Structural and functional alterations of the suicidal brain: An updated review of neuroimaging studies

Psychiatry Res Neuroimaging. 2018 Aug 30:278:77-91. doi: 10.1016/j.pscychresns.2018.05.008. Epub 2018 May 18.

Abstract

Brain imaging is a non-invasive and in vivo direct estimation of detailed brain structure, regional brain functioning and estimation of molecular processes in the brain. The main objective of this review was to analyze functional and structural neuroimaging studies of individuals at risk for suicide. We reviewed articles published between 2005 and 2018, indexed in PubMed and Medline, assessing structural and functional alterations of the brain of individuals at high risk for suicide and at low risk for suicide. We reviewed functional and structural neuroimaging studies which included individuals with a history of suicidal ideation or attempt in major depressive disorder (MDD), bipolar disorder (BD), psychosis, and borderline personality disorder (BPD). We selected 45 papers that focused on suicidality in MDD, 17 papers on BD, 11 papers on psychosis, and 5 papers on BPD. The suicidal brain across psychiatric diagnoses seems to heavily involve dysfunction of the fronto-temporal network, primarily involving reductions of gray and white matter volumes in the pre-frontal cortex (PFC), anterior cingulate, and superior temporal gyrus. Nonetheless, there are several ways to define suicidal behaviour and ideation. Therefore, it still remains difficult to combine the evidence from imaging studies that used different definitions of suicidality.

Keywords: Functional magnetic resonance Imaging (fMRI); Magnetic resonance imaging (MRI); Neuroimaging; Positron emission tomography (PET); Suicidal behaviour.

Publication types

  • Review

MeSH terms

  • Bipolar Disorder / diagnostic imaging
  • Bipolar Disorder / pathology
  • Bipolar Disorder / psychology
  • Borderline Personality Disorder / diagnostic imaging
  • Borderline Personality Disorder / pathology
  • Borderline Personality Disorder / psychology
  • Brain / diagnostic imaging
  • Brain / pathology
  • Depressive Disorder, Major / diagnostic imaging*
  • Depressive Disorder, Major / pathology
  • Depressive Disorder, Major / psychology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Neuroimaging / methods
  • Suicidal Ideation*
  • White Matter / diagnostic imaging
  • White Matter / pathology