A, Romero M, Singh MK. Fronto-Limbic Connectivity as a Predictor of Improvement in Nonsuicidal Self-Injury in Adolescents Following Psychotherapy. J Child Adolesc Psychopharmacol 2019; 29:456-465. [PMID: 31225733 DOI: 10.1089/cap.2018.0152] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Key neurobiological factors contribute to vulnerability to nonsuicidal self-injury (NSSI) among adolescents and how they respond to treatment targeted to reduce such behaviors. This study aims to examine differences in intrinsic functional connectivity between adolescents with NSSI and healthy controls (HCs) and to identify baseline connectivity markers that predict improvements in NSSI after psychotherapy. Methods: Adolescents aged 12-17 (n = 24) with repetitive NSSI along with demographically similar HCs (n = 16) underwent resting-state functional MRI scanning after which patients received up to 4 months of psychological treatment. A seed-based approach was used to examine baseline between-group differences in intrinsic functional connectivity of the amygdala and the medial prefrontal cortex (mPFC). Further analyses examined the associations between intrinsic functional connectivity at baseline and improvement in NSSI after psychological treatment. Results: Compared with HCs, adolescents with NSSI showed significantly reduced connectivity between the amygdala and the anterior cingulate cortex, subcallosal cortex, and paracingulate gyrus, as well as between the amygdala and a cluster encompassing the right planum temporale and right insula. Adolescents with NSSI, compared with HCs, also showed reduced connectivity between the mPFC and two clusters: one located in the precentral and postcentral gyri and another in the left insula. After treatment, 50% of patients reported fewer NSSI episodes compared to baseline, which was considered as improvement. Stronger negative amygdala-prefrontal connectivity was associated with greater posttreatment improvement in NSSI. Conclusions: Adolescents with NSSI may have aberrant amygdala and mPFC connectivity compared with HCs. Furthermore, stronger baseline negative amygdala-prefrontal connectivity may predict greater improvement in NSSI after psychological intervention. Given that no prior study has used resting-state functional connectivity to predict response to psychological treatment in adolescents with NSSI, replication of these findings is needed.
Collapse
Affiliation(s)
- Pilar Santamarina-Perez
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Soledad Romero
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
- 2Biomedical Research Networking Centre Consortium (CIBERSAM), Madrid, Spain
| | - Iria Mendez
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Sara M Leslie
- 3Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Mary M Packer
- 3Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Gisela Sugranyes
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
- 2Biomedical Research Networking Centre Consortium (CIBERSAM), Madrid, Spain
- 4August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Marisol Picado
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Elena Font
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Elena Moreno
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Esteve Martinez
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Astrid Morer
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
- 2Biomedical Research Networking Centre Consortium (CIBERSAM), Madrid, Spain
- 4August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Miguel Romero
- 1Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | - Manpreet K Singh
- 3Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
35
|
Davis MT, Hillmer A, Holmes SE, Pietrzak RH, DellaGioia N, Nabulsi N, Matuskey D, Angarita G, Carson RE, Krystal JH, Esterlis I. In vivo evidence for dysregulation of mGluR5 as a biomarker of suicidal ideation. Proc Natl Acad Sci U S A 2019; 116:11490-11495. [PMID: 31085640 PMCID: PMC6561298 DOI: 10.1073/pnas.1818871116] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Recent evidence implicates dysregulation of metabotropic glutamatergic receptor 5 (mGluR5) in pathophysiology of PTSD and suicidality. Using positron emission tomography and [18F]FPEB, we quantified mGluR5 availability in vivo in individuals with PTSD (n = 29) and MDD (n = 29) as a function of suicidal ideation (SI) to compare with that of healthy comparison controls (HC; n = 29). Volume of distribution was computed using a venous input function in the five key frontal and limbic brain regions. We observed significantly higher mGluR5 availability in PTSD compared with HC individuals in all regions of interest (P's = 0.001-0.01) and compared with MDD individuals in three regions (P's = 0.007). mGluR5 availability was not significantly different between MDD and HC individuals (P = 0.17). Importantly, we observed an up-regulation in mGluR5 availability in the PTSD-SI group (P's = 0.001-0.007) compared with PTSD individuals without SI. Findings point to the potential role for mGluR5 as a target for intervention and, potentially, suicide risk management in PTSD.
Collapse
Affiliation(s)
- Margaret T Davis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
| | - Ansel Hillmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520
| | - Sophie E Holmes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT 06516
| | - Nicole DellaGioia
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520
| | - David Matuskey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520
| | - Gustavo Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT 06516
| | - Irina Esterlis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511;
- Clinical Neurosciences Division, National Center for PTSD, US Department of Veterans Affairs, West Haven, CT 06516
| |
Collapse
|
36
|
Ho TC, Cichocki AC, Gifuni AJ, Catalina Camacho M, Ordaz SJ, Singh MK, Gotlib IH. Reduced dorsal striatal gray matter volume predicts implicit suicidal ideation in adolescents. Soc Cogn Affect Neurosci 2019; 13:1215-1224. [PMID: 30256980 PMCID: PMC6234322 DOI: 10.1093/scan/nsy089] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/23/2018] [Indexed: 11/20/2022] Open
Abstract
Suicidal ideation (SI), a potent risk factor for suicide attempts, increases in adolescence. While alterations in dopaminergic functioning have been implicated in suicidal acts—particularly in adults—we do not know whether morphological alterations in dopamine-rich regions of the brain, such as the striatum, are vulnerability factors for the emergence of SI in adolescents. At baseline, a community sample of 152 adolescents (89 female; mean age: 11.41 ± 1.01 years) completed a magnetic resonance imaging (MRI) scan that was used to estimate gray matter volumes (GMVs) of three striatal structures: caudate, nucleus accumbens and putamen. At a 24 month follow-up session, participants completed a self-report measure of SI frequency [Suicidal Ideation Questionnaire (SIQ)] and the death version of the Implicit Association Test (IAT). Robust linear regression models were conducted to predict SIQ and IAT scores from striatal GMV. Bilateral putamen and left caudate GMV significantly predicted IAT scores (all Ps < 0.03). No other associations were significant (all Ps > 0.05). Our finding of reduced dorsal striatal GMV predicting implicit SI may indicate that downstream dopaminergic dysfunction is implicated in the development of overt suicidal behaviors. Self-reported SI was not associated with striatal GMV, suggesting that biological correlates of suicide risk may correlate specifically with objective measurements of SI in adolescents.
Collapse
Affiliation(s)
- Tiffany C Ho
- Department of Psychology, Stanford University, Stanford, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Anna C Cichocki
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Anthony J Gifuni
- McGill University and Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | | | - Sarah J Ordaz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Manpreet K Singh
- University of Pittsburgh, Center for Neuroscience, Pittsburgh, PA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| |
Collapse
|
37
|
Abstract
Suicide morbidity and mortality are serious public health problems, accounting for over 40,000 deaths annually and over $10 billion in combined medical and work loss costs. Suicidal behavior is the outcome of a complex causal web of distal and proximal risk processes that includes a range of interacting environmental and biological determinants. We review current understanding of risk and protective factors, including recent findings on inflammatory processes, discuss recent research on environmental risks for suicidal behaviors with a focus on economic stress, and examine potential mechanisms by which external factors and internal processes such as inflammation might contribute to pathways leading to suicidal behavior. We propose a model that links changes in the default network or resting state of brain activity with corresponding changes in brain structure and function, which in turn may be influenced by diverse inflammatory mediators, and suggest a potential framework that highlights multidisciplinary opportunities for further research.
Collapse
|
38
|
Fan S, Lippard ET, Sankar A, Wallace A, Johnston JA, Wang F, Pittman B, Spencer L, Oquendo MA, Blumberg HP. Gray and white matter differences in adolescents and young adults with prior suicide attempts across bipolar and major depressive disorders. J Affect Disord 2019; 245:1089-1097. [PMID: 30699851 PMCID: PMC6903411 DOI: 10.1016/j.jad.2018.11.095] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/24/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Findings regarding brain circuitry abnormalities in suicide attempters (SAs) converge across bipolar disorder (BD) and major depressive disorder (MDD), the most common disorders observed in suicides. These abnormalities appear to be present during adolescence/young adulthood when suicide rates increase steeply, and suicide is a leading cause of death in this age group. Identification of brain circuitry common to adolescent/young adult SAs with BD and MDD is important for generating widely effective early prevention strategies. We examined brain circuitry in SAs in adolescents/young adults across these two disorders. METHODS Eighty-three participants (ages 14-25 years), 46 with BD (21 SAs) and 37 with MDD (19 SAs), underwent structural and diffusion-weighted magnetic resonance scanning. Whole-brain analyses compared gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) between SAs and non-suicide attempters (NSAs) across and within BD and MDD (p < 0.005). RESULTS Across and within BD and MDD, SAs showed differences compared to NSAs in ventral prefrontal cortex (PFC) GM volume and fronto-limbic (including uncinate fasciculus (UF)) WM FA. Exploratory analyses showed additional within-disorder differences for BD SAs in dorsolateral PFC (dlPFC) and hippocampus GM volume and UF FA, and for MDD SAs dorsomedial and dlPFC GM and dorsal frontal WM. However, there was no significant interaction between suicide attempt status and diagnosis. LIMITATIONS Modest sample size. CONCLUSIONS Common fronto-limbic gray and white matter alterations in adolescent/young adult SAs are potential targets for suicide prevention strategies across mood disorders. Preliminary findings of disorder-specific regional findings could suggest diagnostic-specific optimal targets may exist.
Collapse
Affiliation(s)
- Siyan Fan
- Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Elizabeth T.C. Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Amanda Wallace
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA; USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA,Department of Child Study Center, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
39
|
Preliminary examination of gray and white matter structure and longitudinal structural changes in frontal systems associated with future suicide attempts in adolescents and young adults with mood disorders. J Affect Disord 2019; 245:1139-1148. [PMID: 30699858 PMCID: PMC6487887 DOI: 10.1016/j.jad.2018.11.097] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mood disorders are major risk factors for suicidal behavior. While cross-sectional studies implicate frontal systems, data to aid prediction of suicide-related behavior in mood disorders are limited. Longitudinal research on neuroanatomical mechanisms underlying suicide risk may assist in developing targeted interventions. Therefore, we conducted a preliminary study investigating baseline gray and white matter structure and longitudinal structural changes associated with future suicide attempts. METHODS High-resolution structural magnetic resonance imaging, diffusion tensor imaging, and suicide-related behavioral assessment data for 46 adolescents and young adults with mood disorders [baseline agemean = 18 years; 61% female] were collected at baseline and at follow-up (intervalmean = 3 years). Differences in baseline and longitudinal changes in gray matter volume and white matter fractional anisotropy in frontal systems that distinguished the participants who made future attempts from those who did not were investigated. RESULTS Seventeen (37%) of participants attempted suicide within the follow-up period. Future attempters (those attempting suicide between their baseline and follow-up assessment), compared to those who did not, showed lower baseline ventral and rostral prefrontal gray matter volume and dorsomedial frontal, anterior limb of the internal capsule, and dorsal cingulum fractional anisotropy, as well as greater decreases over time in ventral and dorsal frontal fractional anisotropy (p < 0.005, uncorrected). LIMITATIONS Sample size was modest. CONCLUSIONS Results suggest abnormalities of gray and white matter in frontal systems and differences in developmental changes of frontal white matter may increase risk of suicide-related behavior in youths with mood disorders. Findings provide potential new leads for early intervention and prevention strategies.
Collapse
|
40
|
Bajaj S, Raikes AC, Smith R, Vanuk JR, Killgore WDS. The Role of Prefrontal Cortical Surface Area and Volume in Preclinical Suicidal Ideation in a Non-Clinical Sample. Front Psychiatry 2019; 10:445. [PMID: 31312146 PMCID: PMC6613495 DOI: 10.3389/fpsyt.2019.00445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 06/05/2019] [Indexed: 01/08/2023] Open
Abstract
Suicidal ideation (SUI) can occur in the absence of concomitant psychiatric diagnoses, and even normal levels can be problematic among individuals experiencing excess stress or lack of social support. The objective of this study was to investigate the neuroanatomical basis of SUI in non-clinical human populations who are within the normal limits of SUI, after accounting for elevated stress and perceived lack of social support. Neuroanatomical data were collected from 55 healthy individuals (mean age 30.9 ± 8.1 years, 27 females) whose depression severity levels were below the Diagnostic and Statistical Manual of Mental Disorders criteria. Measures of SUI, aggression, stress, non-support, and treatment rejection were collected from the treatment-consideration scales (TCS) of the Personality Assessment Inventory (PAI). Correlations between standardized SUI scores and three brain morphometry measures, including vertex wise cortical thickness (CT), cortical surface area (CSA), and cortical volume (CV), were estimated for each participant, controlling for age, sex, intracranial volume, and the remaining TCS measures. We observed a significant negative association between scores on SUI and both CSA and CV (cluster-forming threshold of p < 0.005, clusterwise threshold of p < 0.05, FDR corrected for multiple comparisons) within the left rostral middle frontal gyrus. Our findings suggest that greater CSA and CV within the dorsolateral prefrontal cortex are associated with reduced SUI in a non-clinical population with mild levels of stress and perceived lack of social support. Because the dorsolateral prefrontal cortex has been broadly linked to cognitive reappraisal, self-critical thoughts, and emotional regulation, greater CSA and CV within these regions may lead to better mental health by protecting healthy individuals from engaging in SUI during periods of stress and perceived insufficient social support. As our data consisted of only healthy individuals with non-clinical levels of SUI, further investigation will be necessary to explore the neural basis of SUI in populations who may be at greater risk of future suicidal behavior.
Collapse
Affiliation(s)
- Sahil Bajaj
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Adam C Raikes
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Ryan Smith
- The Laureate Institute for Brain Research (LIBR), Tulsa, OK, United States
| | - John R Vanuk
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - William D S Killgore
- Social, Cognitive and Affective Neuroscience Laboratory (SCAN Lab), Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| |
Collapse
|
41
|
Ambrosi E, Arciniegas DB, Curtis KN, Patriquin M, Spalletta G, Sani G, Frueh BC, Fowler JC, Madan A, Salas R. Resting-State Functional Connectivity of the Habenula in Mood Disorder Patients With and Without Suicide-Related Behaviors. J Neuropsychiatry Clin Neurosci 2019; 31:49-56. [PMID: 30282513 PMCID: PMC6697145 DOI: 10.1176/appi.neuropsych.17120351] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The habenula is a small midbrain structure that is important for brain signaling and learning from negative events. Thus, the habenula is strongly connected to both the reward system and motor regions. Increasing evidence suggests a role for the habenula in the etiology of psychiatric disorders, including mood and substance use disorders. However, no studies to date have investigated habenular resting-state functional connectivity (rsFC) in suicide-related behaviors (SB). The authors enrolled 123 individuals with major depressive disorder (MDD) or bipolar disorder and a history of suicide-related behaviors (SB+), 74 individuals with MDD or bipolar disorder and a history of suicidal ideation but no history of SB (SB-), and 75 healthy control subjects (HC). A seed-based approach was used to identify regions showing different rsFC with the habenula followed by region of interest to region of interest post hoc comparisons. Compared with both the SB- and HC groups, the SB+ group showed higher connectivity between the left habenula and the left parahippocampal gyrus, the right amygdala, and the right precentral and postcentral gyri. Patients with mood disorders displayed higher rsFC between the left habenula and left middle temporal gyrus, the left angular gyrus, and the left posterior cingulate cortex, as well as lower rsFC between the right habenula and the left thalamus, when compared with HCs. These findings suggest that the habenula is involved in the neural circuitry of suicide. The higher habenular rsFC found in the SB+ group may mediate a dysfunction in the mechanism that links the habenula with motor activity and contextual associative processing.
Collapse
Affiliation(s)
- Elisa Ambrosi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX
| | - Kaylah N Curtis
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
| | - Michelle Patriquin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - Gabriele Sani
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant’ Andrea Hospital, Rome, Italy,Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | | | - J Christopher Fowler
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Alok Madan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
| |
Collapse
|
42
|
Naifeh JA, Mash HBH, Stein MB, Fullerton CS, Kessler RC, Ursano RJ. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): progress toward understanding suicide among soldiers. Mol Psychiatry 2019; 24:34-48. [PMID: 30104726 PMCID: PMC6756108 DOI: 10.1038/s41380-018-0197-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 06/22/2018] [Accepted: 07/02/2018] [Indexed: 01/11/2023]
Abstract
Responding to an unprecedented increase in the suicide rate among soldiers, in 2008 the US Army and US National Institute of Mental Health funded the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), a multicomponent epidemiological and neurobiological study of risk and resilience factors for suicidal thoughts and behaviors, and their psychopathological correlates among Army personnel. Using a combination of administrative records, representative surveys, computerized neurocognitive tests, and blood samples, Army STARRS and its longitudinal follow-up study (STARRS-LS) are designed to identify potentially actionable findings to inform the Army's suicide prevention efforts. The current report presents a broad overview of Army STARRS and its findings to date on suicide deaths, attempts, and ideation, as well as other important outcomes that may increase suicide risk (e.g., mental disorders, sexual assault victimization). The findings highlight the complexity of environmental and genetic risk and protective factors in different settings and contexts, and the importance of life and career history in understanding suicidal thoughts and behaviors.
Collapse
Affiliation(s)
- James A. Naifeh
- 0000 0001 0421 5525grid.265436.0Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Holly B. Herberman Mash
- 0000 0001 0421 5525grid.265436.0Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Murray B. Stein
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA USA ,0000 0004 0419 2708grid.410371.0VA San Diego Healthcare System, San Diego, CA USA
| | - Carol S. Fullerton
- 0000 0001 0421 5525grid.265436.0Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Ronald C. Kessler
- 000000041936754Xgrid.38142.3cDepartment of Health Care Policy, Harvard Medical School, Boston, MA USA
| | - Robert J. Ursano
- 0000 0001 0421 5525grid.265436.0Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| |
Collapse
|
43
|
Croarkin PE, Nakonezny PA, Deng ZD, Romanowicz M, Vande Voort JL, Camsari DD, Schak KM, Port JD, Lewis CP. High-frequency repetitive TMS for suicidal ideation in adolescents with depression. J Affect Disord 2018; 239:282-290. [PMID: 30031247 PMCID: PMC6431788 DOI: 10.1016/j.jad.2018.06.048] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/27/2018] [Accepted: 06/26/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND This exploratory study sought to examine the effect of an acute course of high-frequency repetitive TMS on suicidal ideation in adolescents. METHODS Data were pooled from 3 prior protocols providing a 30-session course of open-label TMS treatment for adolescents with treatment-resistant depression. All participants (n = 19) were outpatients taking antidepressant medication, with TMS provided as adjunctive treatment. Suicidality was assessed at baseline, after 10 treatments, after 20 treatments, and after 30 treatments. Outcome measures of suicidal ideation included the Columbia Suicide Severity Rating Scale (C-SSRS) "Intensity of Ideation" subscale and Item 13 "Suicidality" on the Children's Depression Rating Scale, Revised (CDRS-R). RESULTS The predicted odds of suicidal ideation (CDRS-R Item 13 and C-SSRS Intensity of Ideation subscale) significantly decreased over 6 weeks of acute TMS treatment without adjustments for illness (depression) severity. However, the magnitude of the decrease in the predicted odds of suicidal ideation across 6 weeks of treatment was attenuated and rendered non-significant in subsequent analyses that adjusted for illness (depression) severity. LIMITATIONS This was an exploratory study with a small sample size and no sham control. Regulatory and ethical barriers constrained enrollment of adolescents with severe suicidality. CONCLUSIONS The present findings suggest that open-label TMS mitigated suicidal ideation in adolescents through the treatment and improvement of depressive symptom severity. Although caution is warranted in the interpretation of these results, the findings can inform the design and execution of future interventional trials targeting suicidal ideation in adolescents.
Collapse
Affiliation(s)
- Paul E. Croarkin
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA,Corresponding Author: Paul E. Croarkin DO, MS, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, Tel: (507) 293-2557, Fax: (507) 284-3933,
| | - Paul A. Nakonezny
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zhi-De Deng
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Magdalena Romanowicz
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L. Vande Voort
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Deniz Doruk Camsari
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Kathryn M. Schak
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - John D. Port
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA,Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Charles P. Lewis
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
44
|
Bani-Fatemi A, Tasmim S, Graff-Guerrero A, Gerretsen P, Strauss J, Kolla N, Spalletta G, De Luca V. Structural and functional alterations of the suicidal brain: An updated review of neuroimaging studies. Psychiatry Res Neuroimaging 2018; 278:77-91. [PMID: 29929763 DOI: 10.1016/j.pscychresns.2018.05.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 12/21/2022]
Abstract
Brain imaging is a non-invasive and in vivo direct estimation of detailed brain structure, regional brain functioning and estimation of molecular processes in the brain. The main objective of this review was to analyze functional and structural neuroimaging studies of individuals at risk for suicide. We reviewed articles published between 2005 and 2018, indexed in PubMed and Medline, assessing structural and functional alterations of the brain of individuals at high risk for suicide and at low risk for suicide. We reviewed functional and structural neuroimaging studies which included individuals with a history of suicidal ideation or attempt in major depressive disorder (MDD), bipolar disorder (BD), psychosis, and borderline personality disorder (BPD). We selected 45 papers that focused on suicidality in MDD, 17 papers on BD, 11 papers on psychosis, and 5 papers on BPD. The suicidal brain across psychiatric diagnoses seems to heavily involve dysfunction of the fronto-temporal network, primarily involving reductions of gray and white matter volumes in the pre-frontal cortex (PFC), anterior cingulate, and superior temporal gyrus. Nonetheless, there are several ways to define suicidal behaviour and ideation. Therefore, it still remains difficult to combine the evidence from imaging studies that used different definitions of suicidality.
Collapse
Affiliation(s)
- Ali Bani-Fatemi
- Group for Suicide Studies, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Samia Tasmim
- Group for Suicide Studies, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute; Multimodal Imaging Group at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute; Multimodal Imaging Group at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John Strauss
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Medical Informatics; Child, Youth and Family Program at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nathan Kolla
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute
| | - Gianfranco Spalletta
- IRCCS Santa Lucia Foundation, Rome, Italy; Menninger Department of psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Vincenzo De Luca
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, 250 College St, Toronto, ON M5T 1R8, Canada.
| |
Collapse
|
45
|
Liao W, Li J, Duan X, Cui Q, Chen H, Chen H. Static and dynamic connectomics differentiate between depressed patients with and without suicidal ideation. Hum Brain Mapp 2018; 39:4105-4118. [PMID: 29962025 DOI: 10.1002/hbm.24235] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 02/03/2023] Open
Abstract
Neural circuit dysfunction underlies the biological mechanisms of suicidal ideation (SI). However, little is known about how the brain's "dynome" differentiate between depressed patients with and without SI. This study included depressed patients (n = 48) with SI, without SI (NSI), and healthy controls (HC, n = 30). All participants underwent resting-state functional magnetic resonance imaging. We constructed dynamic and static connectomics on 200 nodes using a sliding window and full-length time-series correlations, respectively. Specifically, the temporal variability of dynamic connectomic was quantified using the variance of topological properties across sliding window. The overall topological properties of both static and dynamic connectomics further differentiated between SI and NSI, and also predicted the severity of SI. The SI showed decreased overall topological properties of static connectomic relative to the HC. The SI exhibited increases in overall topological properties with regard to the dynamic connectomic when compared with the HC and the NSI. Importantly, combining the overall topological properties of dynamic and static connectomics yielded mean 75% accuracy (all p < .001) with mean 71% sensitivity and mean 75% specificity in differentiating between SI and NSI. Moreover, these features may predict the severity of SI (mean r = .55, all p < .05). The findings revealed that combining static and dynamic connectomics could differentiate between SI and NSI, offering new insight into the physiopathological mechanisms underlying SI. Furthermore, combining the brain's connectome and dynome may be considered a neuromarker for diagnostic and predictive models in the study of SI.
Collapse
Affiliation(s)
- Wei Liao
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Jiao Li
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Xujun Duan
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Qian Cui
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Heng Chen
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Huafu Chen
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,Center for Information in BioMedicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| |
Collapse
|
46
|
Hwang J, Legarreta M, Bueler CE, DiMuzio J, McGlade E, Lyoo IK, Yurgelun-Todd D. Increased efficiency of brain connectivity networks in veterans with suicide attempts. Neuroimage Clin 2018; 20:318-326. [PMID: 30105203 PMCID: PMC6086217 DOI: 10.1016/j.nicl.2018.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/31/2018] [Accepted: 04/21/2018] [Indexed: 01/09/2023]
Abstract
Background Suicide is a public health concern for United States veterans and civilians. Prior research has shown neurobiological factors in suicide. However, studies of neuroimaging correlates of suicide risk have been limited. This study applied complex weighted network analyses to characterize the neural connectivity in white matter in veterans with suicide behavior. Methods Twenty-eight veterans without suicide behavior (NS), 29 with a history of suicidal ideation only (SI), and 23 with prior suicide attempt (SA) completed diffusion tensor brain imaging, the Columbia Suicide Severity Rating Scale and Barratt Impulsiveness Scale (BIS). Structural connectivity networks among 82 parcellated brain regions were produced using whole-brain tractography. Global and nodal metrics of network topology have been calculated. Results SA had shorter characteristic path length and greater global efficiency and mean weighted degree of global network metrics (p < 0.024). SA had more hub nodes than NS and SI. The left posterior cingulate cortex (PCC) showed significantly greater weighted degree in SA relative to others (p < 0.0003). Nonplanning subscale of BIS correlated with the weighted degrees of the left PCC within SA. In rich club connectivity, SA had higher local connections than others (p = 0.001). Conclusion Veterans with prior suicide attempt had altered connectivity networks characteristics in the white matter. These findings may be distinctive neurobiological markers for individuals with suicide attempt. Strong connectivity in the left PCC may be implicated in impulsivity in veterans with suicide attempt.
Collapse
Affiliation(s)
- Jaeuk Hwang
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, Soonchunhyang University Hospital, Seoul, South Korea
| | - Margaret Legarreta
- MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States
| | | | - Jennifer DiMuzio
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
| | - Erin McGlade
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Deborah Yurgelun-Todd
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States; Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; MIRECC, Department of Veterans Affairs, Salt Lake City, UT, United States.
| |
Collapse
|
47
|
Sonal A, Raghavan V. Brain derived neurotrophic factor (BDNF) and suicidal behavior: A review of studies from Asian countries. Asian J Psychiatr 2018. [PMID: 29525506 DOI: 10.1016/j.ajp.2018.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The biological basis of suicide and suicidal behavior is actively researched. Recently, the role of Brain Derived Neurotropic Factor (BDNF) in suicidal behavior has gained attention and significant results are observed. In this review, we aimed to focus on the studies from Asian countries that have explored the role of BDNF and suicidal behavior. The review highlights the findings from these studies and discusses the possible avenues that should be explored in future studies from Asian countries to understand more on suicidal behavior and possible prevention.
Collapse
Affiliation(s)
- Akanksha Sonal
- Department of Geriatric Psychiatry, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vijaya Raghavan
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India.
| |
Collapse
|
48
|
Balcioglu YH, Kose S. Neural substrates of suicide and suicidal behaviour: from a neuroimaging perspective. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2017.1420378] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Yasin Hasan Balcioglu
- Neurology, and Neurosurgery, Forensic Psychiatry Unit, Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Istanbul, Turkey
| | - Samet Kose
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
- Department of Psychiatry, University of Texas Medical School of Houston, Houston, TX, USA
- eCenter for Neurobehavioral Research on Addictions, Houston, TX, USA
| |
Collapse
|
49
|
|
50
|
Kim YJ, Park HJ, Jahng GH, Lee SM, Kang WS, Kim SK, Kim T, Cho AR, Park JK. A pilot study of differential brain activation to suicidal means and DNA methylation of CACNA1C gene in suicidal attempt patients. Psychiatry Res 2017; 255:42-48. [PMID: 28521147 DOI: 10.1016/j.psychres.2017.03.058] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 03/19/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022]
Abstract
Suicide is a serious public health problem. In this study, we investigated functional brain changes to novel visual stimuli of suicidal means, DNA methylation status, and the relationship between the two markers. 14 suicidal attempt patients (SAs) and 22 healthy controls were included. Pictures of facial expressions and suicidal means were shown to subjects during fMRI scanning. 11 CpG sites within transcription factor binding site of CACNA1C gene were selected. In knives (K) vs. natural landscape (NL) condition, left middle frontal gyrus (Brodmann's area, BA 6 and 46) and left inferior frontal gyrus (BA 9) were shown to be significantly higher brain activation in the SAs than the controls (p<0.001). DNA methylation percentages of CpG site 4 (p=0.005) and 6 (p=0.037) were found to be related to the SAs. In the SAs, methylation degree of site 4 and site 6 was positively correlated with signal intensity of K vs. NL condition in left thalamus. The degree of site 4 was positively correlated with signal intensity in left middle and inferior frontal gyri in SAs. The possibility that these findings might be involved in the neurobiology of suicidal behavior is suggested.
Collapse
Affiliation(s)
- Young Jong Kim
- Department of Psychiatry, Myongji Hospital, Goyang-si, Gyeonggi-do 10475, Republic of Korea
| | - Hae Jeong Park
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Sang Min Lee
- Department of Psychiatry, Konyang University College of Medicine, Konyang University Hospital, Daejeon 35365, Republic of Korea
| | - Won Sub Kang
- Department of Neuropsychiatry, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Su Kang Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Tae Kim
- Department of Biomedical Sciences and Engineering, Gwangju Institute of Science and Technology, Gwangju 61005, Republic of Korea
| | - Ah Rang Cho
- Department of Neuropsychiatry, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jin Kyung Park
- Department of Neuropsychiatry, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.
| |
Collapse
|