A global alliance to unlock brain mechanisms influencing suicidal behaviors through the ENIGMA Consortium

通过 ENIGMA 联盟解锁影响自杀行为的大脑机制的全球联盟

• 批准号: 9761598
• 负责人: Neda Jahanshad
• 金额: $ 37.22万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-09 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9761598
• 关键词: Age; Bipolar Disorder; Brain; Cause of Death; Characteristics; Chronic lung disease; Classification; Clinical; Clinical Data; Cognitive; Collaborations; Country; Data; Data Set; Decision Trees; Development; Dimensions; Disease; Evaluation; Feeling suicidal; Frequencies; Future; Grain; HIV; Homicide; Individual; Influenza; Institution; Intervention; Investigation; Lung diseases; Magnetic Resonance Imaging; Major Depressive Disorder; Mental disorders; Methodology; Nature; Neurobiology; Pathway interactions; Patients; Pattern; Phenotype; Prevention; Prevention strategy; Preventive Intervention; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Sample Size; Sampling; Schizophrenia; Severities; Stroke; Structure; Substance Use Disorder; Suicide; Suicide attempt; Suicide prevention; System; Time; Woman; accomplished suicide; base; biopsychosocial; brain circuitry; clinical phenotype; cohort; cost efficient; high risk; ideation; neurobiological mechanism; neuroimaging; neuromechanism; novel; psychosocial; relating to nervous system; sex; sociodemographics; suicidal; suicidal behavior; suicidal risk; suicide attempter

ABSTRACT One million people around the world die from suicide annually. Suicide is the tenth leading cause of death for all ages and the second leading cause of death among young people with mental disorders. More people under the age of 55 die by suicide than from HIV, stroke, influenza, respiratory diseases, chronic lung disease and homicide. There are at least 20 suicide attempts for every completed suicide. Better prevention strategies are urgently needed; yet, mechanisms that confer increased risk for suicidal behaviors (ranging from suicidal ideation to suicide attempts and completed suicide) remain largely unknown. Neurobiological alterations associated with a history of suicidal thoughts and behaviors may predict future risk and provide targets for interventions. Inquiry into the neurobiology of suicidal behaviors is hindered by a low base rate of occurrence and the heterogeneous nature of suicidal attempts, requiring large, inclusive samples from around the world to understand the underlying mechanisms. We propose a worldwide collaboration to study the neurobiological and transdiagnostic mechanisms underlying suicidal behaviors in people with mental disorders. Research to date has been performed in small (typically N<50) samples of suicidal ideators and attempters and examined neural markers of suicidal behaviors within a single mental illness. We will pool existing neuroimaging and clinical data from approximately 23,000 individuals with and without mental health disorders forming the “ENIGMA-Suicidal Thoughts and Behaviors (STB)” initiative. We will integrate and analyze datasets from 24 institutions worldwide in a cost-efficient manner to (1) identify transdiagnostic neural mechanisms that differentiate between suicidal ideators and suicide attempters through MRI, and how these vary with age, sex, and disease characteristics; (2) integrate differential explanatory levels and investigate interacting effects between brain mechanisms and sociodemographic, psychosocial, clinical and cognitive risk factors on suicidal behaviors. We will identify different biopsychosocial pathways that discriminate suicidal ideators from people with a history of suicide attempt, yielding novel suicide risk subtypes based on different configurations of biopsychosocial risk factors; (3) go beyond binary classifications of ideation or attempt and conduct an in-depth investigation of structural and functional brain circuitries underlying fine-grained dimensional phenotypes of suicidal behaviors in a subset of samples. Transdiagnostic brain mechanisms uniquely associated with suicidal ideation and suicide attempts, and with more in-depth dimensional suicidal behavior phenotypes, can inform the development of novel interventions directly or indirectly targeting alterations in these brain circuitries. The biopsychosocial suicide risk subtypes identified through this study may highlight distinct pathways to suicidal behaviors in different groups of people and have the potential for individualizing the selection of prevention and intervention strategies.

摘要 全世界每年有一百万人死于自杀。自杀是导致所有人死亡的第十大原因 年龄和精神障碍年轻人的第二大死因。更多的人生活在 55岁的人死于自杀而不是死于艾滋病毒、中风、流感、呼吸系统疾病、慢性肺部疾病和 凶杀组。每完成一次自杀，至少有20次自杀未遂。更好的预防策略是 迫切需要；然而，增加自杀行为(从自杀念头到自杀意念)风险的机制 自杀未遂和自杀完成)在很大程度上仍然不为人知。与神经生物学改变相关的 有自杀念头和行为的病史可能会预测未来的风险，并为干预提供目标。询价 研究神经生物学中的自杀行为受阻于低的基础发生率和异质性 自杀未遂的性质，需要来自世界各地的大样本，以了解潜在的 机制。我们建议在全球范围内合作研究神经生物学和跨诊断 精神障碍患者自杀行为的潜在机制。到目前为止，研究一直是 在自杀意念者和未遂者的小样本(通常为N&lt；50)中进行测试，并检查神经标志物 一次精神疾病中的自杀行为。我们将汇集现有的神经成像和临床数据 约23,000名患有和不患有精神健康障碍的人形成了“自杀之谜” 思想和行为(STB)“倡议。我们将整合和分析来自全球24家机构的数据集 以经济高效的方式(1)确定区分自杀和自杀之间的跨诊断神经机制 通过核磁共振检查理想者和自杀未遂者，以及这些随年龄、性别和疾病特征的变化情况；(2) 整合不同解释水平，并研究大脑机制和 自杀行为的社会人口学、心理社会、临床和认知危险因素。我们将确定不同的 区分有自杀意念的人和有自杀未遂历史的人的生物心理社会途径， 根据生物、心理和社会风险因素的不同配置产生新的自杀风险亚型；(3)GO 超越概念或企图的二元化分类，并对结构和 自杀行为的细粒度维度表型下的功能性脑回路 样本。与自杀意念和自杀企图有关的跨诊断大脑机制， 并具有更深入的维度自杀行为表型，可以为小说的发展提供信息 直接或间接针对这些大脑回路的改变的干预。生物、心理和社会自杀风险 通过这项研究确定的亚型可能会突出不同群体中自杀行为的不同途径 并有可能使预防和干预策略的选择个人化。