Format

Send to

Choose Destination
J Affect Disord. 2015 Dec 1;188:202-9. doi: 10.1016/j.jad.2015.08.049. Epub 2015 Sep 3.

Control-related frontal-striatal function is associated with past suicidal ideation and behavior in patients with recent-onset psychotic major mood disorders.

Author information

1
Department of Psychiatry, University of California, San Francisco School of Medicine, and Veterans Affairs Medical Center, San Francisco, CA, USA. Electronic address: Michael.minzenberg@ucsf.edu.
2
Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA, USA.
3
Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, and the VA Palo Alto Health Care System, Palo Alto, CA, USA.
4
Department of Psychiatry, University of California, San Francisco School of Medicine, and Veterans Affairs Medical Center, San Francisco, CA, USA.
5
Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA, USA; Center for Neuroscience, University of California, Davis, CA, USA.

Abstract

OBJECTIVE:

Suicide is highly-prevalent in major mood disorders, yet it remains unclear how suicidal ideation and suicidal behavior relate to brain functions, especially those that support control processes. We evaluated how prefrontal cortex (PFC) activity during goal-representation (an important component of cognitive control) relates to past suicidal ideation and behavior in patients with psychotic major mood disorders.

METHOD:

30 patients with recent-onset of either DSM-IV-TR-defined bipolar disorder type I (n=21) or major depressive disorder (n=9) with psychotic features, but neither in a major mood episode nor acutely psychotic at study, were evaluated for past suicidal ideation and behavior (Columbia Suicide Severity Rating Scale) and functional MRI during cognitive control task performance. Group-level regression models of brain activation accounted for current depression, psychosis and trait impulsivity.

RESULTS:

Intensity of past suicidal ideation was associated with higher control-related activation in right-hemisphere regions including the ventrolateral PFC (VLPFC) and orbitofrontal cortex, rostral insula, and dorsal striatum. Among those with past suicidal ideation (n=16), past suicidal behavior (n=8) was associated with higher control-related activation in right-hemisphere regions including VLPFC, rostrolateral PFC, and frontal operculum/rostral insula; and relatively lower activity in midline parietal regions, including cuneus and precuneus.

LIMITATIONS:

The sample size of subjects with past suicidal behavior was modest, and all subjects were taking psychotropic medication.

CONCLUSIONS:

This study provides unique evidence that in early-course psychotic major mood disorders, suicidal ideation and behavior histories directly relate to PFC-based circuit function in support of cognitive control.

KEYWORDS:

Bipolar I disorder; Cognitive control; Frontal cortex; Major depressive disorder; Psychosis; Suicide risk

PMID:
26363618
DOI:
10.1016/j.jad.2015.08.049
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center