Decreased cerebral blood flow in the limbic and prefrontal cortex using SPECT imaging in a cohort of completed suicides
Open accessAbstract
Suicide has a high comorbidity with impulsivity and depression, and finding imaging biomarkers indicative of patients at high risk for suicidal behavior is invaluable to the clinician. Using single-photon emission computed tomography (SPECT) imaging, we have previously reported regional cerebral blood flow (rCBF) decreases in the medial prefrontal cortex, ventral tegmental area and subgenual cingulate cortex (Brodmann area 25 (BA 25)), a region found to be hypoperfused with treatment-resistant depression. From 2007 to 2010, we have extended our analysis to include nine additional completed suicides. In all, 27 healthy, age- and gender-matched subjects from a previously acquired healthy brain study served as controls to our 21 completed suicides. All 21 suicides had been previously diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorder-IV criterion. Voxel-by-voxel analyses were performed using statistical parametric mapping to compare the differences in technetium-99m hexamethylpropylene amine oxime brain uptake between the groups. Factor analysis of the data identified the top 10 regions of hypoperfusion in the suicidal group, including the bilateral superior frontal lobes, the right precuneus, the rolandic operculum, postcentral gyrus, left caudate and insular cortex. We also demonstrate more focal decreases in rCBF in the subgenual cingulate cortex (BA 25) in 18 subjects, supporting our previous hypothesis that hypoperfusion of BA 25 may be a risk factor for suicide in depressed patients. This work suggests that SPECT might be useful in predicting risk for suicide completion in subjects with depression or treatment-resistant depression. Further investigation of this work is necessary to better understand the predictive value of this finding.
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Structural and functional deficits in dmPFC, dlPFC, vlPFC, and dACC correlate with subjective depression severity and contribute to less top-down control over vmPFC regions, leading to impaired decision making and suicidal behavior.
“2) structural and functional deficits in the dorsomedial prefrontal cortex (dmPFC), dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), and dorsal anterior cingulate cortex (dACC) that correlate with severity of subjective depression (66) and contribute to less top-down control over vmPFC regions, resulting in impaired decision making and, in turn, suicidal behavior (”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [67]
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- Authors
- Willeumier, K., Taylor, D. V., & Amen, D. G.
- Affiliations
- Amen Clinics (US)
- Corresponding author
- Amen, D G
- Venue
- Translational Psychiatry
- Published
- 2011-08-09
- Volume
- 1
- Issue
- 8
- Pages
- e28-e28
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC3309501
- OpenAlex
- W1999887172
- Cited by
- 107
- References
- 29
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 7 · 2023: 1 · 2022: 5 · 2021: 13 · 2020: 8 · 2019: 3 · 2018: 26 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 11 · 2013: 2 · 2012: 1
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- www.springer.com/tdm (unspecified)
- Locations
- Translational Psychiatry (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- suicide, suicide mortality, regional cerebral blood flow, subgenual anterior cingulate cortex, treatment-resistant depression, hypoperfusion, Tc-99m HMPAO, neuroimaging biomarkers, suicide risk prediction, limbic cortex, prefrontal cortex
- MeSH terms
- Adult, Mental Disorders, Cerebrovascular Circulation, Depression, Female, Gyrus Cinguli, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Suicide, Comorbidity, Tomography, Emission-Computed, Single-Photon, Prefrontal Cortex, Radiopharmaceuticals, Young Adult
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