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Tymofiyeva O, Ho TC, Connolly CG, Gorrell S, Rampersaud R, Darrow SM, Max JE, Yang TT. Examining putamen resting-state connectivity markers of suicide attempt history in depressed adolescents. Front Psychiatry 2024; 15:1364271. [PMID: 38903634 PMCID: PMC11187256 DOI: 10.3389/fpsyt.2024.1364271] [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: 01/02/2024] [Accepted: 04/24/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Suicide is a current leading cause of death in adolescents and young adults. The neurobiological underpinnings of suicide risk in youth, however, remain unclear and a brain-based model is lacking. In adult samples, current models highlight deficient serotonin release as a potential suicide biomarker, and in particular, involvement of serotonergic dysfunction in relation to the putamen and suicidal behavior. Less is known about associations among striatal regions and relative suicidal risk across development. The current study examined putamen connectivity in depressed adolescents with (AT) and without history of a suicide attempt (NAT), specifically using resting-state functional magnetic resonance imaging (fMRI) to evaluate patterns in resting-state functional connectivity (RSFC). We hypothesized the AT group would exhibit lower striatal RSFC compared to the NAT group, and lower striatal RSFC would associate with greater suicidal ideation severity and/or lethality of attempt. Methods We examined whole-brain RSFC of six putamen regions in 17 adolescents with depression and NAT (MAge [SD] = 16.4[0.3], 41% male) and 13 with AT (MAge [SD] = 16.2[0.3], 31% male). Results Only the dorsal rostral striatum showed a statistically significant bilateral between-group difference in RSFC with the superior frontal gyrus and supplementary motor area, with higher RSFC in the group without a suicide attempt compared to those with attempt history (voxel-wise p<.001, cluster-wise p<.01). No significant associations were found between any putamen RSFC patterns and suicidal ideation severity or lethality of attempts among those who had attempted. Discussion The results align with recent adult literature and have interesting theoretical and clinical implications. A possible interpretation of the results is a mismatch of the serotonin transport to putamen and to the supplementary motor area and the resulting reduced functional connectivity between the two areas in adolescents with attempt history. The obtained results can be used to enhance the diathesis-stress model and the Emotional paiN and social Disconnect (END) model of adolescent suicidality by adding the putamen. We also speculate that connectivity between putamen and the supplementary motor area may in the future be used as a valuable biomarker of treatment efficacy and possibly prediction of treatment outcome.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Tiffany C. Ho
- Department of Psychology, Brain Research Institute, Interdepartmental Graduate Program in Neuroscience, University of California, Los Angeles, Los Angeles, CA, United States
| | - Colm G. Connolly
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Ryan Rampersaud
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Sabrina M. Darrow
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Jeffrey E. Max
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- Department of Psychiatry, Rady Children’s Hospital, San Diego, CA, United States
| | - Tony T. Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
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Gifuni AJ, Pereira F, Chakravarty MM, Lepage M, Chase HW, Geoffroy MC, Lacourse E, Phillips ML, Turecki G, Renaud J, Jollant F. Perception of social inclusion/exclusion and response inhibition in adolescents with past suicide attempt: a multidomain task-based fMRI study. Mol Psychiatry 2024:10.1038/s41380-024-02485-w. [PMID: 38424142 DOI: 10.1038/s41380-024-02485-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
The occurrence of suicidal behaviors increases during adolescence. Hypersensitivity to negative social signals and deficits in cognitive control are putative mechanisms of suicidal behaviors, which necessitate confirmation in youths. Multidomain functional neuroimaging could enhance the identification of patients at suicidal risk beyond standard clinical measures. Three groups of adolescents (N = 96; 78% females, age = 11.6-18.1) were included: patients with depressive disorders and previous suicide attempts (SA, n = 29); patient controls with depressive disorders but without any suicide attempt history (PC, n = 35); and healthy controls (HC, n = 32). We scanned participants with 3T-MRI during social inclusion/exclusion (Cyberball Game) and response inhibition (Go-NoGo) tasks. Neural activation was indexed by the blood-oxygenation-level dependent (BOLD) of the hemodynamic response during three conditions in the Cyberball Game ("Control condition", "Social Inclusion", and "Social Exclusion"), and two conditions in Go-NoGo task ("Go" and "NoGo" blocks). ANCOVA-style analysis identified group effects across three whole-brain contrasts: 1) NoGo vs. Go, 2) Social inclusion vs. control condition, 3) Social exclusion vs. control condition. We found that SA had lower activation in the left insula during social inclusion vs. control condition compared to PC and HC. Moreover, SA compared to PC had higher activity in the right middle prefrontal gyrus during social exclusion vs. control condition, and in bilateral precentral gyri during NoGo vs. Go conditions. Task-related behavioral and self-report measures (Self-reported emotional reactivity in the Cyberball Game, response times and number of errors in the Go-NoGo Task) did not discriminate groups. In conclusion, adolescent suicidal behaviors are likely associated with neural alterations related to the processing of social perception and response inhibition. Further research, involving prospective designs and diverse cohorts of patients, is necessary to explore the potential of neuroimaging as a tool in understanding the emergence and progression of suicidal behaviors.
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Affiliation(s)
- Anthony J Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabricio Pereira
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
- Service de psychiatrie, CHU Nîmes, Nîmes, France
- MIPA, University of Nîmes, Nîmes, France
| | | | - Martin Lepage
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Henri W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Eric Lacourse
- Department of Sociology, Université de Montréal, Montréal, Canada
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada
| | - Fabrice Jollant
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada.
- Department of Psychiatry, McGill University, Montréal, Canada.
- MOODS Team, INSERM 1018, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France.
- Service de psychiatrie, CHU Nîmes, Nîmes, France.
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France.
- Service de psychiatrie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France.
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Wen X, Qu D, Liu D, Shu Y, Zhao S, Wu G, Wang Y, Cui Z, Zhang X, Chen R. Brain structural and functional signatures of multi-generational family history of suicidal behaviors in preadolescent children. Mol Psychiatry 2024; 29:484-495. [PMID: 38102486 DOI: 10.1038/s41380-023-02342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
Parent-child transmission of suicidal behaviors has been extensively studied, but the investigation of a three-generation family suicide risk paradigm remains limited. In this study, we aimed to explore the behavioral and brain signatures of multi-generational family history of suicidal behaviors (FHoS) in preadolescents, utilizing a longitudinal design and the dataset from Adolescent Brain and Cognitive DevelopmentSM Study (ABCD Study®), which comprised 4 years of data and includes a total of 9,653 preadolescents. Our findings revealed that multi-generational FHoS was significantly associated with an increased risk of problematic behaviors and suicidal behaviors (suicide ideation and suicide attempt) in offspring. Interestingly, the problematic behaviors were further identified as a mediator in the multi-generational transmission of suicidal behaviors. Additionally, we observed alterations in brain structure within superior temporal gyrus (STG), precentral/postcentral cortex, posterior parietal cortex (PPC), cingulate cortex (CC), and planum temporale (PT), as well as disrupted functional connectivity of default mode network (DMN), ventral attention network (VAN), dorsal attention network (DAN), fronto-parietal network (FPN), and cingulo-opercular network (CON) among preadolescents with FHoS. These results provide compelling longitudinal evidence at the population level, highlighting the associations between multi-generational FHoS and maladaptive behavioral and neurodevelopmental outcomes in offspring. These findings underscore the need for early preventive measures aimed at mitigating the familial transmission of suicide risk and reducing the global burden of deaths among children and adolescents.
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Affiliation(s)
- Xue Wen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yinuo Shu
- Chinese Institute for Brain Research, Beijing, China
| | - Shaoling Zhao
- Chinese Institute for Brain Research, Beijing, China
| | - Guowei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, China.
| | - Xiaoqian Zhang
- Wulituo Hospital of Shijingshan District, Beijing, China.
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute for Healthy China, Tsinghua University, Beijing, China.
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Meda N, Miola A, Cattarinussi G, Sambataro F. Whole-brain structural and functional neuroimaging of individuals who attempted suicide and people who did not: A systematic review and exploratory coordinate-based meta-analysis. Eur Neuropsychopharmacol 2024; 79:66-77. [PMID: 38237538 DOI: 10.1016/j.euroneuro.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 02/06/2024]
Abstract
Suicide is the cause of death of approximately 800,000 people a year. Despite the relevance of this behaviour, risk assessment tools rely on clinician experience and subjective ratings. Given that previous suicide attempts are the single strongest predictors of future attempts, we designed a systematic review and coordinate-based meta-analysis to demonstrate whether neuroimaging features can help distinguish individuals who attempted suicide from subjects who did not. Out of 5,659 publications from PubMed, Scopus, and Web of Science, we summarised 102 experiments and meta-analysed 23 of them. A cluster in the right superior temporal gyrus, a region implicated in emotional processing, might be functionally hyperactive in individuals who attempted suicide. No statistically significant differences in brain morphometry were evidenced. Furthermore, we used JuSpace to show that this cluster is enriched in 5-HT1A heteroreceptors in the general population. This exploratory meta-analysis provides a putative neural substrate linked to previous suicide attempts. Heterogeneity in the analytical techniques and weak or absent power analysis of the studies included in this review currently limit the applicability of the findings, the replication of which should be prioritised.
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Affiliation(s)
- Nicola Meda
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova University Hospital, Padua, Italy
| | - Alessandro Miola
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Casa di Cura Parco dei Tigli, Padova, Italy
| | - Giulia Cattarinussi
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Via Giustiniani, 3, Padua, Italy; Padova University Hospital, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy.
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Gifuni AJ, Spodenkiewicz M, Laurent G, MacNeil S, Jollant F, Renaud J. Symptoms characteristics of personality disorders associated with suicidal ideation and behaviors in a clinical sample of adolescents with a depressive disorder. Front Psychiatry 2023; 14:1269744. [PMID: 38146283 PMCID: PMC10749562 DOI: 10.3389/fpsyt.2023.1269744] [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: 07/30/2023] [Accepted: 11/16/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood. Methods These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS). Results Findings showed that impulsivity (F = 11.0, p < 0.0001) and antisocial symptoms characteristics of personality disorders (p < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness. Discussion The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.
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Affiliation(s)
- Anthony Joseph Gifuni
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Michel Spodenkiewicz
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- INSERM UMR-1178, Moods Team, CESP, Le Kremlin-Bicêtre, France
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Geneviève Laurent
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sasha MacNeil
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Fabrice Jollant
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Division of Child Psychiatry, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Jordan JT, Chick CF, Rolle CE, Hantke N, Gould CE, Lutz J, Kawai M, Cotto I, Karna R, Pirog S, Berk M, Sudheimer K, O'Hara R, Beaudreau SA. Neurocognitive markers of passive suicidal ideation in late-life depression. Int Psychogeriatr 2023; 35:421-431. [PMID: 33118918 DOI: 10.1017/s1041610220003610] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES (1) To delineate whether cognitive flexibility and inhibitory ability are neurocognitive markers of passive suicidal ideation (PSI), an early stage of suicide risk in depression and (2) to determine whether PSI is associated with volumetric differences in regions of the prefrontal cortex (PFC) in middle-aged and older adults with depression. DESIGN Cross-sectional study. SETTING University medical school. PARTICIPANTS Forty community-dwelling middle-aged and older adults with depression from a larger study of depression and anxiety (NIMH R01 MH091342-05 PI: O'Hara). MEASUREMENTS Psychiatric measures were assessed for the presence of a DSM-5 depressive disorder and PSI. A neurocognitive battery assessed cognitive flexibility, inhibitory ability, as well as other neurocognitive domains. RESULTS The PSI group (n = 18) performed significantly worse on cognitive flexibility and inhibitory ability, but not on other neurocognitive tasks, compared to the group without PSI (n = 22). The group with PSI had larger left mid-frontal gyri (MFG) than the no-PSI group. There was no association between cognitive flexibility/inhibitory ability and left MFG volume. CONCLUSIONS Findings implicate a neurocognitive signature of PSI: poorer cognitive flexibility and poor inhibitory ability not better accounted for by other domains of cognitive dysfunction and not associated with volumetric differences in the left MFG. This suggests that there are two specific but independent risk factors of PSI in middle- and older-aged adults.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christina F Chick
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Camarin E Rolle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Nathan Hantke
- Mental Health and Clinical Neuroscience Division, VA Portland Health Care System, Portland, OR, USA
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Christine E Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Geriatric Research, Education, and Clinical Centers (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Julie Lutz
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Makoto Kawai
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Isabelle Cotto
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rosy Karna
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sophia Pirog
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michelle Berk
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Keith Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sherry A Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
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Vieira R, Faria AR, Ribeiro D, Picó-Pérez M, Bessa JM. Structural and functional brain correlates of suicidal ideation and behaviors in depression: A scoping review of MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110799. [PMID: 37207727 DOI: 10.1016/j.pnpbp.2023.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Identifying and integrating the neural correlates of suicidal ideation and behaviors is crucial to expand the knowledge and develop targeted strategies to prevent suicide. This review aimed to describe the neural correlates of suicidal ideation, behavior and the transition between them, using different magnetic resonance imaging (MRI) modalities, providing an up-to-date overview of the literature. To be included, the observational, experimental, or quasi-experimental studies must include adult patients currently diagnosed with major depressive disorder and investigate the neural correlates of suicidal ideation, behavior and/or the transition using MRI. The searches were conducted on PubMed, ISI Web of Knowledge and Scopus. Fifty articles were included in this review: 22 on suicidal ideation, 26 on suicide behaviors and two on the transition between them. The qualitative analysis of the included studies suggested alterations in the frontal, limbic and temporal lobes in suicidal ideation associated with deficits in emotional processing and regulation, and in the frontal, limbic, parietal lobes, and basal ganglia in suicide behaviors associated with impairments in decision-making. Gaps in the literature and methodological concerns were identified and might be addressed in future studies.
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Affiliation(s)
- Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | | | - Diogo Ribeiro
- Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - João M Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
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8
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Kislov MA, Prikhod'ko AN, Trusova DS, Zhiganova MS, Morozova AY, Pigolkin YI. [Morphofunctional cerebral changes associated with development of suicidal behavior]. Sud Med Ekspert 2023; 66:67-72. [PMID: 37496486 DOI: 10.17116/sudmed20236604167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
THE AIM OF THE STUDY Was to identify the cerebral areas, which demonstrate the most significant structural changes and damaged functional activity in patients with suicidal behavior. The original studies, presented in PubMed database, were used to analyze the literature. Additional literature in the form of atlases, review articles and publications, written in related spheres, was used to interpret the results. The study identified the 69 cerebral regions, demonstrating significant changes and the structures with the most significant deviations among them were selected. The regions of cerebral grey matter, in particular basal ganglia (structures of striatum and limbic system), as well as selected regions of cerebral cortex, specifically frontal, insularis, singulate and parietal mostly were included in the list. The decrease in grey matter volume, changes of neuronal and glial density, special patterns of activity and variations of functional association with other cerebral regions are described within mentioned structures. The literature review found that there was a lack of postmortem examinations in suicidal cases. Advanced study of the described structures is required in cases of completed suicide using new research methods.
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Affiliation(s)
- M A Kislov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - D S Trusova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M S Zhiganova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A Yu Morozova
- Alekseev Psychiatric Clinical Hospital No. 1 of the Moscow Department of Health, Moscow, Russia
| | - Yu I Pigolkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Dobbertin M, Blair KS, Carollo E, Blair JR, Dominguez A, Bajaj S. Neuroimaging alterations of the suicidal brain and its relevance to practice: an updated review of MRI studies. Front Psychiatry 2023; 14:1083244. [PMID: 37181903 PMCID: PMC10174251 DOI: 10.3389/fpsyt.2023.1083244] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Suicide is a leading cause of death in the United States. Historically, scientific inquiry has focused on psychological theory. However, more recent studies have started to shed light on complex biosignatures using MRI techniques, including task-based and resting-state functional MRI, brain morphometry, and diffusion tensor imaging. Here, we review recent research across these modalities, with a focus on participants with depression and Suicidal Thoughts and Behavior (STB). A PubMed search identified 149 articles specific to our population of study, and this was further refined to rule out more diffuse pathologies such as psychotic disorders and organic brain injury and illness. This left 69 articles which are reviewed in the current study. The collated articles reviewed point to a complex impairment showing atypical functional activation in areas associated with perception of reward, social/affective stimuli, top-down control, and reward-based learning. This is broadly supported by the atypical morphometric and diffusion-weighted alterations and, most significantly, in the network-based resting-state functional connectivity data that extrapolates network functions from well validated psychological paradigms using functional MRI analysis. We see an emerging picture of cognitive dysfunction evident in task-based and resting state fMRI and network neuroscience studies, likely preceded by structural changes best demonstrated in morphometric and diffusion-weighted studies. We propose a clinically-oriented chronology of the diathesis-stress model of suicide and link other areas of research that may be useful to the practicing clinician, while helping to advance the translational study of the neurobiology of suicide.
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Affiliation(s)
- Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
- Child and Adolescent Psychiatric Inpatient Center, Boys Town National Research Hospital, Boys Town, NE, United States
- *Correspondence: Matthew Dobbertin,
| | - Karina S. Blair
- Program for Trauma and Anxiety in Children (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Erin Carollo
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL, United States
| | - James R. Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Copenhagen, Denmark
| | - Ahria Dominguez
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
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10
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Investigating the Clinical Profile of Suicide Attempters Who Used a Violent Suicidal Means. J Clin Med 2022; 11:jcm11237170. [PMID: 36498743 PMCID: PMC9735514 DOI: 10.3390/jcm11237170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
In our study, we aimed to explore the profile of the high-risk subgroup of suicide attempters that used a violent means compared to suicide attempters that chose a non-violent suicide means. Therefore, we recruited a sample of inpatients with recent suicide attempts in three psychiatric hospitals in Thuringia, Germany. We used a structured clinical interview to assess the psychiatric diagnoses, sociodemographic data, and characteristics of the suicide attempt. Furthermore, we used several validated clinical questionnaires to measure suicidal ideations, suicide intent, depression severity, hopelessness, impulsivity, aggression, anger expression, and childhood trauma. We compared 41 individuals using violent means to 59 using non-violent means with univariate and multivariate statistical analyses. We found significantly (corrected for multiple comparisons) higher levels of impulsivity-related sensation-seeking in violent suicide attempters in univariate and multivariate analyses, and additionally in anger expression directed inward at an uncorrected statistical threshold. Besides that, there were no significant differences between the two groups. We assume that underlying neurocognitive mechanisms, such as impaired decision-making processes and/or differences in risk/loss assessment, could explain the higher levels of questionnaire-based sensation-seeking in subjects who use violent suicide means. Further research is needed, including neuroimaging and biochemical techniques, to gain more insight into the mechanisms underlying the choice of a suicidal means.
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11
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Bhaskaran AS, Reddi VSK, Suchandra HH, Gowda GS, Muliyala KP. Predictors of future suicide attempts in individuals with high suicide risk admitted to an acute psychiatry suicide intervention unit in India. A survival analysis study. Asian J Psychiatr 2022; 78:103270. [PMID: 36252324 DOI: 10.1016/j.ajp.2022.103270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/29/2022] [Accepted: 09/23/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Determination of suicide vulnerability remains challenging in mental illness. Variability in risk factors identified compound its poor predictability. Longitudinal studies, offering more reliable indices of risk, from developing countries are conspicuously limited. Furthermore, research advances allude to inherent vulnerability. This study, the first of its kind from India, consequently aimed to delineate factors influencing subsequent attempts in mental illness and acute suicidality. METHOD Baseline and follow-up information (up to five years) was obtained from medical records of individuals (n = 130) with acute suicidality [recent attempt (first attempt/ reattempt) and high-risk ideators]. Variables were compared between individuals with, and without subsequent suicide attempts. Time to attempt and factors influencing the same was determined using survival analysis, and Cox proportional hazard for estimating the likelihood of a subsequent suicide attempt. RESULTS Median duration of follow up of the sample (n = 130) was 23 months. The sample comprised of individuals with a recent attempt (first-time attempt), recent reattempt and recent high-risk ideators. Subsequent suicide attempts were noted in 30 (23.1 %) patients. Baseline sociodemographic and clinical variables, including suicidality, could not differentiate individuals with a subsequent suicide attempt. Survival analysis indicated that 65 % of subsequent attempts occurred within 9 months of discharge. Family history of suicide and the presence of impulsive-aggressive traits were associated with both, reduced survival time and overall increased risk of a subsequent suicide attempt. CONCLUSION This study delineates both, the time frame associated with greatest risk, as well as individuals most likely to reattempt suicide. It thereby offers insights into potential windows of opportunity to mitigate prospective suicide risk. Strategies such as enhanced after-care and integrating specific interventions to attenuate impulsive-aggressive behaviors could be a focus to prevent future attempts, thereby decreasing rates of suicide amongst those with mental illness. Furthermore, the findings of this study reaffirm the role of factors that independently confer vulnerability to suicide. Traversing noted regional variations, the findings importantly reinforce the distinct pathophysiological underpinnings of suicide in mental illness.
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Affiliation(s)
| | | | - Hari Hara Suchandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India
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12
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Barnes A, Ye GY, Ayers C, Choflet A, Lee KC, Zisook S, Davidson JE. Entangled: A mixed method analysis of nurses with mental health problems who die by suicide. Nurs Inq 2022; 30:e12537. [PMID: 36283975 DOI: 10.1111/nin.12537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/26/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
Nurses die by suicide at a higher rate than the general population. Previous studies have observed mental health problems, including substance use, as a prominent antecedent before death. The purpose of this study was to explore the characteristics of nurses who died by suicide documented in the death investigation narratives from the National Violent Death Reporting System from 2003 to 2017 using thematic analysis and natural language processing. One thousand three hundred and fifty-eight subjects met these inclusion criteria. Narratives from 601 subjects were thematically analyzed and 2544 individual narratives were analyzed using natural language processing. The analyses revealed five themes: "mental health treatment," "poor general health and chronic pain," "substance use," "worsening mental health after bereavement," and "repeating a family member's suicide." Mental health/substance use, chronic illness, and chronic pain were seen to coexist in a complex, interdependent manner that appeared to be entangled in the nurses' narratives before death. These findings echo the need for reducing the stigmatization of mental health problems in nursing and removing barriers to help-seeking behaviors as early preventative interventions. Future research is needed to determine if a comprehensive healthcare integration approach to address these entangled problems would reduce suicide vulnerability in nurses and improve their quality of life.
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Affiliation(s)
- Arianna Barnes
- Clinical Nurse Specialist, Cardiac Intensive Care Unit Barnes Jewish Hospital St. Louis Missouri USA
| | - Gordon Y. Ye
- Department of Psychiatry University of California San Diego School of Medicine La Jolla California USA
| | - Cadie Ayers
- Department of Veterans Affairs University of California San Diego School of Medicine Fresno California USA
| | - Amanda Choflet
- Bouvé College of Health Sciences, School of Nursing Northeastern University Boston Massachusetts USA
| | - Kelly C. Lee
- Skaggs School of Pharmacy and Pharmaceutical Sciences University of California San Diego San Diego California USA
| | - Sidney Zisook
- Department of Psychiatry University of California San Diego School of Medicine La Jolla California USA
| | - Judy E. Davidson
- University of California San Diego Health San Diego California USA
- Department of Psychiatry, School of Medicine University of California San Diego La Jolla California USA
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13
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Jackson NA, Jabbi MM. Integrating biobehavioral information to predict mood disorder suicide risk. Brain Behav Immun Health 2022; 24:100495. [PMID: 35990401 PMCID: PMC9388879 DOI: 10.1016/j.bbih.2022.100495] [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] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
The will to live and the ability to maintain one's well-being are crucial for survival. Yet, almost a million people die by suicide globally each year (Aleman and Denys, 2014), making premature deaths due to suicide a significant public health problem (Saxena et al., 2013). The expression of suicidal behaviors is a complex phenotype with documented biological, psychological, clinical, and sociocultural risk factors (Turecki et al., 2019). From a brain disease perspective, suicide is associated with neuroanatomical, neurophysiological, and neurochemical dysregulations of brain networks involved in integrating and contextualizing cognitive and emotional regulatory behaviors. From a symptom perspective, diagnostic measures of dysregulated mood states like major depressive symptoms are associated with over sixty percent of suicide deaths worldwide (Saxena et al., 2013). This paper reviews the neurobiological and clinical phenotypic correlates for mood dysregulations and suicidal phenotypes. We further propose machine learning approaches to integrate neurobiological measures with dysregulated mood symptoms to elucidate the role of inflammatory processes as neurobiological risk factors for suicide.
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Affiliation(s)
- Nicholas A. Jackson
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Institute for Neuroscience, The University of Texas at Austin, USA
| | - Mbemba M. Jabbi
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Mulva Clinics for the Neurosciences
- Institute for Neuroscience, The University of Texas at Austin, USA
- Department of Psychology, The University of Texas at Austin, USA
- Center for Learning and Memory, The University of Texas at Austin, USA
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14
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Overs BJ, Roberts G, Ridgway K, Toma C, Hadzi-Pavlovic D, Wilcox HC, Hulvershorn LA, Nurnberger JI, Schofield PR, Mitchell PB, Fullerton JM. Effects of polygenic risk for suicide attempt and risky behavior on brain structure in young people with familial risk of bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2021; 186:485-507. [PMID: 34726322 DOI: 10.1002/ajmg.b.32879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/27/2021] [Accepted: 10/11/2021] [Indexed: 01/11/2023]
Abstract
Bipolar disorder (BD) is associated with a 20-30-fold increased suicide risk compared to the general population. First-degree relatives of BD patients show inflated rates of psychopathology including suicidal behaviors. As reliable biomarkers of suicide attempts (SA) are lacking, we examined associations between suicide-related polygenic risk scores (PRSs)-a quantitative index of genomic risk-and variability in brain structures implicated in SA. Participants (n = 206; aged 12-30 years) were unrelated individuals of European ancestry and comprised three groups: 41 BD cases, 96 BD relatives ("high risk"), and 69 controls. Genotyping employed PsychArray, followed by imputation. Three PRSs were computed using genome-wide association data for SA in BD (SA-in-BD), SA in major depressive disorder (SA-in-MDD) (Mullins et al., 2019, The American Journal of Psychiatry, 176(8), 651-660), and risky behavior (Karlsson Linnér et al., 2019, Nature Genetics, 51(2), 245-257). Structural magnetic resonance imaging processing employed FreeSurfer v5.3.0. General linear models were constructed using 32 regions-of-interest identified from suicide neuroimaging literature, with false-discovery-rate correction. SA-in-MDD and SA-in-BD PRSs negatively predicted parahippocampal thickness, with the latter association modified by group membership. SA-in-BD and Risky Behavior PRSs inversely predicted rostral and caudal anterior cingulate structure, respectively, with the latter effect driven by the "high risk" group. SA-in-MDD and SA-in-BD PRSs positively predicted cuneus structure, irrespective of group. This study demonstrated associations between PRSs for suicide-related phenotypes and structural variability in brain regions implicated in SA. Future exploration of extended PRSs, in conjunction with a range of biological, phenotypic, environmental, and experiential data in high risk populations, may inform predictive models for suicidal behaviors.
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Affiliation(s)
- Bronwyn J Overs
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Kate Ridgway
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Claudio Toma
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid, Spain
| | - Dusan Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Holly C Wilcox
- Child Psychiatry and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Leslie A Hulvershorn
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John I Nurnberger
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia
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15
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Cheng X, Chen J, Zhang X, Zhang Y, Wu Q, Ma Q, Sun J, Zou W, Lin T, Zhong L, Deng W, Sun X, Cui L, Cheng X, Chen Y, Cai Y, Zheng C, Cheng D, Yang C, Ye B, Zhang X, Wei X, Cao L. Alterations in resting-state global brain connectivity in bipolar I disorder patients with prior suicide attempt. Bipolar Disord 2021; 23:474-486. [PMID: 32981096 DOI: 10.1111/bdi.13012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar I disorder (BD-I) is associated with a high risk of suicide attempt; however, the neural circuit dysfunction that confers suicidal vulnerability in individuals with this disorder remains largely unknown. Resting-state functional magnetic resonance imaging (rs-fMRI) allows non-invasive mapping of brain functional connectivity. The current study used an unbiased voxel-based graph theory analysis of rs-fMRI to investigate the intrinsic brain networks of BD-I patients with and without suicide attempt. METHODS A total of 30 BD-I patients with suicide attempt (attempter group), 82 patients without suicide attempt (non-attempter group), and 67 healthy controls underwent rs-fMRI scan, and then global brain connectivity (GBC) was computed as the sum of connections of each voxel with all other gray matter voxels in the brain. RESULTS Compared with the non-attempter group, we found regional differences in GBC values in emotion-encoding circuits, including the left superior temporal gyrus, bilateral insula/rolandic operculum, and right precuneus (PCu)/cuneus in the bipolar disorder (BD) attempter group, and these disrupted hub-like regions displayed fair to good power in distinguishing attempters from non-attempters among BD-I patients. GBC values of the right PCu/cuneus were positively correlated with illness duration and education in the attempter group. CONCLUSIONS Our results indicate that abnormal connectivity patterns in emotion-encoding circuits are associated with the increasing risk of vulnerability to suicide attempt in BD patients, and global dysconnectivity across these emotion-encoding circuits might serve as potential biomarkers for classification of suicide attempt in BD patients.
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Affiliation(s)
- Xiaofang Cheng
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, PR China.,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Jianshan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiaofei Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Yihe Zhang
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Qiuxia Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Qing Ma
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Jiaqi Sun
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Wenjin Zou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Taifeng Lin
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Liangda Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Wenhao Deng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiaoyi Sun
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, PR China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, PR China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, PR China
| | - Liqian Cui
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | | | - Yingmei Chen
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Yinglian Cai
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Chaodun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Daomeng Cheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Chanjuan Yang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Biyu Ye
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
| | - Xiangyang Zhang
- Department of Radiology, Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China
| | - Xinhua Wei
- Jinan University, Guangzhou, Guangdong, PR China.,Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, PR China
| | - Liping Cao
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, PR China
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16
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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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17
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Gifuni AJ, Chakravarty MM, Lepage M, Ho TC, Geoffroy MC, Lacourse E, Gotlib IH, Turecki G, Renaud J, Jollant F. Brain cortical and subcortical morphology in adolescents with depression and a history of suicide attempt. J Psychiatry Neurosci 2021; 46:E347-E357. [PMID: 33961355 PMCID: PMC8327980 DOI: 10.1503/jpn.200198] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Suicidal behaviours are a major source of mortality and morbidity among adolescents. Given the maturational changes that occur in cortical and subcortical structures during adolescence, we tested whether atypical brain structural measurements were associated with a history of suicide attempt. METHODS We assessed 3 groups of adolescents (n = 92; 79% female, mean age 15.9 years, range 11.6-18.1 years): patients with a depressive disorder and a history of suicide attempt (n = 28); patient controls, who had a depressive disorder but no history of suicide attempt (n = 34); and healthy controls (n = 30). We derived regional cortical thickness and surface area, and subcortical volumes, from T1-weighted anatomic MRI scans acquired at 3 T. RESULTS We found significant group differences in surface area in the prefrontal, temporal and parietal regions, as well as in the volume of several subcortical nuclei (pFDR ≤ 0.05), but not in cortical thickness. Post hoc analyses indicated that morphological alterations primarily differentiated patients with a history of suicide attempt from healthy controls, but not from patient controls. However, patients with a history of suicide attempt exhibited positive correlations between age and cortical thickness in the temporal cortices and right insula, and between age and right putamen volume (i.e., thicker regional cortex and larger subcortical volumes with age). These correlations were negative in both patient controls and healthy controls (i.e., thinner regional cortex and smaller subcortical volumes). LIMITATIONS Sample sizes, cross-sectional findings and psychiatric heterogeneity were limitations of this study. CONCLUSION Macroscopic structural differences in several brain regions differentiated adolescents with a history of suicide attempt from healthy controls, but not from patient controls. However, adolescents with a history of suicide attempt may present with atypical maturation of specific cortical and subcortical regions that might contribute to the risk of suicidal behaviour.
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Affiliation(s)
- Anthony J Gifuni
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - M Mallar Chakravarty
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Martin Lepage
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Tiffany C Ho
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Marie-Claude Geoffroy
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Eric Lacourse
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Ian H Gotlib
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Gustavo Turecki
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Johanne Renaud
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
| | - Fabrice Jollant
- From the McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, Canada (Gifuni, Geoffroy, Turecki, Renaud, Jollant); the Department of Psychiatry, McGill University, Montréal, Canada (Gifuni, Chakravarty, Lepage, Turecki, Renaud, Jollant); the Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montréal, Canada (Gifuni, Renaud); the Department of Psychology, Stanford University, Stanford, USA (Gifuni, Gotlib); the Department of Psychiatry & Behavioral Sciences and Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, USA (Ho); the Department of Educational and Counselling Psychology, McGill University, Montréal, Canada (Geoffroy); the Department of Sociology, Université de Montréal, Montréal, Canada (Lacourse); the Université de Paris, Paris, France (Jollant); the GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France (Jollant); and the Academic Hospital (CHU) Nîmes, Nîmes, France (Jollant)
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18
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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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19
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Wagner G, Li M, Sacchet MD, Richard-Devantoy S, Turecki G, Bär KJ, Gotlib IH, Walter M, Jollant F. Functional network alterations differently associated with suicidal ideas and acts in depressed patients: an indirect support to the transition model. Transl Psychiatry 2021; 11:100. [PMID: 33542184 PMCID: PMC7862288 DOI: 10.1038/s41398-021-01232-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 02/08/2023] Open
Abstract
The transition from suicidal ideas to a suicide act is an important topic of research for the identification of those patients at risk of acting out. We investigated here whether specific brain activity and connectivity measures at rest may be differently associated with suicidal thoughts and behaviors. A large sample of acutely depressed patients with major depressive disorder was recruited in three different centers (Montreal/Canada, Stanford/USA, and Jena/Germany), covering four different phenotypes: patients with a past history of suicide attempt (n = 53), patients with current suicidal ideas but no past history of suicide attempt (n = 40), patients without current suicidal ideation nor past suicide attempts (n = 42), and healthy comparison subjects (n = 107). 3-T resting-state functional magnetic resonance imaging (fMRI) measures of the amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were obtained and examined in a whole-brain data-driven analysis. Past suicide attempt was associated with a double cortico-subcortical dissociation in ALFF values. Decreased ALFF and DC values mainly in a frontoparietal network and increased ALFF values in some subcortical regions (hippocampus and thalamus) distinguished suicide attempters from suicide ideators, patient controls, and healthy controls. No clear neural differences were identified in relation to suicidal ideas. Suicide attempters appear to be a distinct subgroup of patients with widespread brain alterations in functional activity and connectivity that could represent factors of vulnerability. Our results also indirectly support at the neurobiological level the relevance of the transition model described at the psychological and clinical levels. The brain bases of suicidal ideas occurrence in depressed individuals needs further investigations.
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Affiliation(s)
- Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany.
| | - Meng Li
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Matthew D. Sacchet
- grid.240206.20000 0000 8795 072XCenter for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, MA USA
| | - Stéphane Richard-Devantoy
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada
| | - Gustavo Turecki
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada
| | - Karl-Jürgen Bär
- grid.275559.90000 0000 8517 6224Department of Gerontopsychiatry and Psychosomatics, Jena University Hospital, Jena, Germany
| | - Ian H. Gotlib
- grid.168010.e0000000419368956Department of Psychology, Stanford University, Stanford, CA USA
| | - Martin Walter
- grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Fabrice Jollant
- grid.412078.80000 0001 2353 5268McGill group for Suicide Studies, McGill University & Douglas Mental Health University Institute, Montréal, QC Canada ,Université de Paris, Faculté de médecine, Paris, France ,grid.414435.30000 0001 2200 9055GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France ,grid.411165.60000 0004 0593 8241Psychiatry Department, CHU Nîmes, Nîmes, France ,grid.7429.80000000121866389Equipe Moods, INSERM, UMR-1178 Paris, France
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20
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Perrain R, Dardennes R, Jollant F. Risky decision-making in suicide attempters, and the choice of a violent suicidal means: an updated meta-analysis. J Affect Disord 2021; 280:241-249. [PMID: 33220560 DOI: 10.1016/j.jad.2020.11.052] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/02/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies showed disadvantageous decision-making in suicide attempters. The present meta-analysis aims to examine the stability of these findings and related questions. METHODS EMBASE and Pubmed databases were searched for studies published between 01/01/2000 and 01/01/2020 with an additional search through bibliographical references. English or French articles published in peer-reviewed journals, reporting quantitative task-based measures of decision-making in suicide attempters were included: 3,582 records were identified, 33 full-text articles screened, and 21 articles finally included. RESULTS All studies were conducted in mood disorders; 18 used the Iowa Gambling Task (IGT) and 3 the Cambridge Gamble Task (CGT). With the IGT, suicide attempters showed riskier choices than patient controls (Hedges' g=-0.28 95%CI (-0.44 - -0.12)) and healthy controls (g=-0.54 (-0.83 - -0.25)) with no significant difference between control groups. The difference between suicide attempters and patient controls was not related to age group, mood disorder type, author, or research center while an effect of time of publication was found (p=0.006). Poorer performance was also found in suicide attempters compared to patient controls when using the CGT (g=-0.57 95%CI (-0.82 - -0.31)). Suicide attempters who used a violent means showed poorer IGT performance than those who used a non-violent means (3 studies). LIMITATION Limited number of studies outside mood disorders. No data to calculate a gender effect. CONCLUSION The present meta-analysis confirmed riskier decision-making in suicide attempters. Although group differences appear to be of modest effect size in general, they were particularly marked in the subgroup of those who used a violent suicidal means.
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Affiliation(s)
- Rebecca Perrain
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Roland Dardennes
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France
| | - Fabrice Jollant
- Université de Paris, Paris, France; GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, Paris, France; McGill Group for suicide studies, McGill University, Montréal, Canada; Nîmes academic hospital (CHU), Nîmes, France; Equipe Moods, INSERM UMR-1178, Paris, France.
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21
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Kim DJ, Bartlett EA, DeLorenzo C, Parsey RV, Kilts C, Cáceda R. Examination of structural brain changes in recent suicidal behavior. Psychiatry Res Neuroimaging 2021; 307:111216. [PMID: 33129637 PMCID: PMC9227957 DOI: 10.1016/j.pscychresns.2020.111216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022]
Abstract
We aimed to identify brain structural changes in cortical and subcortical regions linked to recent suicidal behavior. We performed secondary analyses of structural MRI data of two independent studies, namely the Establishing Moderators/Biosignatures of Antidepressant Response - Clinical Care (EMBARC) study and a Little Rock study on acute suicidal behavior. Study 1 (EMBARC, N = 187), compared individuals with remote suicide attempts (Remote-SA), individuals with lifetime suicide ideation but no attempts (Lifetime-SI only), and depressed individuals without lifetime suicide ideation or attempts (non-suicidal depressed). Study 2 (Little Rock data, N = 34) included patients recently hospitalized for suicide ideation or attempt constituted by: patients who recently attempted suicide (Recent-SA), individuals with remote suicide attempts (Remote-SA), and Lifetime-SI only. Study 3 combined the EMBARC and Little Rock datasets including Recent-SA, Remote-SA, Lifetime-SI only and non-suicidal depressed individuals. In Study 1 and Study 2, no significant differences were observed between groups. In Study 3, significantly lower middle temporal gyrus thickness, insular surface area, and thalamic volume and higher volume in the nucleus accumbens were observed in Recent-SA. This pattern of structural abnormalities may underlie pain and emotion dysregulation, which have been linked to the transition from suicidal thoughts to action.
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Affiliation(s)
- Diane J Kim
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States.
| | - Elizabeth A Bartlett
- Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY, United States; New York State Psychiatric Institute, Division of Molecular Imaging and Neuropathology, New York, New York, United States
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States; Stony Brook University, Department of Biomedical Engineering, Stony Brook, New York, United States
| | - Ramin V Parsey
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
| | - Clinton Kilts
- University of Arkansas for Medical Sciences, Psychiatric Research Institute, Little Rock, Arkansas, United States
| | - Ricardo Cáceda
- Renaissance School of Medicine at Stony Brook University, Department of Psychiatry and Behavioral Health, Stony Brook, New York, United States
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22
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Affiliation(s)
- J John Mann
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York (Mann, Rizk); Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York (Mann, Rizk); Department of Radiology, Columbia University Irving Medical Center, New York (Mann)
| | - Mina M Rizk
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York (Mann, Rizk); Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York (Mann, Rizk); Department of Radiology, Columbia University Irving Medical Center, New York (Mann)
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23
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Brain grey matter abnormalities in first episode non-affective psychosis patients with suicidal behaviours: The role of neurocognitive functioning. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109948. [PMID: 32305356 DOI: 10.1016/j.pnpbp.2020.109948] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of premature death in first-episode psychosis (FEP) patients. The understanding of suicidal behaviour (SB) is limited, and new and integrative approaches focusing on the likely relationship of the biological and cognitive features of SB in the early phases of psychosis are warranted. We aimed to study the relationship of brain grey matter anomalies and cognitive functioning with SB or suicidal risk in a large sample of non-affective FEP patients. METHODS We used a voxel-based morphometry analysis in 145 FEP patients to investigate the pattern of structural brain abnormalities related to SB. In addition, bivariate and multivariate analyses were performed to explore the relationship between cognitive functioning and SB. RESULTS A reduction in grey matter volume in the frontal area, temporal gyrus, precuneus, uncus, amygdala, left cuneus and subcallosal gyrus as well as a marked regional volume reduction in the right hemisphere was linked with the presence of SB. Additionally, worse global cognitive functioning and living in urban areas were identified as suicide risk factors. CONCLUSIONS This study provides some insights about the brain abnormalities associated with SB in FEP patients. Specifically, the areas reported are involved in important functions related to SB, such as impulsivity, problem solving or responses to pain. Thus, the results confirm the relevant role of cognitive functioning on SB.
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24
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Kang W, Shin JH, Han KM, Kim A, Kang Y, Kang J, Tae WS, Paik JW, Lee HW, Seong JK, Ham BJ. Local shape volume alterations in subcortical structures of suicide attempters with major depressive disorder. Hum Brain Mapp 2020; 41:4925-4934. [PMID: 32804434 PMCID: PMC7643352 DOI: 10.1002/hbm.25168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/14/2020] [Accepted: 08/01/2020] [Indexed: 01/18/2023] Open
Abstract
Suicide is among the most important global health concerns; accordingly, an increasing number of studies have shown the risks for suicide attempt(s) in terms of brain morphometric features and their clinical correlates. However, brain studies addressing suicidal vulnerability have been more focused on demonstrating impairments in cortical structures than in the subcortical structures. Using local shape volumes (LSV) analysis, we investigated subcortical structures with their clinical correlates in depressed patients who attempted suicide. Then we compared them with depressed patients without a suicidal history and age- and sex-matched healthy controls (HCs; i.e., 47 suicide attempters with depression, 47 non-suicide attempters with depression, and 109 HCs). Significant volumetric differences were found between suicidal and nonsuicidal depressed patients in several vertices: 16 in the left amygdala; 201 in the left hippocampus; 1,057 in the left putamen; and 140 in the left pallidum; 1 in the right pallidum; and 6 in the bilateral thalamus. These findings indicated subcortical alterations in LSV in components of the limbic-cortical-striatal-pallidal-thalamic circuits. Moreover, our results demonstrated that the basal ganglia was correlated with perceived stress levels, and the thalamus was correlated with suicidal ideation. We suggest that suicidality in major depressive disorder may involve subcortical volume alterations.
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Affiliation(s)
- Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hyeon Shin
- Medical & Health Device Division, Korea Testing Laboratory, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - June Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae-Woo Lee
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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25
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Neural and molecular correlates of psychological pain during major depression, and its link with suicidal ideas. Prog Neuropsychopharmacol Biol Psychiatry 2020; 100:109909. [PMID: 32145361 DOI: 10.1016/j.pnpbp.2020.109909] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Psychological pain increases the risk of suicidal ideas and acts, and represents a potential therapeutic target. However, the mechanisms of mental pain remain unclear. Here, we assessed the peripheral transcriptomic and central neural correlates of mental pain during a depressive episode. METHODS 172 adult un-medicated depressed patients were recruited. Leucocytes were extracted for RNA quantification at baseline (T0) and after 8 weeks (T8) of an antidepressant treatment. Ninety-nine genes of the cortisol, immune, opioid, serotonergic, and kynurenine systems were a priori selected, and 41 were sufficiently expressed to be analyzed. At both T0 and T8, mean level of mental pain over the last 15 days was measured with a visual analog scale. A subset of 38 patients was additionally scanned with Magnetic Resonance Imaging at T0. Resting-state sequences of 4 networks (default-mode, basal ganglia, central executive, salience) were examined. RESULTS Mean psychological pain scores significantly decreased between T0 and T8. At conservative p-corrected levels, T0 mental pain was significantly correlated with 11 brain clusters encompassing the prefrontal, parietal, and temporal cortices, the striatum, and the cerebellum. There was no direct association between peripheral gene expression and mean mental pain at any time points or in terms of temporal changes. However, expressions of 5HTR2B at p-corrected levels, and 5HTR3A, TPH1, and OPRL1 were correlated with the activity of several identified brain clusters at T0. Finally, while suicidal ideas and mental pain were correlated, the neural and molecular correlates of suicidal ideas were not the same. CONCLUSION Our study suggests that the serotonergic and nociceptin systems are associated with the activity of a cortico-subcortical brain network underlying the perception of mental pain during depression. Mental pain may be a necessary but insufficient condition for the emergence of suicidal ideation during depression.
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Brown VM, Wilson J, Hallquist MN, Szanto K, Dombrovski AY. Ventromedial prefrontal value signals and functional connectivity during decision-making in suicidal behavior and impulsivity. Neuropsychopharmacology 2020; 45:1034-1041. [PMID: 32035425 PMCID: PMC7162923 DOI: 10.1038/s41386-020-0632-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/16/2019] [Accepted: 01/26/2020] [Indexed: 11/09/2022]
Abstract
Suicide is linked to impaired value-based decision-making and impulsivity, but whether these risk factors share neural underpinnings is unclear. Disrupted ventromedial prefrontal cortex (vmPFC) value signals may underlie this behavioral phenotype. We investigated vmPFC value signals, vmPFC-frontoparietal connectivity, and the impact of impulsivity during decision-making in depressed individuals with and without suicidal behavior. Middle-aged and older adults (n = 116; 35 with a history of suicide attempts, 25 with ideation only, 25 depressed controls with no ideation, and 31 nonpsychiatric controls) completed a decision-making task with drifting reward probabilities during fMRI. Values of choices, estimated by a reinforcement learning model, were regressed against BOLD signal. VmPFC value activation was compared between groups. Moderating effects of impulsivity on vmPFC-frontoparietal connectivity were assessed in nonpsychiatric controls and compared among patient groups. VmPFC value responses in participants with a history of suicide attempts were reduced relative to nonpsychiatric controls (p < 0.05). In nonpsychiatric controls, vmPFC-frontoparietal connectivity was negatively moderated by impulsivity (pFWE corrected < 0.05). This effect was preserved in comparison patient groups but abolished in suicide attempters (p < 0.001). This change in neural connectivity patterns also affected behavior: people with a history of suicide attempts showed a disrupted effect of vmPFC-frontoparietal connectivity, impulsivity, and reinforcement on choice quality (p < 0.001). These effects were specific to vmPFC and not to striatum. In summary, findings from this study largely support disrupted vmPFC value signals in suicidal behavior. In addition, it uncovers an altered pattern of vmPFC-frontoparietal connectivity in impulsive people with suicidal behavior, which may underlie disrupted choice processes in a suicidal crisis.
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Affiliation(s)
- Vanessa M Brown
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan Wilson
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael N Hallquist
- Department of Psychology, Pennsylvania State University, State College, PA, USA
| | - Katalin Szanto
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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27
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Chattun MR, Zhang S, Chen Y, Wang Q, Amdanee N, Tian S, Lu Q, Yao Z. Caudothalamic dysfunction in drug-free suicidally depressed patients: an MEG study. Eur Arch Psychiatry Clin Neurosci 2020; 270:217-227. [PMID: 30552507 DOI: 10.1007/s00406-018-0968-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 12/06/2018] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD), characterized by low mood or anhedonia, is commonly associated with a greater suicidal susceptibility. There are numerous suicide-related findings pertaining to the dorsolateral prefrontal cortex (DLPFC), caudate nucleus and thalamus, which form a cortico-striato-thalamo-cortical (CSTC) circuit responsible for executive function and working memory. An aberrant CSTC circuitry is hypothesized to be implicated in depressed patients with a high suicidal risk. 27 MDD patients were assessed with the Nurses Global Assessment of Suicide Risk (NGASR), following which 14 patients were classified into a high suicide risk group (NGASR ≥ 12) and 13 patients were assigned to a low suicide risk group (NGASR < 6). All 27 patients were enrolled with 25 healthy controls for resting-state magnetoencephalography (MEG). Cross-frequency coupling (CFC) measured the phase of alpha-band (8-13 Hz) as it modulated to cortical gamma-band (30-48 Hz). There was a significantly lower alpha-to-gamma phase-amplitude coupling (PAC) between the right caudate and left thalamus in high-risk suicide group compared to both the low-risk suicide group and healthy controls. The presence of a weaker coupling between the right caudate and left thalamus is indicative of a caudothalamic abnormality in suicidally depressed patients. This implies that a disruption of CSTC loop could result in executive dysfunction and working memory impairment, leading to an increased suicidal risk in MDD patients. In the future, this preliminary study has the possibility of being replicated on a larger scale, and hence validates caudothalamic dysfunction as a reliable neuroimaging biomarker for suicide in depression.
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Affiliation(s)
- Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China
| | - Siqi Zhang
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China
| | - Yu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China
| | - Qiang Wang
- Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing, 210093, China
| | - Nousayhah Amdanee
- Department of Geriatrics, Jiangsu Province Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, China
| | - Shui Tian
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 Sipailou, Nanjing, 210096, China. .,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, 210096, China.
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, China. .,Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing, 210093, China.
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28
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Huang X, Rootes-Murdy K, Bastidas DM, Nee DE, Franklin JC. Brain Differences Associated with Self-Injurious Thoughts and Behaviors: A Meta-Analysis of Neuroimaging Studies. Sci Rep 2020; 10:2404. [PMID: 32051490 PMCID: PMC7016138 DOI: 10.1038/s41598-020-59490-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/29/2020] [Indexed: 01/13/2023] Open
Abstract
This meta-analysis aims to evaluate whether the extant literature justifies any definitive conclusions about whether and how SITBs may be associated with brain differences. A total of 77 papers (N = 4,903) published through January 1, 2019 that compared individuals with and without SITBs were included, resulting in 882 coordinates. A pooled meta-analysis assessing for general risk for SITBs indicated a lack of convergence on structural differences. When all types of control groups were considered, functional differences in the left posterior cingulate cortex (PCC), right amygdala, left hippocampus, and right thalamus were significant using multi-level kernel density analysis (pcorrected < 0.05) but nonsignificant using activation-likelihood estimation. These results suggest that a propensity for internally-oriented, emotional processing coupled with under-active pain processing could potentially underlie SITBs, but additional research is needed to test this possibility. Separate analyses for types of SITBs suggested that the brain differences associated with deliberate self-harm were consistent with the overall findings. Checkered moderator effects were detected. Overall, the meta-analytic evidence was not robust. More studies are needed to reach definitive conclusions about whether SITBs are associated with brain differences.
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Affiliation(s)
- Xieyining Huang
- Department of Psychology, Florida State University, Tallahassee, Florida, USA.
| | - Kelly Rootes-Murdy
- Department of Psychology, Florida State University, Tallahassee, Florida, USA.,Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Diana M Bastidas
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Derek E Nee
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Joseph C Franklin
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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29
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Lengvenyte A, Conejero I, Courtet P, Olié E. Biological bases of suicidal behaviours: A narrative review. Eur J Neurosci 2019; 53:330-351. [PMID: 31793103 DOI: 10.1111/ejn.14635] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/05/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
Suicidal behaviour is a multifaceted phenomenon that concerns all human populations. It has been suggested that a complex interaction between the individual genetic profile and environmental factors throughout life underlies the pathophysiology of suicidal behaviour. Although epidemiological and genetic studies suggest the existence of a genetic component, exposure to biological and psychosocial adversities, especially during critical developmental periods, also contributes to altering the biological responses to threat and pleasure. This results in amplified maladaptive cognitive and behavioural traits and states associated with suicidal behaviours. Alterations in the cognitive inhibition and decision-making capacity have been implicated in suicidal behaviours. Structural and functional changes in key brain regions and networks, such as prefrontal cortex, insula and default mode network, may underlie this relationship. Furthermore, the shift from health to suicidal behaviour incorporates complex and dynamic changes in the immune and stress responses, monoaminergic system, gonadal system and neuroplasticity. In this review, we describe the major findings of epidemiological, genetic, neuroanatomical, neuropsychological, immunological and neuroendocrinological studies on suicide behaviours to provide a solid background for future research in this field. This broad overview of the biological bases of suicide should promote neuroscience research on suicidal behaviours. This might lead to improved biological models and to the identification of evidence-based biomarkers, treatment options and preventive strategies.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Ismael Conejero
- Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France.,Department of Psychiatry, CHU Nimes, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
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30
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Huber RS, Hodgson R, Yurgelun-Todd DA. A qualitative systematic review of suicide behavior using the cognitive systems domain of the research domain criteria (RDoC) framework. Psychiatry Res 2019; 282:112589. [PMID: 31703982 DOI: 10.1016/j.psychres.2019.112589] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/23/2019] [Accepted: 09/26/2019] [Indexed: 12/24/2022]
Abstract
Neurocognitive deficits are associated with both suicide behavior (SB) and psychiatric disorders. Application of a transdiagnostic framework to identify neurocognitive commonalities of SB may clarify important risk factors of SB across psychiatric disorders. The aim of this study was to conduct a qualitative systematic literature review of SB using the Research Domain Criteria (RDoC) Cognitive Systems framework to determine if cognitive deficits exist independently of psychiatric disorders in SB. The following six constructs that encompass the Cognitive Systems domain were assessed: 1) Attention, 2) Cognitive Control, 3) Declarative Memory, 4) Language, 5) Perception, and 6) Working Memory. A total of 1386 abstracts were identified and 74 studies met the inclusion criteria for this review. The majority of studies reviewed (65%) had significant differences in cognition between individuals with and without SB. Seventy-nine percent of studies with a patient control group showed significant cognitive deficits in SB groups. Deficits in cognitive control were associated with SB and had the greatest percentage of studies with significant main findings. Use of the RDoC cognitive systems framework to evaluate SB revealed that cognitive deficits may be a transdiagnostic risk factor for SB, especially alterations in cognitive control.
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Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States.
| | - Riley Hodgson
- Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States; Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, UT, United States; U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
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31
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Connectomics-Based Functional Network Alterations in both Depressed Patients with Suicidal Behavior and Healthy Relatives of Suicide Victims. Sci Rep 2019; 9:14330. [PMID: 31586117 PMCID: PMC6778100 DOI: 10.1038/s41598-019-50881-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/19/2019] [Indexed: 01/08/2023] Open
Abstract
Understanding the neural mechanisms of suicidal behavior is crucial. While regional brain alterations have previously been reported, knowledge about brain functional connectomics is currently limited. Here, we investigated differences in global topologic network properties and local network-based functional organization in both suicide attempters and suicide relatives. Two independent samples of depressed suicide attempters (N = 42), depressed patient controls (N = 43), healthy controls (N = 66) as well as one sample of healthy relatives of suicide victims (N = 16) and relatives of depressed patients (N = 16) were investigated with functional magnetic resonance imaging in the resting-state condition. Graph theory analyses were performed. Assortativity, clustering coefficients, global efficiency, and rich-club coefficients were calculated. A network-based statistic approach was finally used to examine functional connectivity matrices. In comparison to healthy controls, both patient groups showed significant reduction in assortativity, and decreased functional connectivity in largely central and posterior brain networks. Suicide attempters only differed from patient controls in terms of higher rich-club coefficients for the highest degree nodes. Compared to patient relatives and healthy controls, suicide relatives showed reduced assortativity, reduced clustering coefficients, increased global efficiency, and increased rich-club coefficients for the highest degree nodes. Suicide relatives also showed reduced functional connectivity in one anterior and one posterior sub-network in comparison to healthy controls, and in a largely anterior brain network in comparison to patient relatives. In conclusion, these results suggest that the vulnerability to suicidal behavior may be associated with heritable deficits in global brain functioning – characterized by weak resilience and poor segregation - and in functional organization with reduced connectivities affecting the ventral and dorsal prefrontal cortex, the anterior cingulate, thalamus, striatum, and possibly the insula, fusiform gyrus and the cerebellum.
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32
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Zhou Y, Lutz P, Ibrahim EC, Courtet P, Tzavara E, Turecki G, Belzeaux R. Suicide and suicide behaviors: A review of transcriptomics and multiomics studies in psychiatric disorders. J Neurosci Res 2018; 98:601-615. [DOI: 10.1002/jnr.24367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Yi Zhou
- McGill Group for Suicide Studies Douglas Mental Health University Institute, McGill University Montréal Canada
| | - Pierre‐Eric Lutz
- Centre National de la Recherche Scientifique Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR 3212 Strasbourg France
| | - El Chérif Ibrahim
- Institut de Neurosciences de la Timone ‐ UMR7289,CNRS Aix‐Marseille Université Marseille France
- Fondamental, Fondation de Recherche et de Soins en Santé Mentale Créteil France
| | - Philippe Courtet
- Fondamental, Fondation de Recherche et de Soins en Santé Mentale Créteil France
- CHRU Montpellier, University of Montpellier, INSERM unit 1061 Montpellier France
| | - Eleni Tzavara
- Fondamental, Fondation de Recherche et de Soins en Santé Mentale Créteil France
- INSERM, UMRS 1130, CNRS, UMR 8246, Sorbonne University UPMC, Neuroscience Paris‐Seine Paris France
| | - Gustavo Turecki
- McGill Group for Suicide Studies Douglas Mental Health University Institute, McGill University Montréal Canada
| | - Raoul Belzeaux
- Institut de Neurosciences de la Timone ‐ UMR7289,CNRS Aix‐Marseille Université Marseille France
- Fondamental, Fondation de Recherche et de Soins en Santé Mentale Créteil France
- AP‐HM, Pôle de Psychiatrie Marseille France
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