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J Affect Disord. 2019 Feb 15;245:1089-1097. doi: 10.1016/j.jad.2018.11.095. Epub 2018 Nov 22.

Gray and white matter differences in adolescents and young adults with prior suicide attempts across bipolar and major depressive disorders.

Author information

1
Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA. Electronic address: siyan.fan@yale.edu.
2
Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
3
Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
4
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
5
Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA.

Abstract

BACKGROUND:

Findings regarding brain circuitry abnormalities in suicide attempters (SAs) converge across bipolar disorder (BD) and major depressive disorder (MDD), the most common disorders observed in suicides. These abnormalities appear to be present during adolescence/young adulthood when suicide rates increase steeply, and suicide is a leading cause of death in this age group. Identification of brain circuitry common to adolescent/young adult SAs with BD and MDD is important for generating widely effective early prevention strategies. We examined brain circuitry in SAs in adolescents/young adults across these two disorders.

METHODS:

Eighty-three participants (ages 14-25 years), 46 with BD (21 SAs) and 37 with MDD (19 SAs), underwent structural and diffusion-weighted magnetic resonance scanning. Whole-brain analyses compared gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) between SAs and non-suicide attempters (NSAs) across and within BD and MDD (p < 0.005).

RESULTS:

Across and within BD and MDD, SAs showed differences compared to NSAs in ventral prefrontal cortex (PFC) GM volume and fronto-limbic (including uncinate fasciculus (UF)) WM FA. Exploratory analyses showed additional within-disorder differences for BD SAs in dorsolateral PFC (dlPFC) and hippocampus GM volume and UF FA, and for MDD SAs dorsomedial and dlPFC GM and dorsal frontal WM. However, there was no significant interaction between suicide attempt status and diagnosis.

LIMITATIONS:

Modest sample size.

CONCLUSIONS:

Common fronto-limbic gray and white matter alterations in adolescent/young adult SAs are potential targets for suicide prevention strategies across mood disorders. Preliminary findings of disorder-specific regional findings could suggest diagnostic-specific optimal targets may exist.

KEYWORDS:

Adolescent; Diffusion tensor imaging; Frontal Lobe; Magnetic resonance imaging; Suicide; Young Adult

PMID:
30699851
DOI:
10.1016/j.jad.2018.11.095
[Indexed for MEDLINE]

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