João Paulo Lima Santos1, David Brent2, Michele Bertocci2, Sarrah Mailliard2, Genna Bebko2, Tina Goldstein2, Tae Kim3, Satish Iyengar2, Danella Hafeman2, Vilde Chaya Fenster-Ehrlich2, Alexander Skeba2, Lisa Bonar2, Halimah Abdul-Waalee2, MaryKay Gill2, John Merranko2, Boris Birmaher2, Mary L Phillips2, Amelia Versace4. 1. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: santosjp@upmc.edu. 2. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Magnetic Resonance Research Center, Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania; Magnetic Resonance Research Center, Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: Prevention of suicide in individuals with early-onset bipolar disorder (BD) remains a challenge. Diffusion magnetic resonance imaging studies in BD have identified neural correlates of emotional dysregulation implicated in BD and suicide. Using diffusion magnetic resonance imaging, we sought to identify neural signatures of suicide attempts in adults with childhood-onset BD who have been clinically followed for up to 19 years as part of the COBY (Course and Outcome of Bipolar Youth) study. METHODS: Diffusion magnetic resonance imaging data were collected in 68 adults with BD: 20 in the suicide attempter (SA+) group and 48 in the non-suicide attempter (SA-) group. Multivariate analysis of covariance was used to identify the effect of group (SA+, SA-) on mean fractional anisotropy (indirect index of fiber collinearity) in key white matter tracts of emotional regulation. The effect of suicidal ideation and other clinical factors was further explored. False discovery rate was used to account for multiple comparison. Forty healthy control subjects were included. RESULTS: Analyses revealed a main effect of group on fractional anisotropy (F5,59 = 3.0, p = .017). Specifically, the SA+ group showed lower fractional anisotropy than the SA- and healthy control groups in the middle portion of the forceps minor (FMIN) (F1,63 = 8.5, p = .010) and in the anterior (F1,63 = 7.8, p = .010) and posterior (F1,63 = 8.7, p = .006) portion of the right cingulum bundle (CB). Abnormalities in the FMIN, but not CB, were also associated with suicidal ideation (F1,64 = 10.6, p = .002) and levels of emotional distress at scan. CONCLUSIONS: FMIN and CB abnormalities have been associated with emotional dysregulation in BD. Our findings suggest that the FMIN may represent a generic marker of suicidal ideation and, more broadly, emotional distress, while CB may represent a specific marker of attempted suicide.
BACKGROUND: Prevention of suicide in individuals with early-onset bipolar disorder (BD) remains a challenge. Diffusion magnetic resonance imaging studies in BD have identified neural correlates of emotional dysregulation implicated in BD and suicide. Using diffusion magnetic resonance imaging, we sought to identify neural signatures of suicide attempts in adults with childhood-onset BD who have been clinically followed for up to 19 years as part of the COBY (Course and Outcome of Bipolar Youth) study. METHODS: Diffusion magnetic resonance imaging data were collected in 68 adults with BD: 20 in the suicide attempter (SA+) group and 48 in the non-suicide attempter (SA-) group. Multivariate analysis of covariance was used to identify the effect of group (SA+, SA-) on mean fractional anisotropy (indirect index of fiber collinearity) in key white matter tracts of emotional regulation. The effect of suicidal ideation and other clinical factors was further explored. False discovery rate was used to account for multiple comparison. Forty healthy control subjects were included. RESULTS: Analyses revealed a main effect of group on fractional anisotropy (F5,59 = 3.0, p = .017). Specifically, the SA+ group showed lower fractional anisotropy than the SA- and healthy control groups in the middle portion of the forceps minor (FMIN) (F1,63 = 8.5, p = .010) and in the anterior (F1,63 = 7.8, p = .010) and posterior (F1,63 = 8.7, p = .006) portion of the right cingulum bundle (CB). Abnormalities in the FMIN, but not CB, were also associated with suicidal ideation (F1,64 = 10.6, p = .002) and levels of emotional distress at scan. CONCLUSIONS: FMIN and CB abnormalities have been associated with emotional dysregulation in BD. Our findings suggest that the FMIN may represent a generic marker of suicidal ideation and, more broadly, emotional distress, while CB may represent a specific marker of attempted suicide.
Authors: Tina R Goldstein; Wonho Ha; David A Axelson; Benjamin I Goldstein; Fangzi Liao; Mary Kay Gill; Neal D Ryan; Shirley Yen; Jeffrey Hunt; Heather Hower; Martin Keller; Michael Strober; Boris Birmaher Journal: Arch Gen Psychiatry Date: 2012-11
Authors: João Paulo Lima Santos; Amelia Versace; Richelle S Stiffler; Haris A Aslam; Jeanette C Lockovich; Lisa Bonar; Michele Bertocci; Satish Iyengar; Genna Bebko; Alexander Skeba; Mary Kay Gill; Kelly Monk; Mary Beth Hickey; Boris Birmaher; Mary L Phillips Journal: J Affect Disord Date: 2022-03-21 Impact factor: 4.839
Authors: João Paulo Lima Santos; Michele Bertocci; Genna Bebko; Tina Goldstein; Tae Kim; Satish Iyengar; Lisa Bonar; MaryKay Gill; John Merranko; Anastasia Yendiki; Boris Birmaher; Mary L Phillips; Amelia Versace Journal: J Clin Med Date: 2022-06-15 Impact factor: 4.964