Are structural brain abnormalities associated with suicidal behavior in patients with psychotic disorders?
Are structural brain abnormalities associated with suicidal behavior in patients with psychotic disorders?
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DOI：
10.1016/j.jpsychires.2013.06.011
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发表时间：
2013-10
影响因子：
4.8
通讯作者：
Keshavan, Matcheri S.
中科院分区：
文献类型：
--
作者：
Giakoumatos, Christoforos I.;Tandon, Neeraj;Shah, Jai;Mathew, Ian T.;Brady, Roscoe O.;Clementz, Brett A.;Pearlson, Godfrey D.;Thaker, Gunvant K.;Tamminga, Carol A.;Sweeney, John A.;Keshavan, Matcheri S.
自杀是世界范围内的一个重大健康问题。然而，对自杀行为的神经生物学基础的理解仍然远远没有完成。我们比较了自杀未遂者和非自杀未遂者，以及高致命性和低致命性自杀未遂者，以确定精神病患者与自杀行为相关的大脑区域。在B-SNIP研究中，对489名精神分裂症、情感障碍或精神病性双相情感障碍I患者和262名健康对照者进行了研究。通过尝试历史和先前自杀尝试的最高医学致死率对各组进行比较。97例患者有高致死性尝试史，51例有低致死性尝试史，341例无尝试史。使用FreeSurfer从3 T结构MRI扫描获得灰质体积。ANCOVA用于检查组间差异，然后进行Hochberg多重比较校正。与非抑郁症患者相比，抑郁症患者双侧颞下和上级皮质、左侧上级顶叶、丘脑和边缘上区、右侧额区、上级额区和吻侧额中区的灰质体积显著减少。在自杀者中，有高致死性企图的病史与左舌回和右楔叶的体积显著较小相关。低致死性癫痫患者的左侧边缘上回、丘脑和右侧丘脑显著低于非癫痫患者。脑结构异常可以区分自杀倾向者和非自杀倾向者，以及精神障碍患者中高致死率和低致死率的自杀倾向者。观察到差异的区域是调节抑制、冲动和情感、内脏、视觉和听觉感知的神经回路的一部分。
Suicide represents a major health problem world-wide. Nevertheless, the understanding of the neurobiological underpinnings of suicidal behavior remains far from complete. We compared suicide attempters to non-attempters, and high vs. low lethality attempters, to identify brain regions associated with suicidal behavior in patients with psychotic disorders. 489 individuals with schizophrenia, schizoaffective disorder, or psychotic bipolar disorder I and 262 healthy controls enrolled in the B-SNIP study were studied. Groups were compared by attempt history and the highest medical lethality of previous suicide attempts. 97 patients had a history of a high lethality attempt, 51 of a low lethality attempt and 341 had no attempt history. Gray matter volumes were obtained from 3T structural MRI scans using FreeSurfer. ANCOVAs were used to examine differences between groups, followed by Hochberg multiple comparison correction. Compared to non-attempters, attempters had significantly less gray matter volume in bilateral inferior temporal and superior temporal cortices, left superior parietal, thalamus and supramarginal regions, right insula, superior frontal and rostral middle frontal regions. Among attempters, a history of high lethality attempts was associated with significantly smaller volumes in the left lingual gyrus and right cuneus. Compared to non-attempters, low lethality attempters had significant decreases in the left supramarginal gyrus, thalamus and the right insula. Structural brain abnormalities may distinguish suicide attempters from non-attempters and high from low lethality attempters among individuals with psychotic disorders. Regions in which differences were observed are part of neural circuitries that mediate inhibition, impulsivity and emotion, visceral, visual and auditory perception.
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影响因子：
2.6
作者：
CAMPBELL, R;HEYWOOD, CA;LANDIS, T
通讯作者：
LANDIS, T
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
DOI：
10.3390/ijerph9030985
发表时间：
2012-03
影响因子：
--
作者：
Amitai M;Apter A
通讯作者：
Apter A
影响因子：
2.3
作者：
Buchheim, Anna;Erk, Susanne;Walter, Henrik
通讯作者：
Walter, Henrik
影响因子：
7.8
作者：
Aguilar, EJ;Leal, C;Gracia, R
通讯作者：
Gracia, R