University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Jun;50(6):602-611.e3. doi: 10.1016/j.jaac.2011.03.018. Epub 2011 May 7.
Impaired attentional control and behavioral control are implicated in adult suicidal behavior. Little is known about the functional integrity of neural circuitry supporting these processes in suicidal behavior in adolescence.
Functional magnetic resonance imaging was used in 15 adolescent suicide attempters with a history of major depressive disorder (ATTs), 15 adolescents with a history of depressive disorder but no suicide attempt (NATs), and 14 healthy controls (HCs) during the performance of a well-validated go-no-go response inhibition and motor control task that measures attentional and behavioral control and has been shown to activate prefrontal, anterior cingulate, and parietal cortical circuitries. Questionnaires assessed symptoms and standardized interviews characterized suicide attempts.
A 3 group by 2 condition (go-no-go response inhibition versus go motor control blocks) block-design whole-brain analysis (p < .05, corrected) showed that NATs showed greater activity than ATTs in the right anterior cingulate gyrus (p = .008), and that NATs, but not ATTs, showed significantly greater activity than HCs in the left insula (p = .004) to go-no-go response inhibition blocks.
Although ATTs did not show differential patterns of neural activity from HCs during the go-no-go response inhibition blocks, ATTs and NATs showed differential activation of the right anterior cingulate gyrus during response inhibition. These findings indicate that suicide attempts during adolescence are not associated with abnormal activity in response inhibition neural circuitry. The differential patterns of activity in response inhibition neural circuitry in ATTs and NATs, however, suggest different neural mechanisms for suicide attempt versus major depressive disorder in general in adolescence that should be a focus of further study.
注意力控制和行为控制受损与成人自杀行为有关。关于支持青少年自杀行为的这些过程的神经回路的功能完整性，知之甚少。
在经历过重度抑郁症（ATTs）的 15 名青少年自杀未遂者、经历过抑郁症但无自杀未遂史的 15 名青少年（NATs）和 14 名健康对照者（HCs）中，使用功能磁共振成像在执行经过充分验证的 Go-No-Go 反应抑制和运动控制任务时，测量注意力和行为控制，并已被证明可激活前额叶、前扣带回和顶叶皮质回路。问卷评估症状，标准化访谈描述自杀未遂情况。
三组两条件（Go-No-Go 反应抑制与 Go 运动控制块）全脑分析（p <.05，校正）显示，NATs 在右侧前扣带回（p =.008）的活动比 ATT 更大，而只有 NATs 而非 ATT 显示在 Go-No-Go 反应抑制块中，其左岛叶的活动明显大于 HCs（p =.004）。
尽管 ATT 在 Go-No-Go 反应抑制块中与 HCs 没有表现出不同的神经活动模式，但 ATT 和 NAT 在反应抑制期间显示出右侧前扣带皮层的不同激活。这些发现表明，青春期的自杀尝试与反应抑制神经回路的异常活动无关。然而，ATT 和 NAT 中反应抑制神经回路的不同活动模式表明，青少年一般的自杀企图与重度抑郁症的神经机制不同，这应该是进一步研究的重点。
