Multimodal Neuroimaging of Frontolimbic Structure and Function Associated With Suicide Attempts in Adolescents and Young Adults With Bipolar Disorder

双相情感障碍 心理学 白质 前额叶皮质 神经影像学 神经科学 扁桃形结构 重性抑郁障碍 自杀意念 钩束 毒物控制 神经功能成像 精神科 临床心理学 医学 磁共振成像 部分各向异性 伤害预防 认知 环境卫生 放射科
作者
Jennifer Johnston,Fei Wang,Jie Liu,Benjamin N. Blond,Amanda Wallace,Jia‐Cheng Liu,Linda Spencer,Elizabeth Lippard,Kirstin L. Purves,Angeli Landeros‐Weisenberger,Eric Hermes,Brian Pittman,Sheng Zhang,Robert King,Andrés Martin,María A. Oquendo,Hilary P. Blumberg
出处
期刊:American Journal of Psychiatry [American Psychiatric Association]
卷期号:174 (7): 667-675 被引量:202
标识
DOI:10.1176/appi.ajp.2016.15050652
摘要

Objective: Bipolar disorder is associated with high risk for suicidal behavior that often develops in adolescence and young adulthood. Elucidation of involved neural systems is critical for prevention. This study of adolescents and young adults with bipolar disorder with and without a history of suicide attempts combines structural, diffusion tensor, and functional MR imaging methods to investigate implicated abnormalities in the morphology and structural and functional connectivity within frontolimbic systems. Method: The study had 26 participants with bipolar disorder who had a prior suicide attempt (the attempter group) and 42 participants with bipolar disorder without a suicide attempt (the nonattempter group). Regional gray matter volume, white matter integrity, and functional connectivity during processing of emotional stimuli were compared between groups, and differences were explored for relationships between imaging modalities and associations with suicide-related symptoms and behaviors. Results: Compared with the nonattempter group, the attempter group showed significant reductions in gray matter volume in the orbitofrontal cortex, hippocampus, and cerebellum; white matter integrity in the uncinate fasciculus, ventral frontal, and right cerebellum regions; and amygdala functional connectivity to the left ventral and right rostral prefrontal cortex. In exploratory analyses, among attempters, there was a significant negative correlation between right rostral prefrontal connectivity and suicidal ideation and between left ventral prefrontal connectivity and attempt lethality. Conclusions: Adolescent and young adult suicide attempters with bipolar disorder demonstrate less gray matter volume and decreased structural and functional connectivity in a ventral frontolimbic neural system subserving emotion regulation. Among attempters, reductions in amygdala–prefrontal functional connectivity may be associated with severity of suicidal ideation and attempt lethality.
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