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. .

与自杀死亡率相比，精神疾病的死亡率约为 普通人群。在精神疾病中，躁郁症（BD）的尝试率最高 （〜40％），比主要抑郁症（MDD）高2-3倍。而神经回路 已经提出了自杀行为，这些行为主要基于MDD的研究，并排除了 小脑。我们小组和其他人的工作使小脑在自杀行为，冲动性， 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 研究推定的自杀风险回路（SRC），其中包括小脑，以预期评估 该神经回路的连接组和拟议SRC节点中的代谢。评估SRC，大脑 成像以及自杀行为，精神病症状和人格特征的测量结果将是 在300名精神疾病（BD I和MDD）的样本中获得了75例自杀的样本 尝试和75没有事先尝试每个精神病诊断。 75个匹配的控件也将 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），connectome（静止状态fMRI和扩散成像）和代谢（MRS和T1ρ）。这个数据 将用于回答以下目的：目标1）SRC是否将自杀式定位与非 - BD中的Attempter？ AIM 2）SRC在MDD中区分了自杀式 /非攻击者 作为BD？这项工作将增加我们对自杀行为实施的大脑电路的理解，如何 小脑可能参与这些电路，哪些代谢差异与自杀有关 行为。此外，该研究将揭示同一神经回路（即SRC）是否在 跨疾病的自杀行为，或者是否涉及各种疾病的神经回路。目标 该项目将更好地在自杀的神经生物学下，以帮助确定那些有未来自杀的风险的人 试图。我们预计这项研究将揭示用于治疗有自杀行为风险的受试者的新目标。 。