Periventricular white matter hyperintensities as predictors of suicide attempts in bipolar disorders and unipolar depression

Pompili, Maurizio; Innamorati, Marco; Mann, J. John; Oquendo, María A.; Lester, David; Casale, Antonio Del; Serafini, Gianluca; Rigucci, Silvia; Romano, Andrea; Tamburello, Antonino; Manfredi, Giovanni; Pisa, Eleonora De; Ehrlich, Stefan; Giupponi, Giancarlo; Amore, Mario; Tatarelli, Roberto; Girardi, Paolo

doi:10.1016/j.pnpbp.2008.05.009

Cited by 103 publications

(65 citation statements)

References 61 publications

(64 reference statements)

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“…[6][7][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.…”

Section: Introductionmentioning

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

103

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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...

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Section: Introductionmentioning

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

103

View full text Add to dashboard Cite

show abstract

“…Regarding suicide attempts in bipolar patients, the data remain rare. Periventricular white matter hyperintensities have been reported in patients with major affective disorders who attempt suicide (Pompili et al, 2008;Grangeon et al, 2010). Moreover, abnormalities in the structure and function of the prefrontal cortex in bipolar patients who attempt suicide have also been found, but these abnormalities have been found in suicidal patients with other psychiatric diagnoses as well (Sublette et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Reduced posterior corpus callosum area in suicidal and non-suicidal patients with bipolar disorder

Nery-Fernandes

Rocha

Jackowski

et al. 2012

Journal of Affective Disorders

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“…Structural neuroimaging in depressed suicide attempters has shown periventricular white matter hyperintensities (6), while suicide risk in unipolar depression is related to basal ganglia gray matter hyperintensities (7). Thus, there are biological differences between patients who do and do not attempt suicide.…”

mentioning

confidence: 99%

“…Thus, there are biological differences between patients who do and do not attempt suicide. However, they are poor predictors of individual suicide risk (6).…”

mentioning

confidence: 99%

High-Field Magnetic Resonance Imaging of Suicidality in Patients With Major Depressive Disorder

Jia

Huang²,

Wu³

et al. 2010

AJP

130

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Periventricular white matter hyperintensities as predictors of suicide attempts in bipolar disorders and unipolar depression

Cited by 103 publications

References 61 publications

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

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

Reduced posterior corpus callosum area in suicidal and non-suicidal patients with bipolar disorder

High-Field Magnetic Resonance Imaging of Suicidality in Patients With Major Depressive Disorder

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