Neural Correlates Associated With Suicide and Nonsuicidal Self-injury in Youth

Auerbach, Randy P.; Pagliaccio, David; Allison, Grace O.; Alqueza, Kira L.; Alonso, María Fernanda Mancebo

doi:10.1016/j.biopsych.2020.06.002

Cited by 104 publications

(122 citation statements)

References 133 publications

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“…Although SI and NSSI typically emerge during adolescence (2,5) and often co-occur (6,7), researchers and clinicians have long recognized that these phenomena are distinct (8,9) and likely have unique neurobiological substrates (10,11). Thus, elucidating the specific neurobiological patterns that characterize SI and NSSI in adolescents may shed insight into the diverse etiology of these behaviors, help to refine brain-based conceptual models (12,11), and identify neural circuits that are sufficiently sensitive to assess the efficacy of targeted interventions (13).…”

Section: Introductionmentioning

confidence: 99%

“…Few researchers have used neuroimaging to examine SI or NSSI in adolescents, and almost no studies have utilized clinical controls (for reviews, 14,11). To date, studies in this area have identified patterns of brain activation and connectivity related to SI and NSSI that are broadly consistent with neurobiological models of psychiatric disorders anchored in dysfunction of intrinsic large-scale brain networks (i.e., distributed regions with which intrinsic signals coactivate) of the human brain (15,16): the central executive network (CEN), the default mode network (DMN), and the salience network (SN).…”

Section: Introductionmentioning

confidence: 99%

“…The SN is an integrative attentional system composed of the dorsal anterior cingulate cortex (dACC), anterior insula, amygdala, and striatum that evaluates and processes internal and external stimuli to facilitate the selection and deployment of appropriate behavioral responses (19,20). While task-based fMRI studies have provided key knowledge of the psychological processes undergirding SI and NSSI, separately, in adolescents (11), these studies have not examined both SI and NSSI in a single cohort. Moreover, it is difficult to pinpoint the precise functional network patterns that are associated with these behaviors given the diverse tasks that have been used across investigations.…”

Section: Introductionmentioning

confidence: 99%

“…In this context, advances in our understanding of intrinsic large-scale functional networks (21,22) makes resting-state fMRI ideal for examining network-based perturbations in a variety of clinical conditions. Indeed, a small number of resting-state fMRI studies have documented nuanced alterations in the CEN, DMN, and SN in adolescents with history of suicide attempts, with SI, and with NSSI (for a review, see 11). In depressed adolescents, greater severity of SI has been associated with both greater connectivity between one node of the DMN (precuneus) with sensorimotor regions, as well as lower connectivity between another node of the DMN (PCC) with visual attention regions (23).…”

Section: Introductionmentioning

confidence: 99%

“…Critically, we used a data-driven multivariate approach that is sensitive to detect the spatiotemporal subdivisions of the DMN and SN, circuits in which the greatest heterogeneity with respect to directionality and specific regions in resting-state and task-based fMRI findings have been reported (11). Based on the studies reviewed above, we hypothesized: 1) depressed adolescents with SI will exhibit lower CEN, DMN, and SN coherence compared to the other two groups and 2) depressed adolescents with NSSI will exhibit lower SN coherence compared to the other two groups.…”

Section: Introductionmentioning

confidence: 99%

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Default Mode and Salience Network Alterations in Suicidal and Non-Suicidal Self-Injurious Thoughts and Behaviors in Adolescents with Depression

Walker

Teresi

et al. 2020

Preprint

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Suicidal ideation (SI) and non-suicidal self-injury (NSSI) are two distinct yet often co-occurring risk factors for suicide in adolescents. Elucidating the neurobiological patterns that specifically characterize SI and NSSI in adolescents is needed to inform the use of these markers in intervention studies and to develop brain-based treatment targets. Here, we clinically assessed 70 adolescents—49 adolescents with depression and 21 healthy controls—to determine SI and NSSI history. Twenty-eight of the depressed adolescents had a history of SI and 29 had a history of NSSI (20 overlapping). All participants underwent a resting-state fMRI scan. We compared groups in network coherence of subdivisions of the central executive network (CEN), default mode network (DMN), and salience network (SN). We also examined group differences in between-network connectivity and explored brain-behavior correlations. Depressed adolescents with SI and with NSSI had lower coherence in the ventral DMN compared to those without SI or NSSI, respectively, and healthy controls (all ps<0.043). Depressed adolescents with NSSI had lower coherence in the anterior DMN and in insula-SN (all ps<0.030), and higher CEN–DMN connectivity compared to those without NSSI and healthy controls (all ps<0.030). Lower network coherence in all DMN subnetworks and insula-SN were associated with higher SI and NSSI (all ps<0.001). Thus, SI and NSSI are related to brain networks associated with difficulties in self-referential processing and future planning, while NSSI specifically is related to brain networks associated with disruptions in interoceptive awareness. Intrinsic network patterns may be reliable biomarkers of SI and NSSI in adolescents.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Default Mode and Salience Network Alterations in Suicidal and Non-Suicidal Self-Injurious Thoughts and Behaviors in Adolescents with Depression

Walker

Teresi

et al. 2020

Preprint

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Brain grey and white matter structural associations with future suicidal ideation and behaviors in adolescent and young adult females with mood disorders

et al. 2022

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Background To reduce suicide in females with mood disorders, it is critical to understand brain substrates underlying their vulnerability to future suicidal ideation and behaviors (SIBs) in adolescence and young adulthood. In an international collaboration, grey and white matter structure was investigated in adolescent and young adult females with future suicidal behaviors (fSB) and ideation (fSI), and without SIBs (fnonSIB). Methods Structural (n = 91) and diffusion‐weighted (n = 88) magnetic resonance imaging scans at baseline and SIB measures at follow‐up on average two years later (standard deviation, SD = 1 year) were assessed in 92 females [age(SD) = 16.1(2.6) years] with bipolar disorder (BD, 28.3%) or major depressive disorder (MDD, 71.7%). One‐way analyses of covariance comparing baseline regional grey matter cortical surface area, thickness, subcortical grey volumes, or white matter tensor‐based fractional anisotropy across fSB (n = 40, 43.5%), fSI (n = 33, 35.9%) and fnonSIB (n = 19, 20.6%) groups were followed by pairwise comparisons in significant regions (p < 0.05). Results Compared to fnonSIBs, fSIs and fSBs showed significant decreases in cortical thickness of right inferior frontal gyrus pars orbitalis and middle temporal gyrus, fSIs of left inferior frontal gyrus, pars orbitalis. FSIs and fSBs showed lower fractional anisotropy in left uncinate fasciculus and corona radiata, and fSBs in right uncinate and superior fronto‐occipital fasciculi. Conclusions The study provides preliminary evidence of grey and white matter alterations in brain regions subserving emotional and behavioral regulation and perceptual processing in adolescent and young adult females with mood disorders with, versus without, future SIBs. Findings suggest potential targets to prevent SIBs in female adolescents and young adults.

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