Suicidality in Bipolar and Major Depression Disorders

在精神疾病中，自杀死亡率大约是 普通民众。在精神障碍中，双相情感障碍(BD)的尝试比率最高 (~40%)，这是严重抑郁障碍(MDD)的2-3倍。而潜在的神经回路 自杀行为已经被提出，这些行为主要是基于对MDD的研究而出现的，并排除了 小脑。我们团队和其他人的研究表明，小脑与自杀行为、冲动、 和双相情感障碍，这表明它可能在自杀行为中发挥关键作用。在这项研究中，我们建议 研究包括小脑在内的假定自杀风险回路(SRC)以前瞻性地评估 这一神经回路的连接体和建议的SRC的节点的新陈代谢。评估SRC，大脑 成像与自杀行为、精神症状和人格特征的测量相结合将是 在300名患有精神障碍(BD I和MDD)的受试者中获得，其中75人有自杀前科 每一次精神病学诊断中，有75人尝试，而没有事先尝试。75名匹配的对照也将 被收购。脑成像将包括多模式磁共振成像，以研究解剖(T1，T2)、功能(任务 基于功能磁共振成像)、连接体(静息状态功能磁共振成像和弥散成像)和代谢(MRS和T1ρ)。此数据 将用于回答以下目标：目标1)SRC是否区分自杀未遂者和非自杀未遂者 BD中的尝试者？目的2)在MDD患者中，自杀未遂者和非自杀未遂者是否有相同的区别 以BD的身份？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，如何 小脑可能参与了这些回路，以及哪些代谢差异与自杀有关 行为。此外，这项研究将揭示相同的神经回路(即SRC)是否在 跨障碍的自杀行为，或者跨障碍的不同神经回路。的目标是 这个项目是为了更好地了解自杀的神经生物学，帮助识别那些未来有自杀风险的人。 尝试。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。 。

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. .