Functional Magnetic Resonance Imaging Markers of Early-Onset Suicide Attempt

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DESCRIPTION (provided by applicant): The proposed application will provide the candidate with the needed expertise to establish an independent research career focusing on the investigation of the neurobiology suicide attempt in children and adolescents. The applicant is a child and adolescent psychiatrist who proposes to obtain multidisciplinary training from mentors in suicidology and functional neuroimaging, with a panel of experts in childhood neurobiology, child development, neuroimaging, and data analysis. We propose to use established methods in functional neuroimaging and neuroscience to characterize the neurobiology underlying early onset suicide attempt. We will assess these adolescents, and age-matched psychiatric controls and healthy controls with well-established neurocognitive tasks. We hypothesize that history of suicide attempt in adolescents will be associated with differences in patterns of neural activity compared with both psychiatric and healthy controls. The primary objective of this research project is to examine the neural circuitry underlying traitdependent abnormalities in cognitive and emotion processing in adolescents with depression with and without history of suicide attempt, by focusing on the following areas: emotional processing, cognitive control, and risky decision-making, that have been demonstrated to recruit ventral and dorsomedial prefrontal cortices and amygdala and ventral striatum, dorsal prefrontal cortical regions, and ventromedial and dorsomedial prefrontal cortices, respectively. Our study of the neural circuitry of adolescent suicide attempt is important in that it will help to more precisely define: 1) cognitive and affective processing abnormalities associated with suicidal behavior; 2) functional neurocircuitry related to these neurocognitive abnormalities; and, in turn, 3) the relationship between these abnormalities and onset and history of suicidal behavior. Increased understanding of these neural markers will have a significant impact upon the future targeting of treatment and prevention efforts to improve the long-term outcome of individuals with suicidal behavior. This is the first study of its kind in a pediatric population. The functional neuroimaging instruction, didactics, coursework, and clinical research training, sponsored by Mary Phillips, M.D., M.D. (Cantab), Director of the Functional Neuroimaging Program, and David Brent, M.D., Endowed Chair in Suicide Studies, will prepare the candidate to perform multidisciplinary cognitive neuroscience research in adolescent suicide prevention. PUBLIC HEALTH RELEVANCE: Identification of markers for suicide risk and increased understanding of the cognitive neuroscience of suicide attempt may have a significant impact upon the future design and monitoring of treatment and prevention efforts to prevent death and improve the long-term outcome of individuals with suicidal behavior. This is the first study of its kind in adolescents.