Brain scans with fMRI may provide clues to suicide risk

Brain scans with fMRI may provide clues to suicide risk

Press releases may be edited for formatting or style | October 11, 2019 MRI
UNIVERSITY OF ILLINOIS AT CHICAGO -- Researchers at the University of Utah Health and the University of Illinois at Chicago have identified brain circuitry differences that might be associated with suicidal behavior in individuals with mood disorders. The study, published in Psychological Medicine, provides a promising lead toward tools that can predict which individuals are at the highest risk for suicide.

Suicide rates are rising steadily among young adults, especially those with mood disorders such as depression. More than half of individuals who are lost to suicide saw a health professional within the past 30 days, but they did not necessarily seek care for mood problems. Emergency departments and urgent care clinics might ask screening questions about mood and follow up depending on the patient's answers if necessary. Yet suicide rates continue to rise.

"At present, we have very few tools to identify individuals who may be at high risk for suicide-related behavior," said Scott Langenecker, professor of psychiatry at U of U Health and senior author on the study. "Right now, we go on self-report and clinician judgment. Those are good, but they're not great."

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Previous studies have identified brain circuits associated with mood disorders: the cognitive control network (CCN), which is involved in executive function, problem-solving and impulsivity; the salience and emotional network (SEN), which is involved in emotion processing and regulation; and the default mode network (DMN), which is active when individuals are engaged in self-focused thought. However, these studies have focused primarily on depression.

"This is one of the first studies to try to understand brain mechanisms that may be relevant to suicide risk," said Jonathan Stange, assistant professor of psychiatry at UIC and first author on the study.

The Psychological Medicine study used resting-state functional MRI (fMRI), which captured brain images while participants were rested and calm, to assess the connectivity of these circuits in 212 young adults at UIC and the University of Michigan.

"For risk factors involved in suicide, the tasks we have to measure are pretty nonspecific and inexact," Langenecker said. "If we go to the level of the resting-state networks, we're actually asking the brain to tell us which brain networks and connections are most relevant."

The study population included individuals with mood disorders and a history of suicide attempts, those with mood disorders and a history of suicidal thoughts, those with mood disorders and no history of suicidal behavior or thoughts, and healthy controls. All study participants with mood disorders were in remission.

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