Suicidal brains: A review of functional and structural brain studies in association with suicidal behaviour

Heeringen, Cornelis Van; Bijttebier, Stijn; Godfrin, Karen

doi:10.1016/j.neubiorev.2010.08.007

Cited by 140 publications

(92 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These factors have the advantage of potentially acting as objective markers, overcoming the biases present with self-reports, for instance reports of past, current or future suicidal intent (Glenn and Nock, 2014). Recent systematic reviews into the brain structural and functional abnormalities associated with self-harm suggest that the main regions involved include the orbitofrontal cortex (OFC), ventromedial prefrontal cortex (VMPFC), dorsolateral prefrontal cortex (DLPFC), and anterior cingulate cortex (ACC), indicating potentially impaired functioning of the prefrontal network (Cox Lippard et al, 2014;Jollant, 2016;Jollant et al, 2011;Van Heeringen et al, 2011;van Heeringen et al, 2014;van Heeringen and Mann, 2014), in addition to other regions including the parietal cortex, some subcortical nuclei and possibly the cerebellum (Gifuni et al, 2016;Jollant et al, 2008a;Richard-Devantoy et al, 2016a).…”

Section: Can We Use Neurocognition To Predict Repetition Of Self-harm?mentioning

confidence: 99%

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Cates

Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

View full text Add to dashboard Cite

Background:Prediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be established Aims:Identify neurocognitive factors that may predict repetition of self-harm. Methods:Systematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed. Results:7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions. Conclusions:Selected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.

show abstract

Section: Can We Use Neurocognition To Predict Repetition Of Self-harm?mentioning

confidence: 99%

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Cates

Rees

Jollant

et al. 2017

Neuroscience & Biobehavioral Reviews

View full text Add to dashboard Cite

show abstract

“…40 In previous studies, changes in brain structure and function in individuals with a history of suicidal behaviour are mainly found in the OFC and MFC, where changes could cause neuropsychological disturbances in decision-making, problem solving and affect modulation, which have been reported in people with a history of suicide attempts and in depressed patients. 41 The thalamus receives strong dopaminergic projections and plays a critical role in the mood-related neural networks. 42 Previous research has shown that functional and histological abnormalities in the thalamus are involved in the pathophysiology of depression and suicidal behaviours.…”

Section: 38mentioning

confidence: 99%

Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T

Jia

Wang

Huang

et al. 2014

J Psychiatry Neurosci

104

View full text Add to dashboard Cite

IntroductionSuicide is one of the leading causes of death in children and middle-aged individuals and represents a major public health problem throughout the world. Current trends suggest that about 1.5 million people will die by suicide in the year 2020.1 Major depressive disorder (MDD) is a highly prevalent, etiologically multifactorial and clinically heterogen eous disorder. The lifetime risk of suicide in patients with MDD is about 6%, which represents a 20-fold increase from the general population.2,3 Suicide attempts, defined as selfdestructive acts with some degree of intent to end one's life, are one of the strongest predictors of future suicidal acts. 4,5 Thus, suicide attempts represent an important intervention point for suicide prevention efforts, and in vivo studies of individuals who attempt suicide represent an important strategy for learning about the neurobiology of suicide.Conventional magnetic resonance imaging (MRI) studies have found white matter and grey matter hyperintensities and reduced orbitofrontal cortex grey matter volumes on scans of depressed patients with a history of suicide attempts.6-8 A functional MRI experiment revealed that suicidal patients were distinguished from nonsuicidal patients in their activation patterns in frontal, cingulate and cerebellar regions.9 A positron emission tomography study revealed localized prefrontal hypofunction and impaired responsivity of serotonergic systems to pharmaco logic al challenge that were proportional to the lethality of the suicide attempt in individuals with MDD. Background:The neurobiology of suicide is largely unknown. Studies of white matter tracts in patients with a history of suicidal behaviour have shown alteration in the left anterior limb of the internal capsule (ALIC). Our aim was to determine whether particular target fields of fibre projections through the ALIC are affected in depressed patients who recently attempted suicide. Methods: We studied patients with major depressive disorder (MDD) with and without a history of suicide attempts and healthy controls using diffusion tensor imaging (DTI) and deterministic tractography to generate fibre tract maps for each participant. Tract voxels were coded as being unique to the left ALIC. We compared the mean percentage of fibres projecting to relevant brain regions in the 3 groups using analysis of covariance. Results: We included 63 patients with MDD (23 with and 40 without a history of suicide attempts) and 46 controls in our study. Both groups of depressed patients had reduced fibre projections through the ALIC to the left medial frontal cortex, orbitofrontal cortex and thalamus. Those with a history of suicide attempts had greater abnormalities than those without suicide attempts in the left orbitofrontal cortex and thalamus. Limitations: Diffusion tensor imaging deterministic tracking is unable to distinguish between afferent and efferent pathways, limiting our ability to distinguish the directionality of altered fibre tracts. Conclusion: Frontothalamic loops passing throu...

show abstract

“…However, central to many models is a stress-diathesis component which states that suicidal behavior is a result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). Evidence is accumulating from post-mortem, neuroimaging and in-vivo studies that a trait diathesis is not only manifested in impairments of the serotonergic and noradrenergic neurotransmitter systems, in structural brain abnormalities and via epigenetic pathways but also in dysregulation of hypothalamic-pituitary-adrenal (HPA) axis stress response activity (Mann, 2013;Turecki et al, 2012;van Heeringen et al, 2011;van Heeringen and Mann, 2014).…”

Section: Introductionmentioning

confidence: 99%

Cortisol levels and suicidal behavior: A meta-analysis

O’Connor¹,

Ferguson²,

Green³

et al. 2015

Psychoneuroendocrinology

View full text Add to dashboard Cite

Suicide is a major cause of death worldwide, responsible for 1.5% of all mortality. The causes of suicidal behavior are not fully understood. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, is one potential risk factor. This meta-analytic review aimed i) to estimate the strength and variability of the association between naturally fluctuating cortisol levels and suicidal behavior and ii) to identify moderators of this relationship. A systematic literature search identified 27 studies (N = 2226; 779 suicide attempters & 1447 non-attempters) that met the study eligibility criteria from a total of 417 unique records initially examined. Estimates of effect sizes (r) obtained from these studies were analysed using Comprehensive Meta-Analysis. In these analyses, we compared participants identified as having a past history of suicide attempt(s) to those with no such history. Study quality, mean age of sample and percentage of male participants were examined as potential moderators. Overall, there was no significant effect of suicide group on cortisol. However, significant associations between cortisol and suicide attempts were observed as a function of age. In studies where the mean age of the sample was below 40 years the association was positive (i.e., higher cortisol was associated with suicide attempts; r = .234, p < .001), and where the mean age was 40 or above the association was negative (i.e., lower cortisol was associated with suicide attempts; r = -.129, p < .001). These findings confirm that HPA axis activity, as indicated by age-dependent variations in cortisol levels, is associated with suicidal behavior. The challenge for theory and clinical practice is to explain the complete reversal of the association with age and to identify its clinical implications.

show abstract

Suicidal brains: A review of functional and structural brain studies in association with suicidal behaviour

Cited by 140 publications

References 34 publications

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Are neurocognitive factors associated with repetition of self-harm? A systematic review

Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T

Cortisol levels and suicidal behavior: A meta-analysis

Contact Info

Product

Resources

About