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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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