Suicidality in Bipolar and Major Depression Disorders

双相情感障碍和重度抑郁症的自杀倾向

• 批准号: 10359342
• 负责人: VINCENT A MAGNOTTA
• 金额: $ 75.4万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10359342
• 关键词: Algorithms; Anatomy; Anterior; Back; Behavior; Bipolar Depression; Bipolar Disorder; Brain; Brain imaging; Cell Nucleus; Cerebellar vermis structure; Cerebellum; Coupled; Data; Dependence; Diffusion; Disease; Dorsal; Exhibits; Failure; Feeling suicidal; Functional Magnetic Resonance Imaging; Future; General Population; Globus Pallidus; Goals; Image; Impulsivity; Individual; Inferior; Knowledge; Lateral; Magnetic Resonance Imaging; Major Depressive Disorder; Measurement; Measures; Mediating; Mental disorders; Metabolic; Metabolism; Modeling; Mood Disorders; Moods; Neurobiology; Parietal Lobe; Participant; Personality Traits; Play; Prefrontal Cortex; Psychiatric Diagnosis; Regulation; Rest; Risk; Role; Sampling; Suicide; Suicide attempt; Surface; Testing; Thalamic structure; Time; Work; base; connectome; disorder control; frontal lobe; imaging study; multimodality; neural circuit; new therapeutic target; prospective; psychiatric symptom; random forest; reducing suicide; response; routine screening; screening; suicidal; suicidal behavior; suicidal risk; suicide attempter; suicide mortality; suicide rate

The rate of mortality by suicide is approximately twenty times higher in psychiatric disorders as compared to the general population. Among psychiatric disorders, bipolar disorder (BD) has the highest rate of attempts (~40%), which is 2-3 times higher than in major depressive disorder (MDD). While neural circuits underlying suicidal behavior have been proposed, these have emerged largely based on studies of MDD and exclude the cerebellum. Work from our group and others have implicated the cerebellum in suicidal behavior, impulsivity, and bipolar disorder suggesting that it may play a key role in suicidal behavior. In this study, we propose to study a putative suicide risk circuit (SRC) that includes the cerebellum to prospectively evaluate the connectome of this neural circuit and metabolism in the nodes of the proposed SRC. To assess the SRC, brain imaging coupled with measurements of suicidal behavior, psychiatric symptoms, and personality traits will be acquired in a sample of 300 subjects with a psychiatric disorder (BD I and MDD) with 75 having a prior suicide attempt and 75 without a prior attempt for each psychiatric diagnosis. Seventy-five matched controls will also be acquired. Brain imaging will include multi-modal MR imaging to study anatomy (T1, T2), functional (task based fMRI), connectome (resting state fMRI and diffusion imaging) and metabolism (MRS and T1ρ). This data will be used to answer the following aims: Aim 1) Does the SRC differentiate suicide attempter from non- attempter in BD? and Aim 2) Does the SRC differentiate suicide attempter / non-attempter in MDD in the same way as BD? This work will increase our understanding of the brain circuits implicated in suicidal behavior, how the cerebellum may be involved in these circuits, and what metabolic differences are associated with suicidal behavior. In addition, the study will reveal if the same neural circuit (i.e. the SRC) plays a significant role in suicidal behavior across disorders or if there are different neural circuits involved across disorders. The goal of this project is to better undertand the neurobiology of suicidality to help identify those at risk for a future suicide attempt. We anticipate that this study will reveal new targets for treating subjects at risk for suicidal behavior. .

精神疾病的自杀死亡率大约是精神疾病的20倍， 一般人。在精神疾病中，双相情感障碍（BD）的尝试率最高 （~40%），比重度抑郁症（MDD）高2-3倍。当神经回路 自杀行为已经提出，这些已经出现了很大程度上基于MDD的研究，并排除了 小脑我们小组和其他人的工作表明小脑与自杀行为、冲动、 和双相情感障碍表明它可能在自杀行为中起关键作用。在这项研究中，我们建议 研究包括小脑在内的推定自杀风险回路（SRC）， 该神经回路的连接体和所提出的SRC的节点中的代谢。为了评估SRC，大脑 影像学结合自杀行为、精神症状和人格特征的测量， 在300名患有精神疾病（BD I和MDD）的受试者样本中获得，其中75名有自杀史 对于每项精神病诊断，尝试和75次事先未尝试。75个匹配的对照组也将 被收购。脑成像将包括多模式MR成像，以研究解剖结构（T1、T2）、功能（任务 基于fMRI）、连接体（静息状态fMRI和弥散成像）和代谢（MRS和T1ρ）。该数据 将用于回答以下目标：目标1）SRC是否区分自杀者和非自杀者 在BD中的搜索器？和目的2）SRC是否在相同的时间内区分MDD中的自杀者/非自杀者 如BD？这项工作将增加我们对自杀行为所涉及的大脑回路的理解， 小脑可能参与了这些回路，什么样的代谢差异与自杀有关 行为此外，该研究还将揭示同一神经回路（即SRC）是否在以下方面发挥重要作用： 自杀行为，或者是否有不同的神经回路参与疾病。的目标 这个项目是为了更好地理解自杀的神经生物学，以帮助识别那些有未来自杀风险的人。 企图。我们预计，这项研究将揭示治疗有自杀行为风险的受试者的新靶点。 .