PDF(Pubmed)
Abstract：
UNASSIGNED: Suicide is a current leading cause of death in adolescents and young adults. The neurobiological underpinnings of suicide risk in youth, however, remain unclear and a brain-based model is lacking. In adult samples, current models highlight deficient serotonin release as a potential suicide biomarker, and in particular, involvement of serotonergic dysfunction in relation to the putamen and suicidal behavior. Less is known about associations among striatal regions and relative suicidal risk across development. The current study examined putamen connectivity in depressed adolescents with (AT) and without history of a suicide attempt (NAT), specifically using resting-state functional magnetic resonance imaging (fMRI) to evaluate patterns in resting-state functional connectivity (RSFC). We hypothesized the AT group would exhibit lower striatal RSFC compared to the NAT group, and lower striatal RSFC would associate with greater suicidal ideation severity and/or lethality of attempt.
UNASSIGNED: We examined whole-brain RSFC of six putamen regions in 17 adolescents with depression and NAT (MAge [SD] = 16.4[0.3], 41% male) and 13 with AT (MAge [SD] = 16.2[0.3], 31% male).
UNASSIGNED: Only the dorsal rostral striatum showed a statistically significant bilateral between-group difference in RSFC with the superior frontal gyrus and supplementary motor area, with higher RSFC in the group without a suicide attempt compared to those with attempt history (voxel-wise p<.001, cluster-wise p<.01). No significant associations were found between any putamen RSFC patterns and suicidal ideation severity or lethality of attempts among those who had attempted.
UNASSIGNED: The results align with recent adult literature and have interesting theoretical and clinical implications. A possible interpretation of the results is a mismatch of the serotonin transport to putamen and to the supplementary motor area and the resulting reduced functional connectivity between the two areas in adolescents with attempt history. The obtained results can be used to enhance the diathesis-stress model and the Emotional paiN and social Disconnect (END) model of adolescent suicidality by adding the putamen. We also speculate that connectivity between putamen and the supplementary motor area may in the future be used as a valuable biomarker of treatment efficacy and possibly prediction of treatment outcome.
UNASSIGNED: We examined whole-brain RSFC of six putamen regions in 17 adolescents with depression and NAT (MAge [SD] = 16.4[0.3], 41% male) and 13 with AT (MAge [SD] = 16.2[0.3], 31% male).
UNASSIGNED: Only the dorsal rostral striatum showed a statistically significant bilateral between-group difference in RSFC with the superior frontal gyrus and supplementary motor area, with higher RSFC in the group without a suicide attempt compared to those with attempt history (voxel-wise p<.001, cluster-wise p<.01). No significant associations were found between any putamen RSFC patterns and suicidal ideation severity or lethality of attempts among those who had attempted.
UNASSIGNED: The results align with recent adult literature and have interesting theoretical and clinical implications. A possible interpretation of the results is a mismatch of the serotonin transport to putamen and to the supplementary motor area and the resulting reduced functional connectivity between the two areas in adolescents with attempt history. The obtained results can be used to enhance the diathesis-stress model and the Emotional paiN and social Disconnect (END) model of adolescent suicidality by adding the putamen. We also speculate that connectivity between putamen and the supplementary motor area may in the future be used as a valuable biomarker of treatment efficacy and possibly prediction of treatment outcome.
摘要：
■自杀是目前青少年死亡的主要原因。青少年自杀风险的神经生物学基础，然而,尚不清楚，缺乏基于大脑的模型。在成人样本中，目前的模型强调血清素释放不足是一种潜在的自杀生物标志物，特别是,5-羟色胺能功能障碍与壳核和自杀行为有关。关于纹状体区域之间的关联和整个发育过程中的相对自杀风险知之甚少。当前的研究检查了患有（AT）和没有自杀企图（NAT）史的抑郁青少年的壳核连接，特别是使用静息态功能磁共振成像（fMRI）来评估静息态功能连接（RSFC）的模式。我们假设与NAT组相比，AT组将表现出更低的纹状体RSFC，和较低的纹状体RSFC将与更高的自杀意念严重程度和/或尝试的致死率相关。
■我们检查了17名患有抑郁症和NAT的青少年的六个壳核区的全脑RSFC（MAge[SD]=16.4[0.3]，41%的男性）和13的AT（MAge[SD]=16.2[0.3]，31%男性）。
■仅在RSFC中显示出具有额上回和补充运动区的有统计学意义的双侧组间差异，与有自杀未遂史的人群相比，无自杀未遂组的RSFC较高（体素p<.001，聚类p<.01）。在尝试过的人中，任何壳核RSFC模式与自杀意念的严重程度或尝试的致死率之间均未发现显着关联。
■结果与最近的成人文献一致，具有有趣的理论和临床意义。对结果的可能解释是，在有尝试史的青少年中，5-羟色胺向壳核和补充运动区域的转运不匹配，从而导致这两个区域之间的功能连通性降低。通过添加壳核，获得的结果可用于增强青少年自杀的素质压力模型和情绪情绪与社会脱节（END）模型。我们还推测，壳核与辅助运动区之间的连通性将来可能会用作治疗功效的有价值的生物标志物，并可能预测治疗结果。
■我们检查了17名患有抑郁症和NAT的青少年的六个壳核区的全脑RSFC（MAge[SD]=16.4[0.3]，41%的男性）和13的AT（MAge[SD]=16.2[0.3]，31%男性）。
■仅在RSFC中显示出具有额上回和补充运动区的有统计学意义的双侧组间差异，与有自杀未遂史的人群相比，无自杀未遂组的RSFC较高（体素p<.001，聚类p<.01）。在尝试过的人中，任何壳核RSFC模式与自杀意念的严重程度或尝试的致死率之间均未发现显着关联。
■结果与最近的成人文献一致，具有有趣的理论和临床意义。对结果的可能解释是，在有尝试史的青少年中，5-羟色胺向壳核和补充运动区域的转运不匹配，从而导致这两个区域之间的功能连通性降低。通过添加壳核，获得的结果可用于增强青少年自杀的素质压力模型和情绪情绪与社会脱节（END）模型。我们还推测，壳核与辅助运动区之间的连通性将来可能会用作治疗功效的有价值的生物标志物，并可能预测治疗结果。
