Prefrontal cortex, temporal cortex, and hippocampus volume are affected in suicidal psychiatric patients
Open accessAbstract
Suicide is a leading cause of death in America, with over 40,000 reported suicides per year. Mental illness is a major risk factor for suicidality. This study attempts to validate findings of volumetric differences from studies on suicidality. Psychiatric inpatients classified as having mildly severe or severe depression were separated into two groups: suicide attempted in the past two months (SA; n=20), non-suicidal control group (DA; n=20); these patients were all depressed and not significantly different for age, gender, race, marital status, education level, anxiety level, and substance abuse. Healthy controls (HC; n=20) were not significantly different from the suicidal groups for age and gender. Volunteers underwent MRI to assess volumes of cortical lobes, corpus callosum, and subcortical regions of interest, including the thalamus, insula, limbic structures, and basal ganglia. The right hippocampal volume of the SA group was significantly reduced compared to healthy controls. The frontal and temporal lobe volumes of the SA group were significantly decreased compared to the DA group. These volumetric reductions confirm previous findings and support the hypothesis that fronto-temporal function may be altered in suicidal patients.
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Individuals without a history of mTBI who attempted suicide or have a history of SI also show diminished VMPFC volume and reduced connectivity between the prefrontal cortex and the limbic system.
“Interestingly, individuals without a history of mTBI who attempted suicide or have a history of SI also show diminished VMPFC volume and reduced connectivity between the prefrontal cortex and the limbic system, further supporting it as a potential therapeutic target [31,81].”
From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [81]
The Results report reduced frontal-lobe volume in psychiatric inpatients who recently attempted suicide compared with depressed non-attempters. They do not identify a VMPFC reduction, and they found no significant volumetric differences for the suicidal-ideation group. The study assessed brain volumes, not prefrontal–limbic connectivity; its Methods establish absence of head trauma for healthy controls, not for the psychiatric patients. (LLM, conf=0.89)
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“…imaging studies have reported abnormalities in cortical and subcortical structures, including the frontal and temporal lobes, the hippocampus (Gosnell et al., 2016), amygdala (Monkul et al., 2007), and basal ganglia (Ahearn et al., 2001; Vang, Ryding, Träskman-Bendz, van Westen, & Lindström,…”
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“The suicidal brain shows structural changes in the prefrontal cortex (Monkul et al ., 2007; Gosnell et al .”
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“In line with our results, smaller GMV in the frontal lobe has been consistently observed among the SA group when compared to the NSA and HC groups (Fan et al., 2019; Wang et al., 2020; Hwang et al., 2010; Gosnell et al., 2016).”
Feng, S., Zhou, S., Huang, Y., Peng, R., Han, R., Li, H., Yi, Y., Feng, Y., Ning, Y., Han, W., et al. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.10.031 · Cited by 15 · see citing works
Bajaj, S., Blair, K., Dobbertin, M., Patil, K., Tyler, P. M., Ringle, J., Bashford-Largo, J., Mathur, A., Elowsky, J., Dominguez, A., et al. (2023) · Discover Mental Health · doi:10.1007/s44192-023-00033-6 · Cited by 14 · see citing works
“The components within these cortices included reduced CT, reduced CSA, and/or reduced CV within the superior frontal gyrus [16, 52], inferior frontal gyrus [15, 19, 53, 54], orbitofrontal cortex [55], superior temporal [18, 20, 21, 52, 53], middle temporal gyri [22], and fusiform gyrus [56, 57].”
BackgroundResultInfluentialOvers, B. J., Roberts, G. M. P., Ridgway, K., Claudio Toma, A., Hadzi‐Pavlovic, D., Wilcox, H. C., Hulvershorn, L. A., Nürnberger, J. I., Schofield, P. R., Mitchell, P. B., et al. (2021) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32879 · Cited by 12 · see citing works
Yin, Y., Tong, J., Huang, J., Wang, L., Tian, B., Chen, S., Tan, S., Wang, Z., Yu, T. Y., Li, Y., et al. (2023) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-023-01554-5 · Cited by 10 · see citing works
“Our finding of smaller hippocampus was consistent with some finding in major depressive disorder [20, 63] and bipolar disorder [45].”
ResultKamimura, H., Matsuoka, T., Okai, H., Shimizu, N., Harada, S., & Matsuo, K. (2022) · Scientific Reports · doi:10.1038/s41598-022-22345-3 · Cited by 10 · see citing works
Li, H., Zhang, H., Qin, K., Yin, L., Chen, Z., Zhang, F., Wu, B., Chen, T., Sweeney, J. A., Gong, Q., et al. (2024) · Brain Imaging and Behavior · doi:10.1007/s11682-024-00870-1 · Cited by 9 · see citing works
“Previous studies have reported decreased hippocampal volumes in depressed suicidal patients compared to controls, consistent with regional pathology in this region, which might be related to alterations in white matter connectivity (Gosnell et al., 2016).”
Treatment response with ketamine in chronic suicidality: An open label functional connectivity study
Can, A., Hermens, D. F., Mohamed, A. Z., Shan, Z., Dutton, M., Gallay, C. C., Forsyth, G., Jamieson, D., & Lagopoulos, J. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.03.064 · Cited by 10 · see citing works
Bajaj, S., Raikes, A. C., Smith, R. S., Vanuk, J. R., & Killgore, W. D. S. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00445 · Cited by 8 · see citing works
“Gosnell and colleagues also suggested that reduced volume within the frontal lobe (and within the temporal lobe) may be an important risk factor for suicidal thoughts or behavior (12).”
BackgroundIntegrating biobehavioral information to predict mood disorder suicide risk
Jackson, N., & Jabbi, M. (2022) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100495 · Cited by 7 · see citing works
Huber, R. S., Subramaniam, P., Heinrich, L., Boxer, D., Shi, X., Schreiner, M. W., Renshaw, P. F., Yurgelun-Todd, D. A., & Kondo, D. G. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.047 · Cited by 6 · see citing works
Paolo, A.-L. D., Nichols, E. S., Tomfohr‐Madsen, L. M., Giesbrecht, G. F., Manning, K. Y., Lebel, C. A., & Duerden, E. G. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03527-9 · Cited by 6 · see citing works
Aaronson, A. L., Smith, B., Krese, K., Barnhart, M., Adamson, M., de Wit, H., Philip, N. S., Brenner, L. A., Bender-Pape, T., & Herrold, A. A. (2024) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/appi.neuropsych.20230044 · Cited by 6 · see citing works
Structural alterations as a predictor of depression – a 7-Tesla MRI-based multidimensional approach
Schnellbächer, G. J., Rajkumar, R., Veselinović, T., Ramkiran, S., Hagen, J., Collée, M., Shah, N. J., & Neuner, I. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02854-5 · Cited by 4 · see citing works
“In contrast, the gyri fi cation alterations identi fi ed by the SVM and subsequent permutation procedure were not subject to modi fi cation through disease severity and are most likely more static.”
Meda, N., Miola, A., Cattarinussi, G., & Sambataro, F. (2024) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2023.10.003 · Cited by 6 · see citing works
“…a history of SA might be characterized by abnormalities in brain regions that subserve emotion regulation, decision-making, and impulse control, including the prefrontal and temporal cortex, hypothalamus, brainstem and hippocampus (Gosnell et al., 2016; Ono et al., 2002; Sequeira et al., 2009).”
BackgroundFunctional connectome-based predictive modeling of suicidal ideation
Averill, L. A., Tamman, A. J. F., Fouda, S., Averill, C. L., Nemati, S., Ragnhildstveit, A., Gosnell, S. N., Akiki, T. J., Salas, R., & Abdallah, C. G. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119518 · Cited by 4 · see citing works
Self-citationXu, Y., Cui, D., Zhao, Y., Wu, C., Mu, Q., Fang, Z., Hu, S., Huang, M., Zhang, P., & Lu, S. (2023) · Behavioural Brain Research · doi:10.1016/j.bbr.2023.114733 · Cited by 5 · see citing works
Das, S. C., Schulmann, A., Callor, W. B., Jerominski, L., Panicker, M. M., Christensen, E. D., Bunney, W. E., Williams, M. E., Coon, H. H., & Vawter, M. P. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.144 · Cited by 4 · see citing works
Concussion risk and suicide prevention: balancing the risks and benefits of youth sport
Clacy, A., Hermens, D. F., Broadhouse, K. M., & Lagopoulos, J. (2019) · The Medical Journal of Australia · doi:10.5694/mja2.50319 · Cited by 4 · see citing works
Ishikawa, K., Nemoto, K., Shiratori, Y., Sodeyama, N., Kodama, K., Usuniwa, H., Yamada, N., Yaguchi, C., Hori, T., Arai, T., et al. (2022) · Psychiatry and Clinical Neurosciences Reports · doi:10.1002/pcn5.35 · Cited by 3 · see citing works
“7 Other studies implicated that SAs had volume reduction in limbic regions and basal ganglia, 8 – 13 but a recent study found no significant volumetric differences in the caudate, pallidum, putamen, nucleus accumbens, hippocampus, amygdala, ventral diencephalon, or thalamus between SAs and NSAs.”
BackgroundCould Epigenetics Play a Role in Suicidal Behavior in Older Age?
Lozupone, M., Mollica, A., Berardino, G., Sardone, R., & Panza, F. (2021) · Epigenomics · doi:10.2217/epi-2021-0390 · Cited by 3 · see citing works
Bernanke, A., Hasley, R., Sabetfakhri, N., de Wit, H., Smith, B. M., Wang, L., Brenner, L. A., Hanlon, C., Philip, N. S., Ajilore, O., et al. (2024) · JMIR Research Protocols · doi:10.2196/58206 · Cited by 2 · see citing works
“RenderX VMPFC volume and reduced connectivity between the prefrontal cortex and the limbic system, further supporting it as a potential therapeutic target [31,81].”
Stress, Vulnerability, and Suicide
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.003 · Cited by 2 · see citing works
Neurobiological understanding of suicide
Kim, S., & Lee, K.-U. (2019) · Journal of Korean Medical Association · doi:10.5124/jkma.2019.62.2.85
Morphofunctional cerebral changes associated with development of suicidal behavior
Кислов, М. А., Николаевич, П. А., Trusova, D. S., Zhiganova, M. S., Morozova, A. Y., & Pigolkin, Y. I. (2023) · Forensic Medical Expertise · doi:10.17116/sudmed20236604167 · Cited by 1 · see citing works
Hong, X., Cui, X., Chen, C., Zhang, Z., Jin, Y., & Wang, Y. (2026) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2026.112223 · Cited by 1 · see citing works
Major Depressive Disorder in Neuroimaging: What is Beyond Fronto-limbic Model?
Lai, C. (2018) · Current Psychiatry Research and Reviews · doi:10.2174/1573400515666181213155225 · Cited by 1 · see citing works
Secondary Suicide Prevention as Neuro-Rehabilitation
Valach, L. (2018) · Journal of Psychiatry and Psychiatric Disorders · doi:10.26502/jppd.2572-519x0036 · Cited by 1 · see citing works
Martins, D., van Wamelen, D. J., Fernandes, L., Howes, O. D., Williams, S., & Shan, L. (2026) · Research Square · doi:10.21203/rs.3.rs-8894094/v1 · Cited by 1 · see citing works
The volumetric parameters of the brain in hospitalized patients with repeated suicidal attempts
Juškienė, J., Adomaitienė, V., Virsila, M., Banionienė, K., Gleiznienė, R., & Steiblienė, V. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.11.889
What Is Suicidal Behavior, and Can It Be Prevented?
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.002
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.008
I Predict, Therefore I Cannot Be
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.009
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.010
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.004
Neuroimaging of suicidal behaviour
Sudol, K., & Oquendo, M. A. (2021) · doi:10.1093/med/9780198834441.003.0048
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.011
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.007
I Think, Therefore I Do Not Want to Be
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.006
(2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.013
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.015
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.001
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.005
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.012
van Heeringen, K. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316563205.014
Wen, X., Wang, Y., Cui, Z., Zhang, X., & Chen, R. (2022) · medRxiv · doi:10.1101/2022.07.28.22278177
“Additionally, consistent with previous studies, individuals with SA history had significantly decreased cortical volume in PCC and LOTC.(4,63,64) Notably, PCC might be the neural basis of an individual’s aggressive behaviours.”
ResultDas, S. C., Schulmann, A., Callor, W. B., Jerominski, L., Panicker, M. M., Christensen, E. D., Bunney, W. E., Williams, M. E., Coon, H. H., & Vawter, M. P. (2023) · medRxiv · doi:10.1101/2023.01.28.23285121
Smaller cornu ammonis (CA3) as a potential risk factor for suicidal behavior in mood disorders
Pantazatos, S. P., Ogden, R. T., Melhem, N., Brent, D. A., Lesanpezeshki, M., Burke, A. K., Keilp, J. G., Miller, J. M., & Mann, J. J. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.05.051
Mishra, J. (2025) · Springer eBooks · doi:10.1007/978-981-96-1403-5_4
Brown, V. M., Gujral, S., Chang, Y.-W., Galfalvy, H., Szántó, K., & Dombrovski, A. Y. (2025) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2025.100552
Chen, V. C., Tsai, Y., Lin, G., Hsu, C.-Y., You, Y.-H., & Weng, J. (2025) · Discover Mental Health · doi:10.1007/s44192-025-00334-y
“These structural changes underscore the potential contribution of brain areas to the emotional and cognitive recovery of patients with SI [10].”
Rôle du corps calleux dans les troubles de l'humeur et les conduites suicidaires
Cyprien, F. (2016) · theses.fr (ABES) · doi:10.70675/9ef59397z06c1z49c0z92e8z2e709b861735
Conejero, I. (2020) · theses.fr (ABES) · doi:10.70675/e0cb59ecz80a8z4338za3ddz2ea8e8d0334d
Chen, X., Chen, J., Ai, M., Hong, S. L., Dai, L., Shen, X., & Kuang, L. (2026) · Frontiers in Neuroimaging · doi:10.3389/fnimg.2026.1811399
“Studies (Gosnell et al., 2016; McLellan et al., 2018) have demonstrated pronounced temporal lobe volume reduction in MDD patients with suicide attempts than in those without.”
Zhao, Z., Zhou, T., Liu, M., Wang, N., Li, Y., Yang, C., Qiu, Y., Wang, J., Wu, W., Bai, Y., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-113503
“21 22 25 Animal studies indicated that light exposure can affect the integrity, activity and functionality of the ventromedial PFC (vmPFC) via ipRGC-mediated pathways, with disruption of these pathways impairing emotion regulation.”
Machine Learning Prediction of First Suicide Attempts in Early Adolescence Among Child Ideators
Nguyen, J., Dwyer, D., Tagliaferri, S. D., Hartmann, S., Clark, S. R., Scott, I., Wigman, J. T. W., Lin, A. P., Thompson, A. D., Gao, C. X., et al. (2026) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2026.07.1245
TMS-EEG correlate of suicidal ideation in individuals with depression: A multi-site synthesis
Stapper, N., Sun, Y., Poorganji, M., Dhami, P., Hadas, I., Bailey, N. W., Kaewpijit, P., Zomorrodi, R., Kohn, J. N., Fitzgerald, P. B., et al. (2026) · Brain stimulation · doi:10.1016/j.brs.2026.103206
Matsunaga, A., Deguchi, Y., Iwasaki, S., & Inoue, K. (2026) · Interdisciplinary Neurosurgery · doi:10.1016/j.inat.2026.102375
- Authors
- Gosnell, S. N., Velasquez, K. M., Molfese, D. L., Molfese, P. J., Madan, A., Fowler, J. C., Christopher Frueh, B., Baldwin, P. R., & Salas, R.
- Affiliations
- Baylor College of Medicine (US)
- Michael E. DeBakey VA Medical Center (US)
- University of Connecticut (US)
- Corresponding author
- Salas, Ramiro
- Venue
- Psychiatry Research: Neuroimaging
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 256
- Pages
- 50-56
- ISSN
- 0925-4927 (ISSN-L)
- PMC
- PMC9694115
- OpenAlex
- W2519649662
- Cited by
- 95
- References
- 31
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 9 · 2023: 9 · 2022: 5 · 2021: 9 · 2020: 11 · 2019: 11 · 2018: 23 · 2017: 3 · 2016: 1
- FWCI
- 16.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatry Research Neuroimaging (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- BCF
- American Foundation for Suicide Prevention
- NARSAD
- NIDA
- Menninger Clinic
- Robert and Janice McNair Foundation
- Ray C. Fish Foundation
- Cain Foundation
- Baylor College of Medicine
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- suicide, suicidal ideation, depression, temporal lobe volume, hippocampal volume, brain volumetry, psychiatric inpatients, corpus callosum, thalamus, insula, basal ganglia, limbic structures
- MeSH terms
- Adolescent, Adult, Depressive Disorder, Major, Major Depressive Disorder, Female, Hippocampus, Humans, Magnetic Resonance Imaging, Male, Organ Size, Risk Factors, Severity of Illness Index, Suicide, Attempted, Temporal Lobe, Prefrontal Cortex, Young Adult, Suicidal Ideation
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