Marks Rocky B, Wee Janelle Y, Jacobson Samantha V, Hashimoto Kimi, O'Connell Katherine L, Golden Sam Adler, Baker Phillip Michael, Law Keyne Catherine
Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, United States.
Department of Biological Structure, University of Washington, Seattle, WA, United States.
Front Behav Neurosci. 2022 Mar 14;16:812952. doi: 10.3389/fnbeh.2022.812952. eCollection 2022.
Despite decades of significant effort in research, policy, and prevention, suicide rates have continued to rise to the current peak of 14.6 per 100,000 deaths. This has resulted in a concerted effort to identify biomarkers associated with suicidal behavior in the brain, to provide predictions that are better than the chance of discerning who will die by suicide. We propose that the lateral habenula (LHb), and its dysfunction during a suicidal crisis, is a critical component of the transition from suicidal ideations to self-harm. Moreover, the LHb-a key functional node in brain reward circuitry-has not been ascribed a contributory role in suicidal behavior. We argue that the LHb anchors a "suicide circuit" and call for suicide researchers to directly examine the role of the LHb, and its long-term modulation, in response to the negative affect in suicidal behavior. Discerning the neural mechanisms of this contribution will require the collaboration of neuroscientists and psychologists. Consequently, we highlight and discuss research on LHb as it relates to suicidal ideation, suicidal behavior, or death by suicide. In so doing we hope to address the bench-to-bedside translational issues currently involved in suicide research and suggest a developmental framework that focuses on specific structures motivated by theoretical anchors as a way to incorporate neurobiological findings within the context of clinical theory.
尽管在研究、政策和预防方面付出了数十年的巨大努力，但自杀率仍持续上升，达到了目前每10万人中有14.6人死亡的峰值。这促使人们齐心协力去识别与大脑中自杀行为相关的生物标志物，以提供比随机猜测谁会自杀更准确的预测。我们提出，外侧缰核（LHb）及其在自杀危机期间的功能障碍，是从自杀念头转变为自我伤害过程中的关键组成部分。此外，作为大脑奖赏回路中的一个关键功能节点，LHb在自杀行为中尚未被赋予促成作用。我们认为LHb构成了一个“自杀回路”，并呼吁自杀研究人员直接研究LHb的作用及其长期调节，以应对自杀行为中的负面影响。要弄清楚这种作用的神经机制，需要神经科学家和心理学家的合作。因此，我们重点介绍并讨论与自杀念头、自杀行为或自杀死亡相关的LHb研究。这样做，我们希望解决目前自杀研究中从实验室到临床的转化问题，并提出一个发展框架，该框架侧重于由理论依据驱动的特定结构，以此将神经生物学研究结果纳入临床理论背景之中。
