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Yale Review: How Brain Alterations Contribute to Suicidal Thoughts and Behaviors

December 02, 2019

How brain alterations contribute to suicidal thoughts and behaviors is the subject of a new published review of brain scanning studies by Yale and international researchers.

Published in Molecular Psychiatry, the review spanned more than two decades of neuroimaging studies and summarized progress made in understanding how alterations in the brain contribute to suicide, now the 10th leading cause of death worldwide.

“The review shows the important advancements that have been made in elucidating the brain circuitry that contributes to suicide risk so the field can provide more targeted and effective suicide prevention strategies,” said Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience, and Professor of Psychiatry, in the Child Study Center and of Radiology and Biomedical Imaging at Yale. “But there is a great deal more research to do.”

Blumberg, the paper’s lead and corresponding author, and other scientists, including Yale experts Carolyn Mazure, PhD, and Lynette Averill, PhD, reviewed the brain scanning research for evidence of structural, functional, and molecular alterations in the brain that could increase risk of suicide.

The researchers wrote that the evidence points to areas of the brain that regulate emotion and impulse in risk for suicide. Specifically, impairments in the medial and lateral ventral prefrontal cortex regions and their connections may affect a person’s negative emotions and stimulate thoughts of suicide. Alterations to the dorsal prefrontal cortex and inferior frontal gyrus system may influence suicide attempt behaviors, in part, due to decreased inhibition, according to the review.

Of note, the researchers stressed that more research must be done to examine sex and gender differences in suicidal thoughts and behaviors, saying a major knowledge gap exists in the literature.

The review is the most comprehensive examination to date of neuroimaging studies that report brain impairments in people who die by suicide and is an effort by the researchers to assist in larger, more global efforts to prevent suicide.

Blumberg has been at the forefront of research into mood disorders across the lifespan and suicide risk. She directs Yale’s Mood Disorders Research Program, which brings together scientists who study genetic and environmental factors that underlie brain differences in mood disorders and suicide risk to generate improved detection, treatment, and prevention strategies.

Mazure directs Women’s Health Research at Yale, which is nationally recognized for initiating new approaches to understanding the influence of sex and gender on health outcomes and advancing science across broad areas of study. Averill, a neuroscientist, is an expert in the valuation of neurocognitive symptoms and the clinical assessment and treatment of trauma- and stress-related psychopathology, including posttraumatic stress disorder and suicidality.

The Nature Publishing group publishes the peer-reviewed scientific journal Molecular Psychiatry. International co-authors include Dr. Lianne Schmaal and Yara Toenders from the University of Melbourne, and Dr. Anne-Laura van Harmelen and Vasiliki Chatzi from Cambridge University.

The research was supported by the mental health charity MQ Brighter Futures Award Program, National Institutes of Health, Department of Veterans Affairs, NHMRC, Royal Society Dorothy Hodgkin Fellowship, American Foundation for Suicide Prevention, Brain and Behavior Foundation, Robert E. Leet and Clara M. Guthrie Patterson Trust, and For the Love of Travis Foundation.

Submitted by Christopher Gardner on November 26, 2019