Altered Cortical GABA in Female Veterans with Suicidal Behavior: Sex Differences and Clinical Correlates.
Altered Cortical GABA in Female Veterans with Suicidal Behavior: Sex Differences and Clinical Correlates.
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DOI：
10.1177/2470547018768771
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发表时间：
2018-01
期刊：
影响因子：
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通讯作者：
Yurgelun-Todd D
中科院分区：
文献类型：
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作者：
Prescot A;Sheth C;Legarreta M;Renshaw PF;McGlade E;Yurgelun-Todd D
在平民和退伍军人中，自杀是一个公共卫生问题。紧张的生活事件是自杀的诱因。压力/创伤和自杀风险之间联系的神经化学基础尚不清楚，特别是在性别差异方面。我们推测，主要的抑制性神经递质伽马氨基丁酸(GABA)可能是一种神经化学候选物质，在退伍军人压力和自杀风险之间的关联中起关键作用。使用3.0特斯拉质子磁共振波谱对81名退伍军人(16名女性)的前扣带回皮质(主要是背侧前扣带皮质)的体内神经化学进行了测量，其中57名(11名女性)支持过去的自杀意念和/或自杀企图，24名(5名女性)没有自杀意念和/或自杀未遂的病史。自杀行为(SB)被定义为存在自杀意念和/或自杀企图。我们观察到有Sb(Sb+)和没有Sb(Sb + )的退伍军人的GABa/肌酸 + 磷酸肌酸(Cr−Pcr)无显著差异。然而，女性Sb+组与女性Sb−组相比，GABAcr+Pcr显著降低。在SB+组中，GABA/Cr+PCr与创伤症状问卷中的防御回避分呈趋势水平的显著负相关。相反，SB−组显示出这两个变量之间的正相关关系。此外，在退伍军人中，我们发现GABA/Cr+Pcr与汉密尔顿抑郁量表评分以及GABA/Cr+Pcr与创伤症状问卷的几个分量表之间存在显著的负相关。本研究提示，退伍军人前扣带回皮质GABA/Cr+PCR值降低可能与抑制能力改变有关，可能是女性退伍军人自杀风险的基础。此外，GABA/Cr+PCR与应激症状和抑郁评分之间的负关联表明，磁共振波谱研究可能有助于揭示SB的中间表型。
Suicide is a public health concern in the civilian and veteran populations. Stressful life events are precipitating factors for suicide. The neurochemical underpinnings of the association between stress/trauma and suicide risk are unclear, especially with regard to sex differences. We hypothesized that gamma-amino butyric acid (GABA), the major inhibitory neurotransmitter, may be a neurochemical candidate that is critical in the association between stress and suicide risk in veterans. Proton magnetic resonance spectroscopy at 3.0 Tesla was used to measure in vivo neurochemistry in the anterior cingulate cortex (predominantly the dorsal anterior cingulate cortex) of 81 veterans (16 females), including 57 (11 females) who endorsed past suicidal ideation and/or suicide attempt and 24 (5 females) with no history of suicidal ideation and/or suicide attempt. Suicidal behavior (SB) was defined as the presence of suicidal ideation and/or suicide attempt. We observed no significant differences in GABA/creatine + phosphocreatine (Cr + PCr) between veterans with SB (SB+) and without SB (SB−). However, the female SB+ group showed significantly reduced GABA/Cr + PCr versus the female SB− group. We observed a trend-level significant negative correlation between GABA/Cr + PCr and the Defensive Avoidance subscale on the Trauma Symptom Inventory in the SB+ group. In contrast, the SB− group exhibited a positive relationship between the two variables. Furthermore, we found significant negative correlations between GABA/Cr + PCr and Hamilton Rating Scale for Depression scores as well as between GABA/Cr + PCr and several subscales of the Trauma Symptom Inventory in female veterans. This study suggests that reduced GABA/Cr + PCr ratio in the anterior cingulate cortex, which may be related to altered inhibitory capacity, may underlie suicide risk in female veterans. Further, the negative association between GABA/Cr + PCr and stress symptomatology and depression scores suggests that magnetic resonance spectroscopy studies may shed light on intermediate phenotypes of SB.