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Cited by 46Bipolar Disorder and TreatmentSuicide and Self-Harm StudiesPsychopathy, Forensic Psychiatry, Sexual Offending

Reduced lateral orbitofrontal cortex volume and suicide behavior in youth with bipolar disorder

Huber, Rebekah S, Subramaniam, Punitha, Kondo, Douglas G, Shi, Xianfeng, Renshaw, Perry F, Yurgelun‐Todd, Deborah A·2019·Bipolar Disorders
DOI 10.1111/bdi.12729
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Abstract

OBJECTIVES: Structural abnormalities in cortical and subcortical regions, including the orbitofrontal cortex (OFC), are altered during brain development in adolescents with bipolar disorder (BD), which may increase risk for suicide. Few studies have examined the neural substrates of suicidal behavior in BD youth. The aim of the present study was to investigate the relationship between suicide behavior and the OFC in youth with BD. METHODS: Thirty-seven participants with BD and 26 non-psychiatric controls, ages 13-21 years, completed a diagnostic interview and mood rating scales. Lifetime symptoms of suicide ideation and behavior were examined using the Columbia Suicide Severity Rating Scale. Participants underwent magnetic resonance imaging on a 3T Siemens Verio scanner. Morphometric analysis of brain images was performed using FreeSurfer. RESULTS: Eighteen participants with BD had a history of suicide attempt (SA). Bipolar youth with a history of SA showed reduced left lateral OFC volumes compared to controls, but there was no difference between BD attempters and non-attempters. Controls and BD non-attempters had significantly greater OFC cortical thickness than BD attempters. Additionally, there was a significant negative correlation between OFC volumes and suicide lethality, demonstrating that as suicide lethality increased, OFC volume in BD youth was reduced. CONCLUSIONS: The OFC is involved in decision-making, impulsivity, and reward circuitry which have shown to be impaired in BD. Reduced OFC volume and its association with lethality of suicide suggest that suicide behavior in BD may be related to the emerging neuroanatomical substrates of the disorder, particularly abnormalities of the OFC.

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  • Structural MRI evidence indicates reduced ventral prefrontal and orbitofrontal cortex volume in youth reporting STB.

    “Structural MRI research suggests reduced volume in the ventral prefrontal and orbitofrontal cortices among youth reporting STB”

    From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [55]

  • PFC findings are complicated by inconsistent laterality effects.

    “Studies on PFC differences, however, are complicated by inconsistent laterality effects (left (54, 55) versus right (53)).”

    From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [55]

  • BD suicide attempters show reduced OFC thickness, and reduced OFC volume correlates negatively with suicide ideation severity and attempt lethality.

    “There is evidence of reduced OFC thickness among BD suicide attempters, and reduced OFC volume negatively correlates with suicide ideation severity and attempt lethality (55).”

    From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [55]

  • Youth STB research is characterized by alterations within prefrontal and limbic systems, where a compromised regulatory system may potentiate suicidal thinking, and perturbations in top-down and bottom-up connections may lead to suicidal behaviors.

    “Consistent with Schmaal and colleagues (32), youth STB research is characterized by alterations within prefrontal (53–55) and limbic (62, 75, 102, 103) systems whereby a compromised regulatory system may potentiate suicidal thinking, and perturbations in top-down and bottom-up connections may lead to suicidal behaviors.”

    From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [55]

  • Adolescent suicidal behavior mostly involves smaller ventral PFC regions, particularly the OFC, which correlates with greater attempt lethality.

    “Adolescent suicidal behavior mostly involves smaller ventral PFC regions, particularly the OFC (74), which correlates with greater attempt lethality (75).”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [75]

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Authors
Huber, R. S., Subramaniam, P., Kondo, D. G., Shi, X., Renshaw, P. F., & Yurgelun‐Todd, D. A.
Affiliations
  • University of Utah (US)
  • United States Department of Veterans Affairs (US)
  • Department of Psychiatry University of Utah School of Medicine Salt Lake City Utah
Corresponding author
Huber, Rebekah S
ORCID
Venue
Bipolar Disorders
Publisher
Wiley
Published
2018-12-13
Volume
21
Issue
4
Pages
321-329
ISSN
  • 1398-5647 (ISSN-L)
  • 1399-5618
DOI
10.1111/bdi.12729
OpenAlex
W2901596179
Cited by
46
References
39
Citations by year
2026: 5 · 2025: 8 · 2024: 4 · 2023: 10 · 2022: 4 · 2021: 6 · 2020: 9
FWCI
2.93
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Bipolar Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
Utah Science Technology and Research
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
bipolar disorder, youth, suicidal behavior, suicide attempts, suicide lethality, orbitofrontal cortex, cortical thickness, brain development, adolescents, suicidal ideation, neuroanatomical substrates
MeSH terms
Adolescent, Bipolar Disorder, Brain Mapping, Decision Making, Female, Humans, Impulsive Behavior, Male, Nerve Net, Organ Size, Reward, Suicide, Attempted, Prefrontal Cortex, Young Adult, Suicidal Ideation

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