Brain scans may help predict suicide risk

Differences in brain circuitry may indicate an individual’s risk for suicide, according to a recent fMRI-based study published in Psychological Medicine.

Researchers from the University of Illinois at Chicago and the University of Utah found patients with a history of suicide-related behavior have distinctly different patterns of brain connectivity in areas associated with cognitive control and impulsivity compared to patients without such history, as well as those with a mood disorder and no history of suicidal behavior.

"This is one of the first studies to try to understand brain mechanisms that may be relevant to suicide risk," first author Jonathan Stange, assistant professor of psychiatry at UIC, said in a statement. Stange added that this research, while in its initial phases, may eventually help identify risk factors for suicide and prevent suicide attempts.

Given that suicide rates among young adults continue to rise—especially among those with mood disorders such as depression—new efforts and tools are needed to identify higher-risk individuals. Stange noted that emergency departments and urgent care clinics might screen for mood disorders and follow up with patients, but improvements can be made.

“Right now, we go on self-report and clinician judgment,” Stange added. “Those are good, but they're not great."

For their study, the researchers used resting-state fMRI to image the brains of 212 young adults, analyzing connectivity in the brain’s cognitive control network (CCN) and the salience and emotional network. The former executes executive function and problem-solving, while the latter is involved in emotional processing and regulation. Stange et al. also evaluated the default mode network (DMN), which activates when individuals think about themselves. 

Past studies have linked these three brain networks with mood disorders, but those focused mainly on depression.

Results showed that patients with a mood disorder and history of suicide attempts had less connectivity in the CCN, and between the CCN and DMN, compared to those with a mood disorder and thoughts of suicide and healthy participants.

A limitation of this study was its small size: only 18 patients analyzed had mood disorders and a history of suicide attempts. A longitudinal study in which researchers measure brain circuit connectivity at the onset then perform periodic follow-ups will offer a better idea of which risk factors clinicians should pay attention to.

“Ultimately, that's what we really care about," Stange said. "It's not just figuring out what happened in the past, but what can we do with this information to try to prevent suicide from happening."