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Camacho-Téllez V, Castro MN, Wainsztein AE, Goldberg X, De Pino G, Costanzo EY, Cardoner N, Menchón JM, Soriano-Mas C, Guinjoan SM, Villarreal MF. Childhood adversity modulates structural brain changes in borderline personality but not in major depression disorder. Psychiatry Res Neuroimaging 2024; 340:111803. [PMID: 38460393 DOI: 10.1016/j.pscychresns.2024.111803] [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: 07/08/2023] [Revised: 11/24/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
Adverse childhood experiences (ACEs) negatively affect the function and structure of emotion brain circuits, increasing the risk of various psychiatric disorders. It is unclear if ACEs show disorder specificity with respect to their effects on brain structure. We aimed to investigate whether the structural brain effects of ACEs differ between patients with major depression (MDD) and borderline personality disorder (BPD). These disorders share many symptoms but likely have different etiologies. To achieve our goal, we obtained structural 3T-MRI images from 20 healthy controls (HC), 19 MDD patients, and 18 BPD patients, and measured cortical thickness and subcortical gray matter volumes. We utilized the Adverse Childhood Experiences (ACE) questionnaire to quantify self-reported exposure to childhood trauma. Our findings suggest that individuals with MDD exhibit a smaller cortical thickness when compared to those with BPD. However, ACEs showed a significantly affected relationship with cortical thickness in BPD but not in MDD. ACEs were found to be associated with thinning in cortical regions involved in emotional behavior in BPD, whereas HC showed an opposite association. Our results suggest a potential mechanism of ACE effects on psychopathology involving changes in brain structure. These findings highlight the importance of early detection and intervention strategies.
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Affiliation(s)
- Vicente Camacho-Téllez
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina
| | - Mariana N Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina.
| | - Agustina E Wainsztein
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Ximena Goldberg
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Gabriela De Pino
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Laboratorio de Neuroimágenes, Departamento de Imágenes, Fleni, Argentina; Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Argentina
| | - Elsa Y Costanzo
- Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Narcís Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José M Menchón
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, USA; Department of Psychiatry, Health Sciences Center, Oklahoma University, and Oxley College, Tulsa University, Tulsa, Oklahoma, USA
| | - Mirta F Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Física, Facultad de Ciencias Exactas y Naturales, UBA, Argentina
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Cheng X, Chen J, Zhang X, Wang T, Sun J, Zhou Y, Yang R, Xiao Y, Chen A, Song Z, Chen P, Yang C, QiuxiaWu, Lin T, Chen Y, Cao L, Wei X. Characterizing the temporal dynamics of intrinsic brain activities in depressed adolescents with prior suicide attempts. Eur Child Adolesc Psychiatry 2024; 33:1179-1191. [PMID: 37284850 PMCID: PMC11032277 DOI: 10.1007/s00787-023-02242-4] [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: 03/09/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
Converging evidence has revealed disturbances in the corticostriatolimic system are associated with suicidal behaviors in adults with major depressive disorder. However, the neurobiological mechanism that confers suicidal vulnerability in depressed adolescents is largely unknown. A total of 86 depressed adolescents with and without prior suicide attempts (SA) and 47 healthy controls underwent resting-state functional imaging (R-fMRI) scans. The dynamic amplitude of low-frequency fluctuations (dALFF) was measured using sliding window approach. We identified SA-related alterations in dALFF variability primarily in the left middle temporal gyrus, inferior frontal gyrus, middle frontal gyrus (MFG), superior frontal gyrus (SFG), right SFG, supplementary motor area (SMA) and insula in depressed adolescents. Notably, dALFF variability in the left MFG and SMA was higher in depressed adolescents with recurrent suicide attempts than in those with a single suicide attempt. Moreover, dALFF variability was capable of generating better diagnostic and prediction models for suicidality than static ALFF. Our findings suggest that alterations in brain dynamics in regions involved in emotional processing, decision-making and response inhibition are associated with an increased risk of suicidal behaviors in depressed adolescents. Furthermore, dALFF variability could serve as a sensitive biomarker for revealing the neurobiological mechanisms underlying suicidal vulnerability.
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Affiliation(s)
- Xiaofang Cheng
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Jianshan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Xiaofei Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Ting Wang
- The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu district, Guangzhou, 510180, Guangdong, People's Republic of China
| | - Jiaqi Sun
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Ruilan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Yeyu Xiao
- Guangzhou Integrated Traditional Chinese and Western Medicine, Guangzhou, 510800, Guangdong, People's Republic of China
| | - Amei Chen
- The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu district, Guangzhou, 510180, Guangdong, People's Republic of China
| | - Ziyi Song
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Pinrui Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Chanjuan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - QiuxiaWu
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Taifeng Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Yingmei Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China
| | - Liping Cao
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, liwan district, Guangzhou, 510370, Guangdong, People's Republic of China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510370, Guangdong, People's Republic of China.
| | - Xinhua Wei
- The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu district, Guangzhou, 510180, Guangdong, People's Republic of China.
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Seidenbecher S, Schöne M, Kaufmann J, Schiltz K, Bogerts B, Frodl T. Neuroanatomical correlates of aggressiveness: a case-control voxel- and surface-based morphometric study. Brain Struct Funct 2024; 229:31-46. [PMID: 37819409 PMCID: PMC10827843 DOI: 10.1007/s00429-023-02715-x] [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: 04/24/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023]
Abstract
Aggression occurs across the population ranging on a symptom continuum. Most previous studies have used magnetic resonance imaging in clinical/forensic samples, which is associated with several confounding factors. The present study examined structural brain characteristics in two healthy samples differing only in their propensity for aggressive behavior. Voxel- and surface-based morphometry (SBM) analyses were performed on 29 male martial artists and 32 age-matched male controls. Martial artists had significantly increased mean gray matter volume in two frontal (left superior frontal gyrus and bilateral anterior cingulate cortex) and one parietal (bilateral posterior cingulate gyrus and precuneus) brain clusters compared to controls (whole brain: p < 0.001, cluster level: family-wise error (FWE)-corrected). SBM analyses revealed a trend for greater gyrification indices in martial artists compared to controls in the left lateral orbital frontal cortex and the left pars orbitalis (whole brain: p < 0.001, cluster level: FWE-corrected). The results indicate brain structural differences between martial artists and controls in frontal and parietal brain areas critical for emotion processing/inhibition of emotions as well as empathic processes. The present study highlights the importance of studying healthy subjects with a propensity for aggressive behavior in future structural MRI research on aggression.
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Affiliation(s)
- Stephanie Seidenbecher
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - Maria Schöne
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Jörn Kaufmann
- Department of Neurology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Kolja Schiltz
- Department of Forensic Psychiatry, Psychiatric Hospital of the Ludwig-Maximilians-University, Munich, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University Magdeburg, Magdeburg, Germany
- Salus-Institute, Salus gGmbH, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University Magdeburg, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany
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Abstract
OBJECTIVE Borderline personality disorder (BPD) is a common and disabling mental health disorder and has detrimental effects on affected individuals across multiple domains. We aimed to investigate whether individuals with BPD differ from control subjects in terms of cognitive functions, and to see if there is a relationship between cognitive functions, impulsivity, and BPD symptom severity. METHODS BPD individuals (n = 26; mean age = 26.7; 69.2% female) and controls (n = 58; mean age = 25.3; 51.7% female) were enrolled. Intra/Extra-Dimensional Set Shift (IED) and One Touch Stockings of Cambridge (OTS) tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to assess cognitive functions. Barratt Impulsivity Scale-version 11 (BIS-11) was administered to measure impulsivity and both the Zanarini Scale for Borderline Personality Disorder self-report and the clinician-administered versions were used to assess BPD symptom severity. RESULTS BPD group showed significantly impaired cognitive performance on the IED task versus controls, but there was not a significant difference in the OTS task. BPD symptom severity was positively correlated with trait (BIS-11) impulsivity and no correlation was found between BPD symptom severity and cognitive functions. CONCLUSIONS This study suggests people with BPD experience impaired cognitive flexibility and heightened impulsivity. Only impulsivity appeared to be directly related to symptom severity, perhaps indicating that cognitive inflexibility could be a vulnerability marker. Future research should focus on a longitudinal approach to extend clinical and theoretical knowledge in this area.
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Affiliation(s)
- Ibrahim H Aslan
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
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Kolla NJ, Tully J, Bertsch K. Neural correlates of aggression in personality disorders from the perspective of DSM-5 maladaptive traits: a systematic review. Transl Psychiatry 2023; 13:330. [PMID: 37884552 PMCID: PMC10603082 DOI: 10.1038/s41398-023-02612-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD. However, to the best of our knowledge, there has never been a synthesis of neuroimaging studies that have investigated links between these traits and aggression in BPD and ASPD. To overcome this gap, we conducted a systematic review under the PRISMA framework to locate neuroimaging articles published since the release of AMPD linking trait anger/hostility, impulsivity, risk-taking, and callousness to aggression in BPD and ASPD. Key findings included the following: i) anger/hostility, associated with alterations in the interplay between prefrontal and subcortical regions (primarily the amygdala), may be a common factor explaining aggressive reactions to response to interpersonal threat or provocation; ii) alterations of fronto-temporal-limbic regions and serotonergic and endocannabinoid signaling systems may link impulsivity to aggression in BPD and ASPD; iii) weaker cortico-striatal connectivity could relate to greater risk taking and greater proclivity for violence. Insufficient evidence from neuroimaging articles was discerned to describe a relationship between callousness and aggression. Overall, results of this review reveal a relative paucity of neuroimaging studies examining AMPD traits relevant to aggression in BPD and ASPD. In addition to encouraging further investigation of neuroimaging markers of AMPD traits linked to aggression, we recommend multi-methodological designs, including the incorporation of other biomarkers, such as hormones and indices of physiological arousal, to fully expand our understanding of aggression in BPD and ASPD.
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Affiliation(s)
- Nathan J Kolla
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
| | - John Tully
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
- NeuroImagine Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Zhong S, Chen P, Lai S, Zhang Y, Chen G, He J, Pan Y, Tang G, Wang Y, Jia Y. Hippocampal Dynamic Functional Connectivity, HPA Axis Activity, and Personality Trait in Bipolar Disorder with Suicidal Attempt. Neuroendocrinology 2023; 114:179-191. [PMID: 37729896 DOI: 10.1159/000534033] [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: 06/22/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Suicide in bipolar disorder (BD) is a multifaceted behavior, involving specific neuroendocrine and psychological mechanisms. According to previous studies, we hypothesized that suicidal BD patients may exhibit impaired dynamic functional connectivity (dFC) variability of hippocampal subregions and hypothalamic-pituitary-adrenal (HPA) axis activity, which may be associated with suicide-related personality traits. The objective of our study was to clarify this. METHODS Resting-state functional magnetic resonance imaging data were obtained from 79 patients with BD, 39 with suicidal attempt (SA), and 40 without SA, and 35 healthy controls (HCs). The activity of the HPA axis was assessed by measuring morning plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels. All participants underwent personality assessment using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). RESULTS BD patients with SA exhibited increased dFC variability between the right caudal hippocampus and the left superior temporal gyrus (STG) when compared with non-SA BD patients and HCs. BD with SA also showed significantly lower ACTH levels in comparison with HCs, which was positively correlated with increased dFC variability between the right caudal hippocampus and the left STG. BD with SA had significantly higher scores of Hypochondriasis, Depression, and Schizophrenia than non-SA BD. Additionally, multivariable regression analysis revealed the interaction of ACTH × dFC variability between the right caudal hippocampus and the left STG independently predicted MMPI-2 score (depression evaluation) in suicidal BD patients. CONCLUSION These results suggested that suicidal BD exhibited increased dFC variability of hippocampal-temporal cortex and less HPA axis hyperactivity, which may affect their personality traits.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China,
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
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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.
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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
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Wang X, Wu H, Wang D, Wang W, Wang W, Jin WQ, Luo J, Jiang W, Tang YL, Ren YP, Yang CL, Ma X, Li R. Reduced suicidality after electroconvulsive therapy is linked to increased frontal brain activity in depressed patients: a resting-state fMRI study. Front Psychiatry 2023; 14:1224914. [PMID: 37502809 PMCID: PMC10368865 DOI: 10.3389/fpsyt.2023.1224914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Objective Suicidality is commonly observed in patients with depressive episodes, and electroconvulsive therapy (ECT) has been found to be effective in treating these patients. However, the role of ECT in suicidality remains unclear. This study used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the changes in brain function before and after ECT in depressed patients with suicidality. Methods In total, 26 depressed patients with suicidality underwent rs-fMRI at baseline and after 8-12 sessions of ECT. In addition, 32 healthy controls (HCs) matched for age, gender, and educational level underwent rs-fMRI once. The amplitude of low-frequency fluctuations (ALFF), the fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were measured to evaluate whole brain function. Differences between the groups and time points (before and after ECT) were compared. Clinical symptoms were assessed using the 17-item Hamilton Depression Scale (HAMD-17) and Beck Scale for Suicide Ideation (BSSI). Results At baseline, patients exhibited decreased ALFF in the right postcentral and precentral gyrus and decreased fALFF in the right supramarginal and postcentral gyrus, left superior frontal gyrus (SFG), as well as the superior and middle temporal gyrus compared to HCs. Patients also had lower ReHo in the left amygdala, anterior cingulate, and postcentral gyrus, and in the right thalamus, insula, and postcentral gyrus. They also exhibited higher ALFF in the bilateral temporal gyrus and insula as well as higher fALFF in the cerebellum. Following ECT, fALFF in the left SFG and orbital frontal cortex (OFC) significantly increased and was inversely correlated with the reduction of BSSI scores (r = -0.416, p = 0.048), whereas no correlation was found with changes in HAMD-17scores. Conclusion Our findings suggest that the left SFG and OFC may play a key role in the mechanism of ECT for suicidality. The decrease of fALFF in the left SFG and OFC may represent a potential mechanism through which ECT effectively treats suicidality in depressed patients.
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Affiliation(s)
- Xue Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Han Wu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dan Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wei Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wen Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wen-qing Jin
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jiong Luo
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wei Jiang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Mental Health Service Line, Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, GA, United States
| | - Yan-ping Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Institution of Mental Health Care, Beijing, China
| | - Chun-lin Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Rena Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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9
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Hu J, Huang Y, Zhang X, Liao B, Hou G, Xu Z, Dong S, Li P. Identifying suicide attempts, ideation, and non-ideation in major depressive disorder from structural MRI data using deep learning. Asian J Psychiatr 2023; 82:103511. [PMID: 36791609 DOI: 10.1016/j.ajp.2023.103511] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
The present study aims to identify suicide risks in major depressive disorders (MDD) patients from structural MRI (sMRI) data using deep learning. In this paper, we collected the sMRI data of 288 MDD patients, including 110 patients with suicide ideation (SI), 93 patients with suicide attempts (SA), and 85 patients without suicidal ideation or attempts (NS). And we developed interpretable deep neural network models to classify patients in three tasks including SA-versus-SI, SA-versus-NS, and SI-versus-NS, respectively. Furthermore, we interpreted the models by extracting the important features that contributed most to the classification, and further discussed these features or ROI/brain regions.
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Affiliation(s)
- Jinlong Hu
- Guangdong Key Lab of Communication and Computer Network, School of Computer Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yangmin Huang
- Guangdong Key Lab of Communication and Computer Network, School of Computer Science and Engineering, South China University of Technology, Guangzhou, China
| | - Xiaojing Zhang
- Guangdong Provincial Key Laboratory of Genome Stability and Disease Prevention and Regional Immunity and Diseases, Department of Pathology, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Bin Liao
- College of Mathematics and Informatics, South China Agricultural University, Guangzhou, China.
| | - Gangqiang Hou
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China.
| | - Ziyun Xu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Shoubin Dong
- Guangdong Key Lab of Communication and Computer Network, School of Computer Science and Engineering, South China University of Technology, Guangzhou, China
| | - Ping Li
- Department of Chinese and Bilingual Studies, Faculty of Humanities, The Hong Kong Polytechnic University, Hong Kong, China
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10
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Zhong S, Chen P, Lai S, Chen G, Zhang Y, Lv S, He J, Tang G, Pan Y, Wang Y, Jia Y. Aberrant dynamic functional connectivity in corticostriatal circuitry in depressed bipolar II disorder with recent suicide attempt. J Affect Disord 2022; 319:538-548. [PMID: 36155235 DOI: 10.1016/j.jad.2022.09.050] [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: 03/30/2022] [Revised: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The underlying neurobiological mechanisms on suicidal behavior in bipolar disorder remain unclear. We aim to explore the mechanisms of suicide by detecting dynamic functional connectivity (dFC) of corticostriatal circuitry and cognition in depressed bipolar II disorder (BD II) with recent suicide attempt (SA). METHODS We analyzed resting-state functional magnetic resonance imaging (fMRI) data from 68 depressed patients with BD-II (30 with SA and 38 without SA) and 35 healthy controls (HCs). The whole-brain dFC variability of corticostriatal circuitry was calculated using a sliding-window analysis. Their correlations with cognitive dysfunction were further detected. Support vector machine (SVM) classification tested the potential of dFC to differentiate BD-II with SA from HCs. RESULTS Increased dFC variability between the right vCa and the right insula was found in SA compared to non-SA and HCs, and negatively correlated with speed of processing. Decreased dFC variability between the left dlPu and the right postcentral gyrus was found in non-SA compared to SA and HCs, and positively correlated with reasoning problem-solving. Both SA and non-SA exhibited decreased dFC variability between the right dCa and the left MTG, and between the right dlPu and the right calcarine when compared to HCs. SVM classification achieved an accuracy of 75.24 % and AUC of 0.835 to differentiate SA from non-SA, while combining the abnormal dFC features between SA and non-SA. CONCLUSIONS Aberrant dFC variability of corticostriatal circuitry may serve as potential neuromarker for SA in BD-II, which might help to discriminate suicidal BD-II patients from non-suicidal patients and HCs.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
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11
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Li X, Chen X, Yu R, Dai L, Ai M, Huang Q, Zhou Y, Chen W, Guo J, Zheng A, Kuang L. Changes in gray matter volume following electroconvulsive therapy in adolescent depression with suicidal ideation: A longitudinal structural magnetic resonance imaging study. Front Psychiatry 2022; 13:944520. [PMID: 36245857 PMCID: PMC9559807 DOI: 10.3389/fpsyt.2022.944520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We aimed to investigate changes in whole-brain gray matter volumes (GMVs) before and after electroconvulsive therapy (ECT) in adolescents with major depressive disorder (MDD) and suicidal ideation (SI). Methods Thirty adolescents with MDD and SI were observed, and structural magnetic resonance imaging (sMRI) was performed at baseline and after ECT for each patient. But Twenty-five healthy controls (HCs) were scanned only at baseline. The voxel-based morphometry (VBM) techniques were used to examine GMVs. Results Compared with HCs, MDDs at baseline showed decreased GMVs in the left middle temporal gyrus, right superior temporal gyrus, right middle temporal gyrus, left precuneus, right precuneus, and left superior frontal gyrus. After ECT, MDDs showed increased GMVs in the right superior frontal gyrus and right superior temporal gyrus. Pearson's correlation found that Beck Scale for Suicide Ideation (BSSI) scores at baseline were negatively correlated with GMVs in the left superior frontal gyrus and HAMD and BSSI scores after ECT were negatively correlated with GMVs in the right superior temporal gyrus. Conclusion Frontal-temporal-precuneus structure changes may be a potential cause of depressive and suicidal symptoms in adolescents. ECT may improve depressive and suicidal symptoms in adolescents by regulating brain structures to compensate original defects.
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Affiliation(s)
- Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaolu Chen
- The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linqi Dai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Huang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wanjun Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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12
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Gong X, Quan F, Wang L, Zhu W, Lin D, Xia LX. The relationship among regional gray matter volume in the brain, Machiavellianism and social aggression in emerging adulthood: A voxel-based morphometric study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03574-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Patel D, Andersen S, Smith K, Ritter A. Completed Suicide by Firearm in an Individual With the Agrammatic Variant of Primary Progressive Aphasia: Case Report. Front Neurol 2022; 13:828155. [PMID: 35370921 PMCID: PMC8965452 DOI: 10.3389/fneur.2022.828155] [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] [Received: 12/03/2021] [Accepted: 02/15/2022] [Indexed: 11/23/2022] Open
Abstract
The agrammatic or nonfluent variant of Primary Progressive Aphasia (nfvPPA) is a form of Frontotemporal Dementia (FTD) that is characterized by progressive language dysfunction, poor sentence construction, and low verbal fluency. Individuals with nfvPPA have intact insight into their decline, which may manifest as frustration and hopelessness, and show signs of impulsivity and disinhibition. Little is known about suicide risk in this patient population. Here we describe a case of an 84 year-old male with nfvPPA who, over the course of his care, experienced a decline in language and motoric functioning which coincided with increasing irritability and impulsivity. Despite this significant decline, he denied depressive symptoms or showed any suicidal tendencies, and he seemed to be looking forward to future events. His suicide, committed with a handgun during what appeared to be a rather innocuous trip to the garage, came as a significant shock to his spouse, family, and his clinical care team. To our knowledge, this is the first reported case of completed suicide in a patient with the nfvPPA subtype of FTD. Though this patient demonstrated demographic risk factors for suicide (advanced age, retired military veteran with easy access to firearms) there is a lack of data regarding how FTD may have contributed. Retained insight especially seems to be a risk factor for suicide across all forms of dementia. Impulsivity may be key when considering suicidality amongst FTD patients. Additionally, this case demonstrates the importance of addressing gun safety as there are few guidelines around gun ownership in this patient population.
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Affiliation(s)
- Deepal Patel
- Kirk Kerkorian School of Medicine, Las Vegas, NV, United States.,University of Nevada, Reno, NV, United States.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Shaun Andersen
- Kirk Kerkorian School of Medicine, Las Vegas, NV, United States.,University of Nevada, Reno, NV, United States.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Kyler Smith
- Kirk Kerkorian School of Medicine, Las Vegas, NV, United States.,University of Nevada, Reno, NV, United States.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Aaron Ritter
- Kirk Kerkorian School of Medicine, Las Vegas, NV, United States.,University of Nevada, Reno, NV, United States.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
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14
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Chu J, Zheng K, Yi J. Aggression in borderline personality disorder: A systematic review of neuroimaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110472. [PMID: 34742774 DOI: 10.1016/j.pnpbp.2021.110472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/30/2021] [Accepted: 10/31/2021] [Indexed: 01/30/2023]
Abstract
Aggressive behaviors are prevalent among patients with Borderline Personality Disorder (BPD). Neuroimaging studies have linked aggression in BPD patients to neurochemical, structural, functional, and metabolic alterations in various brain regions, especially in frontal-limbic areas. This systematic review summarizes current neuroimaging results on aggression among BPD patients and provides an overview of relevant brain mechanisms. A systematic search of PubMed and Web of Science databases, in addition to manual check of references, identified thirty-two eligible articles, including two magnetic resonance spectrum (MRS), thirteen structural magnetic resonance imaging (sMRI), six functional magnetic resonance imaging (fMRI), and eleven positron emission tomography (PET) studies. The reviewed studies have highlighted the abnormalities in prefrontal cortices and limbic structures including amygdala and hippocampus. Less studies have zoomed in the roles of parietal and temporal regions or taken a network perspective. Connectivity studies have shed light on the importance of the frontal-limbic interactions in regulating aggression. Conflicted findings might be attributed to disparity in controlling gender, anatomical subdivisions, and comorbidities, which shall be considered in future studies.
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Affiliation(s)
- Jun Chu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute, Central South University, Changsha, Hunan, China
| | - Kaili Zheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute, Central South University, Changsha, Hunan, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha 410011, China.
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15
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Wang H, Zhu WF, Xia LX. Brain structural correlates of aggression types from the perspective of disinhibition–control: A voxel-based morphometric study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02712-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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Campos AI, Thompson PM, Veltman DJ, Pozzi E, van Veltzen LS, Jahanshad N, Adams MJ, Baune BT, Berger K, Brosch K, Bülow R, Connolly CG, Dannlowski U, Davey CG, de Zubicaray GI, Dima D, Erwin-Grabner T, Evans JW, Fu CHY, Gotlib IH, Goya-Maldonado R, Grabe HJ, Grotegerd D, Harris MA, Harrison BJ, Hatton SN, Hermesdorf M, Hickie IB, Ho TC, Kircher T, Krug A, Lagopoulos J, Lemke H, McMahon K, MacMaster FP, Martin NG, McIntosh AM, Medland SE, Meinert S, Meller T, Nenadic I, Opel N, Redlich R, Reneman L, Repple J, Sacchet MD, Schmitt S, Schrantee A, Sim K, Singh A, Stein F, Strike LT, van der Wee NJA, van der Werff SJA, Völzke H, Waltemate L, Whalley HC, Wittfeld K, Wright MJ, Yang TT, Zarate CA, Schmaal L, Rentería ME. Brain Correlates of Suicide Attempt in 18,925 Participants Across 18 International Cohorts. Biol Psychiatry 2021; 90:243-252. [PMID: 34172278 PMCID: PMC8324512 DOI: 10.1016/j.biopsych.2021.03.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Neuroimaging studies of suicidal behavior have so far been conducted in small samples, prone to biases and false-positive associations, yielding inconsistent results. The ENIGMA-MDD Working Group aims to address the issues of poor replicability and comparability by coordinating harmonized analyses across neuroimaging studies of major depressive disorder and related phenotypes, including suicidal behavior. METHODS Here, we pooled data from 18 international cohorts with neuroimaging and clinical measurements in 18,925 participants (12,477 healthy control subjects and 6448 people with depression, of whom 694 had attempted suicide). We compared regional cortical thickness and surface area and measures of subcortical, lateral ventricular, and intracranial volumes between suicide attempters, clinical control subjects (nonattempters with depression), and healthy control subjects. RESULTS We identified 25 regions of interest with statistically significant (false discovery rate < .05) differences between groups. Post hoc examinations identified neuroimaging markers associated with suicide attempt including smaller volumes of the left and right thalamus and the right pallidum and lower surface area of the left inferior parietal lobe. CONCLUSIONS This study addresses the lack of replicability and consistency in several previously published neuroimaging studies of suicide attempt and further demonstrates the need for well-powered samples and collaborative efforts. Our results highlight the potential involvement of the thalamus, a structure viewed historically as a passive gateway in the brain, and the pallidum, a region linked to reward response and positive affect. Future functional and connectivity studies of suicidal behaviors may focus on understanding how these regions relate to the neurobiological mechanisms of suicide attempt risk.
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Affiliation(s)
- Adrian I Campos
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, California
| | - Dick J Veltman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Elena Pozzi
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Laura S van Veltzen
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, California
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Bernhard T Baune
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Katharina Brosch
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Colm G Connolly
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Greig I de Zubicaray
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City, University of London, London, United Kingdom; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Lower Saxony, Germany
| | - Jennifer W Evans
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Cynthia H Y Fu
- Centre for Affective Disorders, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom; School of Psychology, University of East London, London, United Kingdom
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Lower Saxony, Germany
| | - Hans J Grabe
- German Center for Neurodegenerative Disease, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Dominik Grotegerd
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Matthew A Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Ben J Harrison
- Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Sean N Hatton
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Tiffany C Ho
- Department of Psychiatry & Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Tilo Kircher
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, North Rhine-Westphalia, Germany; Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia; Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Hannah Lemke
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Katie McMahon
- Herston Imaging Research Facility & School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Frank P MacMaster
- Department of Pediatrics and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Strategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Nicholas G Martin
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah E Medland
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Psychiatric Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Austalia; School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Tina Meller
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Igor Nenadic
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands
| | - Jonathan Repple
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Matthew D Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Simon Schmitt
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands
| | - Kang Sim
- West Region, Institute of Mental Health, Buangkok View, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Aditya Singh
- Laboratory of Systems Neuroscience and Imaging in Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Lower Saxony, Germany
| | - Frederike Stein
- Department of Psychiatry, Philipps-University Marburg, Marburg, Hesse, Germany
| | - Lachlan T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Steven J A van der Werff
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Lena Waltemate
- Department of Psychiatry, University of Münster, Münster, North Rhine-Westphalia, Germany
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Katharina Wittfeld
- German Center for Neurodegenerative Disease, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia
| | - Tony T Yang
- Department of Psychiatry & Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.
| | - Miguel E Rentería
- Genetic Epidemiology Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
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17
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Functional alterations of the suicidal brain: a coordinate-based meta-analysis of functional imaging studies. Brain Imaging Behav 2021; 16:291-304. [PMID: 34351557 DOI: 10.1007/s11682-021-00503-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/22/2023]
Abstract
Altered brain activities in suicidal subjects have been reported in a number of neuroimaging studies. However, the activity aberrances were inconsistent in previous investigations. Thus, we aimed to address activity abnormalities in suicidal individuals. Databases were searched to perform a meta-analysis of whole-brain functional MRI studies of suicidal individuals through January 14, 2020. Meta-analyses were conducted using Seed-based d Mapping software. Based on a meta-analysis of 17 studies comprising 381 suicidal individuals and 642 controls, we mainly found that increased activity in the bilateral superior temporal gyrus, left middle temporal gyrus, and bilateral middle occipital gyrus, along with decreased activity in the right putamen and left insula, were detected in suicidal individuals compared with nonsuicidal subjects. To reduce methodological heterogeneity between the included studies, subanalyses of behavioral domains were conducted, and the right superior temporal gyrus was found to increase in all subanalyses of domains. In subanalyses of suicidal attempters and ideators, suicide attempters displayed hyperactivation in the bilateral superior temporal gyrus and left middle temporal gyrus and blunted responses in the left insula relative to controls. Suicidal ideators demonstrated elevated activation in the right middle occipital gyrus and reduced activity in the right putamen relative to controls. The bilateral superior temporal gyrus was the most robust finding, replicable in all data sets in the jackknife sensitive analysis. Moreover, increased activity in the right superior temporal gyrus, left middle temporal gyrus, and right middle occipital gyrus was found to be involved with higher suicide ideation scores. This study revealed several brain regions associated with suicidality. These findings may contribute to our understanding of the pathophysiology of suicide and have important implications for suicide prevention and interventions.
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18
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Yu C, Zhang J, Zuo X, Lian Q, Tu X, Lou C. Correlations of impulsivity and aggressive behaviours among adolescents in Shanghai, China using bioecological model: cross-sectional data from Global Early Adolescent Study. BMJ Open 2021; 11:e043785. [PMID: 34266836 PMCID: PMC8286771 DOI: 10.1136/bmjopen-2020-043785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To examine the correlations between impulsivity and aggressive behaviours among Chinese adolescents. DESIGN A school-based cross-sectional study. SETTING Three primary middle schools located in less developed communities of Shanghai. PARTICIPANTS 1524 adolescents aged 11-16 years. MEASURES The impulsivity was measured by Barratt Impulsivity Scale, and the aggressive behaviours were determined by self-reports. Data were collected through computer-assisted self-interview using tablets. Multivariate Firth logistic regression model was conducted to examine correlations between total, attentional, motor, and non-planning impulsivity and aggressive behaviours, respectively. RESULTS Totally, 7.48% of participants reported aggressive behaviours toward others during the past 6 months. The proportion of aggressors among boys and girls was 10.60% and 4.18%, respectively. Results of the multivariate regression suggested the risk of aggressive behaviours was significantly increased among those with the highest tertile of total impulsivity (adjusted OR (aOR)boys=3.14, 95% CI: 1.48 to 6.65; aORgirls=3.74, 95% CI: 1.10 to 12.76) and motor impulsivity (aORboys=2.91, 95% CI: 1.46 to 5.82; aORgirls=3.57, 95% CI: 1.25 to 10.20.), comparing with those with the lowest tertile, for boys and girls, respectively. Besides, younger age, lower social cohesion and being bullied within 6 months were associated with a higher risk of aggressive behaviours among girls. Less family caring and being bullied within 6 months were associated with the risk among boys. CONCLUSIONS The present study indicates a positive association between impulsivity and aggressive behaviours, with a more salient correlation between motor impulsivity subtrait and aggressive behaviour among both boys and girls. Furthermore, adolescents' aggressive behaviours were affected by multiple factors from individuals, family, peers and community. Comprehensive intervention strategies such as controlling the aggressor's impulsivity, helping them better channel their anger, creating a better family, school and neighbourhood environment, and providing support and services for victims of violence are needed.
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Affiliation(s)
- Chunyan Yu
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Jiashuai Zhang
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Xiayun Zuo
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Qiguo Lian
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Xiaowen Tu
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Chaohua Lou
- Department of Epidemiology and Social Science, NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
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19
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Lopez-Morinigo JD, Boldrini M, Ricca V, Oquendo MA, Baca-García E. Aggression, Impulsivity and Suicidal Behavior in Depressive Disorders: A Comparison Study between New York City (US), Madrid (Spain) and Florence (Italy). J Clin Med 2021; 10:jcm10143057. [PMID: 34300222 PMCID: PMC8303717 DOI: 10.3390/jcm10143057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/07/2021] [Accepted: 06/26/2021] [Indexed: 12/13/2022] Open
Abstract
The association of aggression and impulsivity with suicidal behavior (SB) in depression may vary across countries. This study aimed (i) to compare aggression and impulsivity levels, measured with the Brown-Goodwin Scale (BGS) and the Barratt Impulsivity Scale (BIS), respectively, between New York City (NYC) (US), Madrid (Spain) and Florence (Italy) (ANOVA); and (ii) to investigate between-site differences in the association of aggression and impulsivity with previous SB (binary logistic regression). Aggression scores were higher in NYC, followed by Florence and Madrid. Impulsivity levels were higher in Florence than in Madrid or NYC. Aggression and impulsivity scores were higher in suicide attempters than in non-attempters in NYC and in Madrid. SB was associated with aggression in NYC (OR 1.12, 95% CI 1.07–1.16; p < 0.001) and in Florence (OR 1.11, 95% CI 1.01–1.22; p = 0.032). Impulsivity was linked with SB in NYC (OR 1.01, 95% CI 1.00–1.02; p < 0.001) and in Madrid (OR 1.03, 95% CI 1.02–1.05; p < 0.001). The higher suicide rates in NYC, compared to Madrid or Florence, may be, in part, explained by these cross-cultural differences in the contribution of aggression-impulsivity to SB, which should be considered by future research on SB prevention.
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Affiliation(s)
- Javier-David Lopez-Morinigo
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Psychiatry, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, 28009 Madrid, Spain
- Correspondence: ; Tel.: +34-627-277-126
| | - Maura Boldrini
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irvin Medical Center, New York, NY 10032, USA;
| | - Valdo Ricca
- Department of Health Sciences, University of Florence, 50121 Florence, Italy;
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Enrique Baca-García
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Psychiatry, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, 28400 Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, 28342 Valdemoro, Spain
- Universidad Católica del Maule, Talca 3466706, Chile
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, 30900 Nîmes, France
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20
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Barredo J, Bozzay ML, Primack JM, Schatten HT, Armey MF, Carpenter LL, Philip NS. Translating Interventional Neuroscience to Suicide: It's About Time. Biol Psychiatry 2021; 89:1073-1083. [PMID: 33820628 PMCID: PMC8603185 DOI: 10.1016/j.biopsych.2021.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/26/2022]
Abstract
Despite significant advances in psychiatric and psychological treatment over the last 30 years, suicide deaths have increased. Unfortunately, neuroscience insights have yielded few translational interventions that specifically target suicidal thoughts and behaviors. In our view, this is attributable to two factors. The first factor is our limited integration of neurocircuitry models with contemporary suicide theory. The second challenge is inherent to the variable nature of suicide risk over time. Few interventional neuroscience studies evaluate how temporal fluctuations in risk affect treatment, despite evidence that temporality is a key component distinguishing suicide phenotypes. To wit, individual variability in risk trajectories may provide different treatment targets to engage as a patient moves between suicidal ideation and attempt. Here, we first review contemporary ideation-to-action theories of suicide from a neurobiological perspective, focusing on valence and executive function circuits and the key role of state-induced (e.g., within stressful contexts) functional modulation on longitudinal risk trajectories. We then describe neural correlates of suicide reduction following various interventions, ranging from circuit specific (i.e., transcranial magnetic stimulation) to broader pharmacological (i.e., ketamine, lithium) to psychological (i.e., brief cognitive therapy). We then introduce novel strategies for tracking risk in naturalistic settings and real time using ecological momentary interventions. We provide a critical integration of the literature focusing on the intersection between targets and temporality, and we conclude by proposing novel research designs integrating real-time and biologically based interventions to generate novel strategies for future suicide reduction research.
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Affiliation(s)
- Jennifer Barredo
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; COBRE Center for Neuromodulation and Neuroimaging, Providence, Rhode Island.
| | - Melanie L Bozzay
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jennifer M Primack
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; Psychosocial Research Program, Butler Hospital, Providence, Rhode Island; Providence VA Medical Center, Providence, Rhode Island
| | - Heather T Schatten
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; Psychosocial Research Program, Butler Hospital, Providence, Rhode Island
| | - Michael F Armey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; Psychosocial Research Program, Butler Hospital, Providence, Rhode Island
| | - Linda L Carpenter
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; COBRE Center for Neuromodulation and Neuroimaging, Providence, Rhode Island
| | - Noah S Philip
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island; COBRE Center for Neuromodulation and Neuroimaging, Providence, Rhode Island
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21
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Vidal-Ribas P, Janiri D, Doucet GE, Pornpattananangkul N, Nielson DM, Frangou S, Stringaris A. Multimodal Neuroimaging of Suicidal Thoughts and Behaviors in a U.S. Population-Based Sample of School-Age Children. Am J Psychiatry 2021; 178:321-332. [PMID: 33472387 PMCID: PMC8016742 DOI: 10.1176/appi.ajp.2020.20020120] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Suicide deaths and suicidal thoughts and behaviors are considered a public health emergency, yet their underpinnings in the brain remain elusive. The authors examined the classification accuracy of individual, environmental, and clinical characteristics, as well as multimodal brain imaging correlates, of suicidal thoughts and behaviors in a U.S. population-based sample of school-age children. METHODS Children ages 9-10 years (N=7,994) from a population-based sample from the Adolescent Brain Cognitive Development study were assessed for lifetime suicidal thoughts and behaviors. After quality control procedures, structural MRI (N=6,238), resting-state functional MRI (N=4,134), and task-based functional MRI (range, N=4,075-4,608) were examined. Differences with Welch's t test and equivalence tests, with observed effect sizes (Cohen's d) and their 90% confidence intervals <|0.15|, were examined. Classification accuracy was examined with area under precision-recall curves (AUPRCs). RESULTS Among the 7,994 unrelated children (females, N=3,757, 47.0%), those with lifetime suicidal thoughts and behaviors based on child (N=684, 8.6%), caregiver (N=654, 8.2%), and concordant (N=198, 2.5%) reports had higher levels of social adversity and psychopathology, among themselves and their caregivers, compared with never-suicidal children (N=6,854, 85.7%). Only one imaging test survived statistical correction: caregiver-reported suicidal thoughts and behaviors were associated with a thinner left bank of the superior temporal sulcus. On the basis of the prespecified bounds of |0.15|, approximately 48% of the group mean differences for child-reported suicidal thoughts and behaviors comparisons and approximately 22% for caregiver-reported suicidal thoughts and behaviors comparisons were considered equivalent. All observed effect sizes were relatively small (d≤|0.30|), and both non-imaging and imaging correlates had low classification accuracy (AUPRC ≤0.10). CONCLUSIONS Commonly applied neuroimaging measures did not reveal a discrete brain signature related to suicidal thoughts and behaviors in youths. Improved approaches to the neurobiology of suicide are critically needed.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Science Branch, National Institute of Child Health and Human Development, Bethesda, USA,Mood Brain and Development Unit, National Institute of Mental Health, Bethesda, USA
| | - Delfina Janiri
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Gaelle E Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Boys Town National Research Hospital, Omaha, USA
| | - Narun Pornpattananangkul
- Mood Brain and Development Unit, National Institute of Mental Health, Bethesda, USA,Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Dylan M Nielson
- Mood Brain and Development Unit, National Institute of Mental Health, Bethesda, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Argyris Stringaris
- Mood Brain and Development Unit, National Institute of Mental Health, Bethesda, USA
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22
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Sarkinaite M, Gleizniene R, Adomaitiene V, Dambrauskiene K, Raskauskiene N, Steibliene V. Volumetric MRI Analysis of Brain Structures in Patients with History of First and Repeated Suicide Attempts: A Cross Sectional Study. Diagnostics (Basel) 2021; 11:diagnostics11030488. [PMID: 33801896 PMCID: PMC8000590 DOI: 10.3390/diagnostics11030488] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/27/2021] [Accepted: 03/06/2021] [Indexed: 12/03/2022] Open
Abstract
Structural brain changes are found in suicide attempters and in patients with mental disorders. It remains unclear whether the suicidal behaviors are related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. The sample consisted of 56 patients hospitalized after first suicide attempt (first SA) (n = 29), more than one suicide attempt (SA > 1) (n = 27) and 54 healthy controls (HC). Brain volume was measured using FreeSurfer 6.0 automatic segmentation technique. In comparison to HC, patients with first SA had significantly lower cortical thickness of the superior and rostral middle frontal areas, the inferior, middle and superior temporal areas of the left hemisphere and superior frontal area of the right hemisphere. In comparison to HC, patients after SA > 1 had a significantly lower cortical thickness in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere. The comparison of hippocampus volume showed a significantly lower mean volume of left and right parts in patients with SA > 1, but not in patients with first SA. The atrophy of frontal, temporal cortex and hippocampus parts was significantly higher in repeated suicide attempters than in patients with first suicide attempt.
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Affiliation(s)
- Milda Sarkinaite
- Department of Radiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
- Correspondence: ; Tel.: +370-67876580
| | - Rymante Gleizniene
- Department of Radiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Virginija Adomaitiene
- Psychiatry Clinic of Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (V.A.); (K.D.); (V.S.)
| | - Kristina Dambrauskiene
- Psychiatry Clinic of Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (V.A.); (K.D.); (V.S.)
| | - Nijole Raskauskiene
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Vesta Steibliene
- Psychiatry Clinic of Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (V.A.); (K.D.); (V.S.)
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
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23
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Hong S, Liu YS, Cao B, Cao J, Ai M, Chen J, Greenshaw A, Kuang L. Identification of suicidality in adolescent major depressive disorder patients using sMRI: A machine learning approach. J Affect Disord 2021; 280:72-76. [PMID: 33202340 DOI: 10.1016/j.jad.2020.10.077] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/13/2020] [Accepted: 10/31/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Suicidal behavior is a major concern for patients who suffer from major depressive disorder (MDD), especially among adolescents and young adults. Machine learning models with the capability of suicide risk identification at an individual level could improve suicide prevention among high-risk patient population. METHODS A cross-sectional assessment was conducted on a sample of 66 adolescents/young adults diagnosed with MDD. The structural T1-weighted MRI scan of each subject was processed using the FreeSurfer software. The classification model was conducted using the Support Vector Machine - Recursive Feature Elimination (SVM-RFE) algorithm to distinguish suicide attempters and patients with suicidal ideation but without attempts. RESULTS The SVM model was able to correctly identify suicide attempters and patients with suicidal ideation but without attempts with a cross-validated prediction balanced accuracy of 78.59%, the sensitivity was 73.17% and the specificity was 84.0%. The positive predictive value of suicide attempt was 88.24%, and the negative predictive value was 65.63%. Right lateral orbitofrontal thickness, left caudal anterior cingulate thickness, left fusiform thickness, left temporal pole volume, right rostral anterior cingulate volume, left lateral orbitofrontal thickness, left posterior cingulate thickness, right pars orbitalis thickness, right posterior cingulate thickness, and left medial orbitofrontal thickness were the 10 top-ranked classifiers for suicide attempt. CONCLUSIONS The findings indicated that structural MRI data can be useful for the classification of suicide risk. The algorithm developed in current study may lead to identify suicide attempt risk among MDD patients.
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Affiliation(s)
- Su Hong
- Mobile Doctoral Station, School of Nursing, Chongqing Medical University, Chongqing, China
| | - Yang S Liu
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Bo Cao
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Jianmei Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Andrew Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China.
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24
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Aouidad A, Cohen D, Mirkovic B, Pellerin H, Garny de La Rivière S, Consoli A, Gérardin P, Guilé JM. Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters. BMC Psychiatry 2020; 20:525. [PMID: 33148207 PMCID: PMC7643473 DOI: 10.1186/s12888-020-02930-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) and history of prior suicide attempt (SA) have been shown to be high predictors for subsequent suicide. However, no previous study has examined how both factors interact to modify clinical and suicide severity among adolescents. METHODS This study presents a comprehensive assessment of 302 adolescents (265 girls, mean age = 14.7 years) hospitalized after a SA. To test clinical interactions between BPD and history of prior SA, the sample was divided into single attempters without BPD (non-BPD-SA, N = 80), single attempters with BPD (BPD-SA, N = 127) and multiple attempters with BPD (BPD-MA, N = 95). RESULTS Univariate analyses revealed a severity gradient among the 3 groups with an additive effect of BPD on the clinical and suicide severity already conferred by a history of SA. This gradient encompassed categorical (anxiety and conduct disorders and non-suicidal-self-injury [NSSI]) and dimensional comorbidities (substance use and depression severity) and suicide characteristics (age at first SA). According to regression analyses, the BPD-MA group that was associated with the most severe clinical presentation also showed specific features: the first SA at a younger age and a higher prevalence of non-suicidal self-injury (NSSI) and anxiety disorders. The BPD-MA group was not associated with higher impulsivity or frequency of negative life events. CONCLUSIONS Based on these findings and to improve youth suicide prevention, future studies should systematically consider BPD and the efficacy of reinforcing early interventions for anxiety disorders and NSSI.
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Affiliation(s)
| | - David Cohen
- grid.462015.40000 0004 0617 9849Institut des Systemes Intelligents et de Robotique, Paris, France
| | - Bojan Mirkovic
- grid.417615.00000 0001 2296 5231Hopital Charles Nicolle, Rouen, France
| | - Hugues Pellerin
- grid.411439.a0000 0001 2150 9058Hopital Universitaire Pitie Salpetriere, Paris, France
| | | | - Angèle Consoli
- grid.411439.a0000 0001 2150 9058Hopital Universitaire Pitie Salpetriere, Paris, France
| | | | - Jean-Marc Guilé
- grid.134996.00000 0004 0593 702XCentre Hospitalier Universitaire Amiens-Picardie, Amiens, France
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25
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Gilbert JR, Ballard ED, Galiano CS, Nugent AC, Zarate CA. Magnetoencephalographic Correlates of Suicidal Ideation in Major Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:354-363. [PMID: 31928949 PMCID: PMC7064429 DOI: 10.1016/j.bpsc.2019.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Defining the neurobiological underpinnings of suicidal ideation (SI) is crucial to improving our understanding of suicide. This study used magnetoencephalographic gamma power as a surrogate marker for population-level excitation-inhibition balance to explore the underlying neurobiology of SI and depression. In addition, effects of pharmacological intervention with ketamine, which has been shown to rapidly reduce SI and depression, were assessed. METHODS Data were obtained from 29 drug-free patients with major depressive disorder who participated in an experiment comparing subanesthetic ketamine (0.5 mg/kg) with a placebo saline infusion. Magnetoencephalographic recordings were collected at baseline and after ketamine and placebo infusions. During scanning, patients rested with their eyes closed. SI and depression were assessed, and a linear mixed-effects model was used to identify brain regions where gamma power and both SI and depression were associated. Two regions of the salience network (anterior insula, anterior cingulate) were then probed using dynamic causal modeling to test for ketamine effects. RESULTS Clinically, patients showed significantly reduced SI and depression after ketamine administration. In addition, distinct regions in the anterior insula were found to be associated with SI compared with depression. In modeling of insula-anterior cingulate connectivity, ketamine lowered the membrane capacitance for superficial pyramidal cells. Finally, connectivity between the insula and anterior cingulate was associated with improvements in depression symptoms. CONCLUSIONS These findings suggest that the anterior insula plays a key role in SI, perhaps via its role in salience detection. In addition, transient changes in superficial pyramidal cell membrane capacitance and subsequent increases in cortical excitability might be a mechanism through which ketamine improves SI.
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Affiliation(s)
- Jessica R Gilbert
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Elizabeth D Ballard
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Christina S Galiano
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Allison C Nugent
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Carlos A Zarate
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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26
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Davies G, Hayward M, Evans S, Mason O. A systematic review of structural MRI investigations within borderline personality disorder: Identification of key psychological variables of interest going forward. Psychiatry Res 2020; 286:112864. [PMID: 32163818 DOI: 10.1016/j.psychres.2020.112864] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/09/2020] [Accepted: 02/09/2020] [Indexed: 12/19/2022]
Abstract
Existing models of Borderline Personality Disorder (BPD) suggest that a combination of genetic vulnerability, childhood trauma, and disrupted attachment can lead to the marked emotional lability, impulsivity and interpersonal difficulties observed clinically. Brain structural differences in frontal, limbic and hippocampal regions have been reported in BPD. Less clear is how specific psychological factors relate to these structural differences, and how consistently this is found across studies. This was the focus of the present review. Eighteen studies published between 2004 and 2018 met inclusion criteria encompassing 990 participants. Study quality was assessed using the Nottingham-Ottawa Scale. We also introduce a newly devised scale to assess MRI reporting quality. The most frequently investigated psychological variable were impulsivity (9 studies), depression (8), trauma (6), aggression (6), severity of symptoms (3), global functioning, abuse and dissociation (2). Study quality varied, however, a trend was observed where newer studies were higher in reporting quality. Impulsivity demonstrated greater association with frontal structures, trauma related to the hypothalamus and limbic systems, and aggression with hippocampal and frontal structures. The present review recommends greater exploration of neurocognitive and psychosis-related features such as delusions, paranoia and voice-hearing in future studies, and to investigate cortical changes in longitudinal designs.
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Affiliation(s)
- Geoff Davies
- Faculty of Health and Medical Science, University of Surrey, Guildford, UK; Surrey & Borders NHS Trust, UK.
| | - Mark Hayward
- School of Psychology, University of Sussex, UK; Sussex Partnership NHS Foundation Trust, UK
| | - Simon Evans
- Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Oliver Mason
- Faculty of Health and Medical Science, University of Surrey, Guildford, UK
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27
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Schmaal L, van Harmelen AL, Chatzi V, Lippard ETC, Toenders YJ, Averill LA, Mazure CM, Blumberg HP. Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies. Mol Psychiatry 2020; 25:408-427. [PMID: 31787757 PMCID: PMC6974434 DOI: 10.1038/s41380-019-0587-x] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 01/06/2023]
Abstract
Identifying brain alterations that contribute to suicidal thoughts and behaviors (STBs) are important to develop more targeted and effective strategies to prevent suicide. In the last decade, and especially in the last 5 years, there has been exponential growth in the number of neuroimaging studies reporting structural and functional brain circuitry correlates of STBs. Within this narrative review, we conducted a comprehensive review of neuroimaging studies of STBs published to date and summarize the progress achieved on elucidating neurobiological substrates of STBs, with a focus on converging findings across studies. We review neuroimaging evidence across differing mental disorders for structural, functional, and molecular alterations in association with STBs, which converges particularly in regions of brain systems that subserve emotion and impulse regulation including the ventral prefrontal cortex (VPFC) and dorsal PFC (DPFC), insula and their mesial temporal, striatal and posterior connection sites, as well as in the connections between these brain areas. The reviewed literature suggests that impairments in medial and lateral VPFC regions and their connections may be important in the excessive negative and blunted positive internal states that can stimulate suicidal ideation, and that impairments in a DPFC and inferior frontal gyrus (IFG) system may be important in suicide attempt behaviors. A combination of VPFC and DPFC system disturbances may lead to very high risk circumstances in which suicidal ideation is converted to lethal actions via decreased top-down inhibition of behavior and/or maladaptive, inflexible decision-making and planning. The dorsal anterior cingulate cortex and insula may play important roles in switching between these VPFC and DPFC systems, which may contribute to the transition from suicide thoughts to behaviors. Future neuroimaging research of larger sample sizes, including global efforts, longitudinal designs, and careful consideration of developmental stages, and sex and gender, will facilitate more effectively targeted preventions and interventions to reduce loss of life to suicide.
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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
| | | | - Vasiliki Chatzi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Yara J Toenders
- 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
| | - Lynnette A Averill
- Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs National Center for PTSD, Clinical Neurosciences Division, West Haven, CT, USA
| | - Carolyn M Mazure
- Psychiatry and Women's Health Research at Yale, Yale School of Medicine, New Haven, CT, USA
| | - Hilary P Blumberg
- Psychiatry, Radiology and Biomedical Imaging, Child Study Center, Yale School of Medicine, New Haven, CT, USA.
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28
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Teti Mayer J, Nicolier M, Gabriel D, Masse C, Giustiniani J, Compagne C, Vandel P, Pazart L, Haffen E, Bennabi D. Efficacy of transcranial direct current stimulation in reducing impulsivity in borderline personality disorder (TIMBER): study protocol of a randomized controlled clinical trial. Trials 2019; 20:347. [PMID: 31182143 PMCID: PMC6558822 DOI: 10.1186/s13063-019-3427-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 05/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Impulsivity is a core feature of borderline personality disorder (BPD) and is closely related to suicide risk and destructive and aggressive behaviors. Although transcranial direct current stimulation (tDCS) has shown its promising effects as an intervention to modulate impulsivity, no study has explored its potential regarding BPD. Methods/design This is a multicenter, crossover, double-blind study comparing active versus sham tDCS (2 mA, 30 min), applied over the dorsolateral prefrontal cortex for five consecutive days in 50 BPD patients. Participants will be assessed for impulsivity, depressive symptoms, and suicide risk. The main efficacy criteria on reduction of impulsivity will be the amplitude variation of one specific evoked potential detected by electroencephalography (EEG) during the balloon analogue risk task. Baseline measures will be compared to scores obtained immediately after sessions, then 12 and 30 days later. Discussion This study investigates the safety and effects of tDCS, which may have a significant impact on impulsivity in patients with BPD and may be useful to reduce risky behaviors. Trial registration ClinicalTrials.gov, NCT03498937. Registered on 17 April 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3427-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juliana Teti Mayer
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France. .,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France.
| | - Magali Nicolier
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Damien Gabriel
- Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Caroline Masse
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Julie Giustiniani
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Charline Compagne
- Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Pierre Vandel
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France.,Centre Mémoire Ressources et Recherche, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France
| | - Lionel Pazart
- Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France
| | - Emmanuel Haffen
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France.,Centre Expert Dépression Résistante FondaMental, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France
| | - Djamila Bennabi
- Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Centre d'Investigation Clinique, INSERM CIC 1431, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France.,Laboratoire de Neurosciences Intégratives et Cliniques EA, Université de Bourgogne Franche-Comté, 19 rue Ambroise Paré, 25000, Besançon, France.,Centre Expert Dépression Résistante FondaMental, Centre Hospitalier Universitaire de Besançon, 25030, Besançon Cedex, France
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29
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Soloff PH, Chowdury A, Diwadkar VA. Affective interference in borderline personality disorder: The lethality of suicidal behavior predicts functional brain profiles. J Affect Disord 2019; 252:253-262. [PMID: 30991253 PMCID: PMC6563825 DOI: 10.1016/j.jad.2019.04.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/11/2019] [Accepted: 04/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Negative affective interference with executive cognition is associated with emotion dysregulation and behavioral dyscontrol in BPD, including a diathesis to suicidal and self-injurious behavior. While clinically well described, the neural basis of affective interference with central executive network function, and resulting suicidal behavior is poorly understood. METHOD In an fMRI study, 23 BPD suicide attempters completed an affectively modified Continuous Performance Task(X-CPT), in which targets and distractors were rendered on Negative, Positive and Neutral Ekman faces, with a Distorted image as a behavioral baseline. Responses to targets were contextualized by the affective context of the face. Lethality Rating Scale scores (LRS) were modeled as the primary regressor of interest on activation peaks, with HamD scores covaried. RESULTS In the Negative vs. Neutral contrast, LRS scores were inversely related to activation in the ACC, parietal precuneus, BG and OFC, with no positive relationships. Results were similar in the Negative vs Positive contrast. In the Neutral vs. Positive contrast, activations were much less extensive, with mixed positive and negative relationships. Contextualizing responses based on the effects of valence decreased participant's ability to distinguish between targets and distracters; however, no differences were observed between valence contexts. fMRI-estimated effects were not confounded by differences in behavioral sensitivity across contexts. LIMITATIONS In this female-only sample, possible gender differences were not addressed. CONCLUSIONS With negative affective interference, increased lethality of suicidal behavior in BPD predicted diminished neural activation in areas critical to executive cognitive function. Therapies diminishing affective interference may reduce risk of suicidal behavior.
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Affiliation(s)
- Paul H. Soloff
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
| | - Vaibhav A. Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
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30
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Peña-Salazar C, Simó Algado S, Pons i Baños J, Arrufat FX, Valdés-Stauber J. Life Trajectories of Suicide Attempt Survivors. JOURNAL OF HUMANISTIC PSYCHOLOGY 2019. [DOI: 10.1177/0022167819847100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Judit Pons i Baños
- University of Vic–Central University of Catalonia, Vic, Spain
- Osona Salut Mental, Vic, Spain
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31
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Muñoz-Negro JE, Prudent C, Gutiérrez B, Cervilla JA. Paranoia and risk of personality disorder in the general population. Personal Ment Health 2019; 13:107-116. [PMID: 30989831 DOI: 10.1002/pmh.1443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/14/2019] [Accepted: 03/13/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND We hypothesized that paranoia is associated with personality disorder (PD) in the general population. METHOD This was a population-based cross-sectional survey carried out in Andalusia (Spain) using a representative sample of 4 507 participants. Paranoia was measured using the Green Paranoid Thought Scale, and risk of having a PD was screened using the Standardized Assessment of Personality Abbreviated Scale whilst borderline personality disorder (BPD) was measured with the CEPER-III Exploratory Interview of Personality disorder. Adjusted Pearsons' correlations between paranoia and PD or BPD were calculated. RESULTS Paranoia was associated with the risk of having PD and, more robustly, with BPD. Both associations held true for both personality outcomes (PD and BPD) when tested for two Green Paranoid Thought Scale paranoia subtypes (persecutory and reference) after accounting for the effects of age, sex and child abuse. CONCLUSIONS Paranoia seems to either augment the risk for, or be part of, PD/BPD. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
- José E Muñoz-Negro
- Unidad de Salud Mental, Hospital Universitario San Cecilio de Granada, Instituto Biosanitario de Granada, Servicio Andaluz de Salud, Granada, Spain
| | - Cécile Prudent
- Equipe Émergente de Recherche, BePsyLab, Université d' Angers, Angers, France
| | - Blanca Gutiérrez
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Jorge A Cervilla
- Unidad de Salud Mental, Hospital Universitario San Cecilio de Granada, Instituto Biosanitario de Granada, Servicio Andaluz de Salud, Granada, Spain.,Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
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32
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Voxel-Based Morphometry Correlates of an Agitated-Aggressive Syndrome in the At-Risk Mental State for Psychosis and First Episode Psychosis. Sci Rep 2018; 8:16516. [PMID: 30409978 PMCID: PMC6224526 DOI: 10.1038/s41598-018-33770-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/06/2018] [Indexed: 12/29/2022] Open
Abstract
There are mixed reports on structural neuroimaging correlates of aggression in schizophrenia with weak evidence due to cohort overlaps and lack of replications. To our knowledge, no study examined volumetric neuroimaging correlates of aggression in early stages of psychosis. An agitated-aggressive syndrome is present in at-risk mental state (ARMS) and in first-episode psychosis (FEP) - it is unclear whether this syndrome is associated with structural brain abnormalities in early stages of psychosis. Using three-dimensional magnetic resonance imaging and a whole brain voxel-based morphometry approach, we examined 56 ARMS patients, 55 FEP patients and 25 healthy controls. We operationalized aggression using the Excited Component of the Brief Psychiatric Rating Scale (BPRS-EC) and dichotomized our patient group by median split into "BPRS-EC high" (n = 49) and "BPRS-EC low" groups (n = 62). The "BPRS-EC high" group had significantly smaller left lingual gyrus volume than HC. This finding was not present in the "BPRS-EC low" group. In addition, grey matter volume in the left lingual gyrus showed a negative linear correlation with BPRS-EC over all subjects (ρ = -0.318; p = 0.0001) and in the patient group (ρ = -0.202; p = 0.033). These findings provide first hints on structural brain abnormalities associated with an agitated-aggressive syndrome in ARMS and FEP patients.
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33
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Domínguez-Baleón C, Gutiérrez-Mondragón LF, Campos-González AI, Rentería ME. Neuroimaging Studies of Suicidal Behavior and Non-suicidal Self-Injury in Psychiatric Patients: A Systematic Review. Front Psychiatry 2018; 9:500. [PMID: 30386264 PMCID: PMC6198177 DOI: 10.3389/fpsyt.2018.00500] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/24/2018] [Indexed: 01/19/2023] Open
Abstract
Background: With around 800,000 people taking their own lives every year, suicide is a growing health concern. Understanding the factors that underlie suicidality and identifying specific variables associated with increased risk is paramount for increasing our understanding of suicide etiology. Neuroimaging methods that enable the investigation of structural and functional brain markers in vivo are a promising tool in suicide research. Although a number of studies in clinical samples have been published to date, evidence about neuroimaging correlates for suicidality remains controversial. Objective: Patients with mental disorders have an increased risk for both suicidal behavior and non-suicidal self-injury. This manuscript aims to present an up-to-date overview of the literature on potential neuroimaging markers associated with SB and NSSI in clinical samples. We sought to identify consistently reported structural changes associated with suicidal symptoms within and across psychiatric disorders. Methods: A systematic literature search across four databases was performed to identify all English-language neuroimaging articles involving patients with at least one psychiatric diagnosis and at least one variable assessing SB or NSSI. We evaluated and screened evidence in these articles against a set of inclusion/exclusion criteria and categorized them by disease, adhering to the PRISMA guidelines. Results: Thirty-three original scientific articles investigating neuroimaging correlates of SB in psychiatric samples were found, but no single article focusing on NSSI alone. Associations between suicidality and regions in frontal and temporal cortex were reported by 15 and 9 studies across four disorders, respectively. Furthermore, differences in hippocampus were reported by four studies across three disorders. However, we found a significant lack of replicability (consistency in size and direction) of results across studies. Conclusions: Our systematic review revealed a lack of neuroimaging studies focusing on NSSI in clinical samples. We highlight several potential sources of bias in published studies, and conclude that future studies should implement more rigorous study designs to minimize bias risk. Despite several studies reporting associations between SB and anatomical differences in the frontal cortex, there was a lack of consistency across them. We conclude that better-powered samples, standardized neuroimaging and analytical protocols are needed to continue advancing knowledge in this field.
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Affiliation(s)
- Carmen Domínguez-Baleón
- Licenciatura en Ciencias Genómicas, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - Luis F. Gutiérrez-Mondragón
- Licenciatura en Ciencias Genómicas, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - Adrián I. Campos-González
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Miguel E. Rentería
- Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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34
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Ai H, van Tol MJ, Marsman JBC, Veltman DJ, Ruhé HG, van der Wee NJA, Opmeer EM, Aleman A. Differential relations of suicidality in depression to brain activation during emotional and executive processing. J Psychiatr Res 2018; 105:78-85. [PMID: 30212727 DOI: 10.1016/j.jpsychires.2018.08.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/02/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Abstract
Suicidal behavior is highly prevalent in major depressive disorder (MDD), though not present in all patients. It is unclear whether the tendency for suicidal behavior is associated with a unique functional neuroanatomical signature identifiable through neuroimaging. In this study, we investigated brain activation in suicidal and non-suicidal patients with MDD during facial emotion processing and executive control. Functional magnetic resonance imaging (fMRI) data from the NESDA-fMRI study (MDD patients N = 103, healthy controls N = 26, HC) were analyzed. Patients were divided in a group of suicide attempters (N = 18, SA), suicide ideators (N = 31, SI) and a patient-control group (N = 73, PC). A gender discrimination task with emotional faces and the Tower of London executive planning task were investigated. An ANOVA was performed to compare brain activation among suicidal patients (SA + SI), PC and HC first and then among SI, SA, PC and HC. Significance was determined as meeting p < .05 family wise error (FWE) corrected at the voxel-level. We observed that SA patients showed lower activation in the bilateral fusiform gyri during emotional faces processing compared to SI, PC and HC. No group differences were found during executive planning. Results were independent of childhood emotional maltreatment, depression severity, anxiety severity, use of psychotherapy and SSRI-use. Results suggest that a propensity for suicidal behavior in MDD is associated with abnormal emotional processing but not executive functioning, represented by altered face processing compared to non-suicidal patients and controls. While in need of replication, these results indicate that altered fusiform gyrus activation during emotion processing may serve as a marker for suicidality.
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Affiliation(s)
- Hui Ai
- College of Psychology and Sociology, Shenzhen University, PR China; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands.
| | - Marie-José van Tol
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Jan-Bernard C Marsman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Dick J Veltman
- VU University Medical Center Amsterdam, Department of Psychiatry, the Netherlands; VU University, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Henricus G Ruhé
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands; University of Amsterdam, Academic Medical Center, Department of Psychiatry, Amsterdam, the Netherlands
| | - Nic J A van der Wee
- Leiden University Medical Center, Department of Psychiatry, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Esther M Opmeer
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - André Aleman
- College of Psychology and Sociology, Shenzhen University, PR China; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands; University of Groningen, Department of Psychology, the Netherlands.
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35
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De Berardis D, Fornaro M, Valchera A, Cavuto M, Perna G, Di Nicola M, Serafini G, Carano A, Pompili M, Vellante F, Orsolini L, Fiengo A, Ventriglio A, Yong-Ku K, Martinotti G, Di Giannantonio M, Tomasetti C. Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors. Int J Mol Sci 2018; 19:E2888. [PMID: 30249029 PMCID: PMC6213585 DOI: 10.3390/ijms19102888] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/19/2018] [Indexed: 12/22/2022] Open
Abstract
Despite the continuous advancement in neurosciences as well as in the knowledge of human behaviors pathophysiology, currently suicide represents a puzzling challenge. The World Health Organization (WHO) has established that one million people die by suicide every year, with the impressive daily rate of a suicide every 40 s. The weightiest concern about suicidal behavior is how difficult it is for healthcare professionals to predict. However, recent evidence in genomic studies has pointed out the essential role that genetics could play in influencing person's suicide risk. Combining genomic and clinical risk assessment approaches, some studies have identified a number of biomarkers for suicidal ideation, which are involved in neural connectivity, neural activity, mood, as well as in immune and inflammatory response, such as the mammalian target of rapamycin (mTOR) signaling. This interesting discovery provides the neurobiological bases for the use of drugs that impact these specific signaling pathways in the treatment of suicidality, such as ketamine. Ketamine, an N-methyl-d-aspartate glutamate (NMDA) antagonist agent, has recently hit the headlines because of its rapid antidepressant and concurrent anti-suicidal action. Here we review the preclinical and clinical evidence that lay the foundations of the efficacy of ketamine in the treatment of suicidal ideation in mood disorders, thereby also approaching the essential question of the understanding of neurobiological processes of suicide and the potential therapeutics.
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Affiliation(s)
- Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy.
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Michele Fornaro
- Polyedra Research Group, 64100 Teramo, Italy.
- Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy.
| | - Alessandro Valchera
- Polyedra Research Group, 64100 Teramo, Italy.
- Villa S. Giuseppe Hospital, Hermanas Hospitalarias, 63100 Ascoli Piceno, Italy.
| | - Marilde Cavuto
- Department of Theory, Analysis and Composition, Music Conservatory "L. Canepa", 07100 Sassari, Italy.
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy.
- Department of Psychiatry and Neuropsychology, University of Maastricht, 6221 Maastricht, The Netherlands.
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Coral Gables, FL 33114, USA.
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, 00118 Rome, Italy.
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy.
| | - Alessandro Carano
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "Madonna Del Soccorso", A.S.U.R. 12, 63074 San Benedetto del Tronto, Italy.
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00118 Rome, Italy.
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Laura Orsolini
- Polyedra Research Group, 64100 Teramo, Italy.
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield SG141LZ, UK.
| | - Annastasia Fiengo
- Polyedra Research Group, 64100 Teramo, Italy.
- NHS, Department of Mental Health ASUR Marche AV5, Mental Health Unit, 63100 Ascoli Piceno, Italy.
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy.
| | - Kim Yong-Ku
- Department of Psychiatry, Korea University College of Medicine, Seoul 08826, Korea.
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", 66100 Chieti, Italy.
| | - Carmine Tomasetti
- Polyedra Research Group, 64100 Teramo, Italy.
- Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80121 Naples, Italy.
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Kubera KM, Schmitgen MM, Maier-Hein KH, Thomann PA, Hirjak D, Wolf RC. Differential contributions of cortical thickness and surface area to trait impulsivity in healthy young adults. Behav Brain Res 2018; 350:65-71. [DOI: 10.1016/j.bbr.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/26/2018] [Accepted: 05/07/2018] [Indexed: 01/21/2023]
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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.
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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.
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Suicidal behavior and aggression-related disorders. Curr Opin Psychol 2018; 22:54-58. [DOI: 10.1016/j.copsyc.2017.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/18/2022]
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Abstract
PURPOSE OF REVIEW This review article aims at giving an update on studies investigating correlates of aggression in personality disorders during the last 5 years. RECENT FINDINGS Most data refer to borderline personality disorder (BPD) and antisocial personality disorder (ASPD). In BPD, emotion dysregulation, hypersensitivity to interpersonal rejection/threat, increased rumination, increased negative urgency, aggression-related knowledge structures, and invalidation were either corroborated or emerged as psychological correlates of aggression, while reduced ambiguity sensitivity, hyposensitivity to interpersonal threat, and reduced mindfulness were associated with aggression in ASPD. Neurobiologically, alterations of the monoaminooxidase-A-, the oxytocinergic-, and the prefrontal-limbic-system as well as increases of the thyroid hormone T3, γ-aminobutyric acid and several inflammatory markers were associated with increased aggression across various personality disorders. Our understanding of correlates of aggression in personality disorders has increased over the last 5 years. More efforts in improving the conceptualization of personality disorders and aggression are needed to develop innovative treatments for those affected.
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Affiliation(s)
- Falk Mancke
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany.
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany
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da Silva AG, Malloy-Diniz LF, Garcia MS, Figueiredo CGS, Figueiredo RN, Diaz AP, Palha AP. Cognition As a Therapeutic Target in the Suicidal Patient Approach. Front Psychiatry 2018; 9:31. [PMID: 29487542 PMCID: PMC5816899 DOI: 10.3389/fpsyt.2018.00031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/26/2018] [Indexed: 12/16/2022] Open
Abstract
The current considerations about completed suicides and suicide attempts in different cultures call the attention of professionals to this serious public health problem. Integrative approaches have shown that the confluence of multiple biological and social factors modulate various psychopathologies and dysfunctional behaviors, such as suicidal behavior. Considering the level of intermediate analysis, personality traits and cognitive functioning are also of great importance for understanding the suicide phenomenon. About cognitive factors, we can group them into cognitive schemas of reality interpretation and underlying cognitive processes. On the other hand, different types of primary cognitive alterations are related to suicidal behavior, especially those resulting from changes in frontostriatal circuits. Among such cognitive mechanisms can be highlighted the attentional bias for environmental cues related to suicide, impulsive behavior, verbal fluency deficits, non-adaptive decision-making, and reduced planning skills. Attentional bias consists in the effect of thoughts and emotions, frequently not conscious, about the perception of environmental stimuli. Suicidal ideation and hopelessness can make the patient unable to find alternative solutions to their problems other than suicide, biasing their attention to environmental cues related to such behavior. Recent research efforts are directed to assess the possible use of attention bias as a therapeutic target in patients presenting suicide behavior. The relationship between impulsivity and suicide has been largely investigated over the last decades, and there is still controversy about the theme. Although there is strong evidence linking impulsivity to suicide attempts. Effective interventions address to reduce impulsivity in clinical populations at higher risk for suicide could help in the prevention. Deficits in problem-solving ability also seem to be distorted in patients who attempt suicide. Understanding cognitive changes in patients who attempt suicide open an important perspective in the approach of patients with mental disorders. Identifying cognitive deficits in these patients, along with personality traits, depressive symptoms, and suicidal cognitive schemas may indicate to the psychiatrist the need for emergency care. Behavioral and cognitive interventions have been associated with reductions in suicide ideation, as well as suicide attempts in different populations.
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Affiliation(s)
| | | | - Marina Saraiva Garcia
- Molecular Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Duarte DGG, Neves MDCL, Albuquerque MR, Turecki G, Ding Y, de Souza-Duran FL, Busatto G, Correa H. Structural brain abnormalities in patients with type I bipolar disorder and suicidal behavior. Psychiatry Res Neuroimaging 2017; 265:9-17. [PMID: 28494347 DOI: 10.1016/j.pscychresns.2017.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 04/24/2017] [Accepted: 04/28/2017] [Indexed: 12/20/2022]
Abstract
Some studies have identified brain morphological changes in the frontolimbic network (FLN) in bipolar subjects who attempt suicide (SA). The present study investigated neuroanatomical abnormalities in the FLN to find a possible neural signature for suicidal behavior in patients with bipolar disorder type I (BD-I). We used voxel-based morphometry to compare euthymic patients with BD-I who had attempted suicide (n=20), who had not attempted suicide (n=19) and healthy controls (HCs) (n=20). We also assessed the highest medical lethality of their previous SA. Compared to the participants who had not attempted suicide, the patients with BD-I who had attempted suicide exhibited significantly increased gray matter volume (GMV) in the right rostral anterior cingulate cortex (ACC), which was more pronounced and extended further to the left ACC in the high-lethality subgroup (p<0.05, with family-wise error (FWE) correction for multiple comparisons using small-volume correction). GMV in the insula and orbitofrontal cortex was also related to suicide lethality (p<0.05, FWE-corrected). The current findings suggest that morphological changes in the FLN could be a signature of previous etiopathogenic processes affecting regions related to suicidality and its severity in BD-I patients.
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Affiliation(s)
- Dante G G Duarte
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | - Maila de Castro L Neves
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | | | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Yang Ding
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Fabio Luis de Souza-Duran
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Geraldo Busatto
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Humberto Correa
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
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Abstract
PURPOSE OF REVIEW The rising suicide rate in the USA will not be reversed without improved risk assessment and prevention practices. To date, the best method for clinicians to assess a patient's risk for suicide is screening for past suicide attempts in the patient and their family. However, neuroimaging, genomic, and biochemical studies have generated a body of findings that allow description of an initial heuristic biological model for suicidal behavior that may have predictive value. RECENT FINDINGS We review studies from the past 3 years examining potential biological predictors of suicide attempt behavior. We divide findings into two major categories: (1) structural and functional brain imaging findings and (2) biochemical and genomic findings encompassing several systems, including major neurotransmitters (serotonin, catecholamines, GABA, and glutamate), the hypothalamic pituitary adrenal (HPA) axis, the inflammasome, lipids, and neuroplasticity. The biomarkers that appear promising for assessing suicide risk in clinical settings include indices of serotonergic function, inflammation, neuronal plasticity, and lipids.
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Borderline Personality Features in Students: The Predicting Role of Traumatic Experiences and Aggressive Traits. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2017. [DOI: 10.5812/intjsh.13088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hyper-modulation of brain networks by the amygdala among women with Borderline Personality Disorder: Network signatures of affective interference during cognitive processing. J Psychiatr Res 2017; 88:56-63. [PMID: 28086129 PMCID: PMC5362299 DOI: 10.1016/j.jpsychires.2016.12.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/26/2016] [Accepted: 12/20/2016] [Indexed: 01/16/2023]
Abstract
Emotion dysregulation is a core characteristic of patients with Borderline Personality Disorder (BPD), and is often attributed to an imbalance in fronto-limbic network function. Hyperarousal of amygdala, especially in response to negative affective stimuli, results in affective interference with cognitive processing of executive functions. Clinical consequences include the impulsive-aggression, suicidal and self-injurious behaviors which characterize BPD. Dysfunctional interactions between amygdala and its network targets have not been well characterized during cognitive task performance. Using psychophysiological interaction analysis (PPI), we mapped network profiles of amygdala interaction with key regulatory regions during a Go No-Go task, modified to use negative, positive and neutral Ekman faces as targets. Fifty-six female subjects, 31 BPD and 25 healthy controls (HC), completed the affectively valenced Go No-Go task during fMRI scanning. In the negative affective condition, the amygdala exerted greater modulation of its targets in BPD compared to HC subjects in Rt. OFC, Rt. dACC, Rt. Parietal cortex, Rt. Basal Ganglia, and Rt. dlPFC. Across the spectrum of affective contrasts, hypermodulation in BPD subjects observed the following ordering: Negative > Neutral > Positive contrast. The amygdala seed exerted modulatory effects on specific target regions important in processing response inhibition and motor impulsiveness. The vulnerability of BPD subjects to affective interference with impulse control may be due to specific network dysfunction related to amygdala hyper-arousal and its effects on prefrontal regulatory regions such as the OFC and dACC.
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Soloff PH, Abraham K, Burgess A, Ramaseshan K, Chowdury A, Diwadkar VA. Impulsivity and aggression mediate regional brain responses in Borderline Personality Disorder: An fMRI study. Psychiatry Res 2017; 260:76-85. [PMID: 28039797 PMCID: PMC5272782 DOI: 10.1016/j.pscychresns.2016.12.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/07/2016] [Accepted: 12/10/2016] [Indexed: 01/24/2023]
Abstract
Fronto-limbic brain networks involved in regulation of impulsivity and aggression are abnormal in Borderline Personality Disorder (BPD). However, it is unclear whether, or to what extent, these personality traits actually modulate brain responses during cognitive processing. Using fMRI, we examined the effects of trait impulsivity, aggression, and depressed mood on regional brain responses in 31 female BPD and 25 control subjects during a Go No-Go task using Ekman faces as targets. First-level contrasts modeled effects of negative emotional context. Second-level regression models used trait impulsivity, aggression and depressed mood as predictor variables of regional brain activations. In BPD, trait impulsivity was positively correlated with activation in the dorsal anterior cingulate cortex, orbital frontal cortex (OFC), basal ganglia (BG), and dorsolateral prefrontal cortex, with no areas of negative correlation. In contrast, aggression was negatively correlated with activation in OFC, hippocampus, and BG, with no areas of positive correlation. Depressed mood had a generally dampening effect on activations. Effects of trait impulsivity on healthy controls differed from effects in BPD, suggesting a disorder-specific response. Negative emotional context and trait impulsivity, but not aggression or depression, diminished task performance across both groups. Negative emotional context may interfere with cognitive functioning in BPD through interaction with the neurobiology of personality traits.
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Affiliation(s)
- Paul H Soloff
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Kristy Abraham
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ashley Burgess
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Karthik Ramaseshan
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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Resting-state functional MRI of abnormal baseline brain activity in young depressed patients with and without suicidal behavior. J Affect Disord 2016; 205:252-263. [PMID: 27467529 DOI: 10.1016/j.jad.2016.07.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/23/2016] [Accepted: 07/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Suicide among youth is a major public health challenge, attracting increasing attention. However, the neurobiological mechanisms and the pathophysiology underlying suicidal behavior in depressed youths are still unclear. The fMRI enables a better understanding of functional changes in the brains of young suicide attempters with depressive disorder through detecting spontaneous neural activity. The purpose of this study was to identify the relationship between abnormalities involving local brain function and suicidal attempts in depressed youths using resting-state fMRI (RS-fMRI). METHOD Thirty-five depressed youths aged between 15 and 29 years with a history of suicidal attempts (SU group), 18 patients without suicidal attempts (NSU group) and 47 gender-, age- and education-matched healthy controls (HC) underwent psychological assessment and R-fMRI. The differences in fractional amplitude of low-frequency fluctuation (ALFF) among the three groups were compared. The clinical factors correlated with z-score ALFF in the regions displaying significant group differences were investigated. The ROC method was used to evaluate these clusters as markers to screen patients with suicidal behavior. RESULTS Compared with the NSU and HC groups, the SU group showed increased zALFF in the right superior temporal gyrus (r-STG), left middle temporal gyrus (L-MTG) and left middle occipital gyrus (L-MOG). Additionally, significantly decreased zALFF values in the L-SFG and L-MFG were found in the SU group compared with the NSU group, which were negatively correlated with BIS scores in the SU group. Further ROC analysis revealed that the mean zALFF values in these two regions (sensitivity=83.3% and specificity=71.4%) served as markers to differentiate the two patient subtypes. CONCLUSION The SU group had abnormal spontaneous neural activity during the resting state, and decreased activity in L-SFG and L-MFG was associated with increased impulsivity in SU group. Our results suggested that abnormal neural activity in these brain regions may represent a potential neurobiological diathesis or predisposition to suicidal behavior in youth depression.
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Silvers JA, Hubbard AD, Chaudhury S, Biggs E, Shu J, Grunebaum MF, Fertuck E, Weber J, Kober H, Carson-Wong A, Brodsky BS, Chesin M, Ochsner KN, Stanley B. Suicide attempters with Borderline Personality Disorder show differential orbitofrontal and parietal recruitment when reflecting on aversive memories. J Psychiatr Res 2016; 81:71-8. [PMID: 27392071 PMCID: PMC5021587 DOI: 10.1016/j.jpsychires.2016.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 05/10/2016] [Accepted: 06/24/2016] [Indexed: 11/20/2022]
Abstract
Suicidal behavior and difficulty regulating emotions are hallmarks of Borderline Personality Disorder (BPD). This study examined neural links between emotion regulation and suicide risk in BPD. 60 individuals with BPD (all female, mean age = 28.9 years), 46 of whom had attempted suicide, completed a fMRI task involving recalling aversive personal memories. Distance trials assessed the ability to regulate emotion by recalling memories from a third-person, objective viewpoint. Immerse trials assessed emotional reactivity and involved recalling memories from a first-person perspective. Behaviorally, both groups reported less negative affect on Distance as compared to Immerse trials. Neurally, two sets of findings were obtained. The first reflected differences between attempters and non-attempters. When immersing and distancing, attempters showed elevated recruitment of lateral orbitofrontal cortex, a brain region implicated in using negative cues to guide behavior. When distancing, attempters showed diminished recruitment of the precuneus, a region implicated in memory recall and perspective taking. The second set of findings related to individual differences in regulation success - the degree to which individuals used distancing to reduce negative affect. Here, we observed that attempters who successfully regulated exhibited precuneus recruitment that was more similar to non-attempters. These data provide insight into mechanisms underlying suicide attempts in BPD. Future work may examine if these findings generalize to other diagnoses and also whether prior findings in BPD differ across attempters and non-attempters.
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Affiliation(s)
- Jennifer A Silvers
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA.
| | - Alexa D Hubbard
- Department of Psychology, New York University, 6 Washington Place, New York, NY, 10003, USA
| | - Sadia Chaudhury
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Emily Biggs
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jocelyn Shu
- Department of Psychology, Columbia University, 1190 Amsterdam Avenue, New York, NY, 10027, USA
| | - Michael F Grunebaum
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Eric Fertuck
- The City University of New York, Clinical Psychology Doctoral Program and Graduate Center, New York, NY, 10031, USA
| | - Jochen Weber
- Department of Psychology, Columbia University, 1190 Amsterdam Avenue, New York, NY, 10027, USA
| | - Hedy Kober
- Department of Psychiatry, Yale School of Medicine, One Church Street, New Haven, CT, 06510, USA
| | - Amanda Carson-Wong
- Department of Psychology, Rutgers University, Busch Campus, 152 Frelinghuysen Road, Piscataway, NJ, 08854, USA
| | - Beth S Brodsky
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Megan Chesin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Kevin N Ochsner
- Department of Psychology, New York University, 6 Washington Place, New York, NY, 10003, USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA.
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Gallego JA, Rachamallu V, Yuen EY, Fink S, Duque LM, Kane JM. Predictors of suicide attempts in 3.322 patients with affective disorders and schizophrenia spectrum disorders. Psychiatry Res 2015; 228:791-796. [PMID: 26077849 PMCID: PMC4532595 DOI: 10.1016/j.psychres.2015.05.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/31/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
Abstract
This study explores risk factors for suicide attempts using the electronic health records of 3322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior.
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Affiliation(s)
- Juan A. Gallego
- The Zucker Hillside Hospital, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA
,The Feinstein Institute for Medical Research, Manhasset, New York, USA
,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA
| | | | - Eunice Y. Yuen
- State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Sabina Fink
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - John M. Kane
- The Zucker Hillside Hospital, North Shore - Long Island Jewish Health System, Glen Oaks, New York, USA
,The Feinstein Institute for Medical Research, Manhasset, New York, USA
,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA
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Affective context interferes with brain responses during cognitive processing in borderline personality disorder: fMRI evidence. Psychiatry Res 2015; 233:23-35. [PMID: 25982488 PMCID: PMC4465042 DOI: 10.1016/j.pscychresns.2015.04.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 01/21/2015] [Accepted: 04/21/2015] [Indexed: 01/18/2023]
Abstract
Emotion dysregulation in borderline personality disorder (BPD) is associated with loss of cognitive control in the face of intense negative emotion. Negative emotional context may interfere with cognitive processing through the dysmodulation of brain regions involved in regulation of emotion, impulse control, executive function and memory. Structural and metabolic brain abnormalities have been reported in these regions in BPD. Using novel fMRI protocols, we investigated the neural basis of negative affective interference with cognitive processing targeting these regions. Attention-driven Go No-Go and X-CPT (continuous performance test) protocols, using positive, negative and neutral Ekman faces, targeted the orbital frontal cortex (OFC) and the anterior cingulate cortex (ACC), respectively. A stimulus-driven Episodic Memory task, using images from the International Affective Pictures System, targeted the hippocampus (HIP). Participants comprised 23 women with BPD, who were compared with 15 healthy controls. When Negative>Positive faces were compared in the Go No-Go task, BPD subjects had hyper-activation relative to controls in areas reflecting task-relevant processing: the superior parietal/precuneus and the basal ganglia. Decreased activation was also noted in the OFC, and increased activation in the amygdala (AMY). In the X-CPT, BPD subjects again showed hyper-activation in task-relevant areas: the superior parietal/precuneus and the ACC. In the stimulus-driven Episodic Memory task, BPD subjects had decreased activation relative to controls in the HIP, ACC, superior parietal/precuneus, and dorsal prefrontal cortex (dPFC) (for encoding), and the ACC, dPFC, and HIP for retrieval of Negative>Positive pictures, reflecting impairment of task-relevant functions. Negative affective interference with cognitive processing in BPD differs from that in healthy controls and is associated with functional abnormalities in brain networks reported to have structural or metabolic abnormalities. Task demands exert a differential effect on the cognitive response to negative emotion in BPD compared with control subjects.
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Mancke F, Bertsch K, Herpertz SC. Gender differences in aggression of borderline personality disorder. Borderline Personal Disord Emot Dysregul 2015; 2:7. [PMID: 26401309 PMCID: PMC4579514 DOI: 10.1186/s40479-015-0028-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/18/2015] [Indexed: 01/08/2023] Open
Abstract
Aggression is a core feature of borderline personality disorder (BPD). Well-replicated results from the general population indicate that men engage in aggression more frequently than women. This article addresses the question of whether gender also influences aggression in BPD, and whether the neurobiological mechanisms underlying aggressive behavior differ between male and female BPD patients. Data show that most self-reports, interviews and behavioral tasks investigating samples of BPD patients do not find enhanced aggressiveness in male patients, suggesting that BPD attenuates rather than aggravates gender differences usually present in the general population. Neurobiological studies comparing BPD patients with gender-matched healthy controls, however, reveal a number of interesting gender differences: On the one hand, there are well-replicated findings of reduced amygdala and hippocampal gray matter volumes in female BPD patients, while these findings are not shared by male patients with BPD. On the other hand, only male BPD patients exhibit reduced gray matter volume of the anterior cingulate cortex, increased gray matter volume of the putamen, reduced striatal activity during an aggression task, and a more pronounced deficit in central serotonergic responsivity. These neurobiological findings point to a particular importance of impulsivity for the aggression of male BPD patients. Limitations include the need to control for confounding influences of comorbidities, particularly as male BPD patients have been consistently found to show higher percentages of aggression-predisposing comorbid disorders, such as antisocial personality disorder, than female BPD patients. In the future, studies which include systematic comparisons between females and males are warranted in order to disentangle gender differences in aggression of BPD patients with the aim of establishing gender-sensitive treatments where needed.
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Affiliation(s)
- Falk Mancke
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
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