Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
Federal University of Viçosa, Minas Gerais, Brazil.
Psychiatry Res Neuroimaging. 2017 Jul 30;265:9-17. doi: 10.1016/j.pscychresns.2017.04.012. Epub 2017 May 2.
Some studies have identified brain morphological changes in the frontolimbic network (FLN) in bipolar subjects who attempt suicide (SA). The present study investigated neuroanatomical abnormalities in the FLN to find a possible neural signature for suicidal behavior in patients with bipolar disorder type I (BD-I). We used voxel-based morphometry to compare euthymic patients with BD-I who had attempted suicide (n=20), who had not attempted suicide (n=19) and healthy controls (HCs) (n=20). We also assessed the highest medical lethality of their previous SA. Compared to the participants who had not attempted suicide, the patients with BD-I who had attempted suicide exhibited significantly increased gray matter volume (GMV) in the right rostral anterior cingulate cortex (ACC), which was more pronounced and extended further to the left ACC in the high-lethality subgroup (p<0.05, with family-wise error (FWE) correction for multiple comparisons using small-volume correction). GMV in the insula and orbitofrontal cortex was also related to suicide lethality (p<0.05, FWE-corrected). The current findings suggest that morphological changes in the FLN could be a signature of previous etiopathogenic processes affecting regions related to suicidality and its severity in BD-I patients.
一些研究已经确定了尝试自杀（SA）的双相情感障碍患者额 - 边缘网络（FLN）的大脑形态变化。本研究旨在通过研究 FLN 的神经解剖异常，为双相情感障碍 I 型（BD-I）患者的自杀行为找到一个可能的神经特征。我们使用基于体素的形态计量学比较了 20 名尝试过自杀的双相情感障碍 I 型患者（SA 组）、20 名未尝试过自杀的患者（非 SA 组）和 20 名健康对照组（HCs）。我们还评估了他们之前自杀未遂的最高医疗致死率。与未尝试自杀的参与者相比，尝试过自杀的 SA 组患者右侧额前扣带回皮质（ACC）的灰质体积（GMV）明显增加，在高致死率亚组中，这种增加更为显著，并进一步扩展到左侧 ACC（p<0.05，采用小体积校正的多重比较的全脑校正（FWE）校正）。岛叶和眶额皮质的 GMV 也与自杀致死率相关（p<0.05，FWE 校正）。目前的研究结果表明，FLN 的形态变化可能是影响与自杀及其严重程度相关的区域的先前病因发病过程的特征，在 BD-I 患者中。
