Scientists identify a brain marker indicating future suicide risk
[May 13, 2023: Staff Writer, The Brighter Side of News]
Suicide risk assessment has traditionally depended on self-reporting methods, which are inherently reliant on an individual's comfort level and willingness to disclose suicidal thoughts and behaviors. (CREDIT: Creative Commons)
In a groundbreaking study, researchers from the VA Boston Healthcare System and Boston University have made considerable strides in the critical task of identifying individuals at high risk of suicide. The findings, which promise to transform the field of suicide prevention and treatment, have been published online in the Journal of Affective Disorders.
For over half a century, the ability to identify those at greatest risk of suicide has seen only modest improvements. Suicide risk assessment has traditionally depended on self-reporting methods, which are inherently reliant on an individual's comfort level and willingness to disclose suicidal thoughts and behaviors. This new study, however, posits a novel approach: the identification of unique brain markers.
Dr. Audreyana Jagger-Rickels, the principal investigator in the National Center for PTSD at the VA Boston Healthcare System and an assistant professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine, spearheaded the research.
"We believe we've found a potential brain connectivity marker that might be identifiable before a suicide attempt," explained Jagger-Rickels. "This is a significant breakthrough, as it could help identify those at risk for suicide and pave the way for new treatments targeting these brain regions and their underlying functions."
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The study drew its participants from post-9/11 veterans who took part in a longitudinal study at VA Boston Translational Research Center for Traumatic Brain Injury and Stress Disorders (TRACTS).
This comprehensive research program assesses participants' brain, cognitive, physical, and psychological health. A crucial component of the study was a "resting" functional MRI scan, which gauges intrinsic communication between brain regions and networks.
From this substantial dataset, researchers identified a subset of veterans who reported a suicide attempt at a one-to-two-year follow-up assessment but had not reported any such attempt in their previous assessments. The researchers then identified a second group, with equivalent symptoms of depression and posttraumatic stress disorder (PTSD), but without any report of a suicide attempt.
Hazard ratios [HR] and 95% confidence intervals [95% CI] for risk of suicide associated with a diagnosis of post-traumatic stress disorder [PTSD], with various stages of adjustment during multivariable modelling. (CREDIT: Science)
This methodical selection of comparison groups allowed the research team to pinpoint brain connectivity associated exclusively with suicide attempts, independent of other contributing factors like PTSD and depression.
Analyzing the brain connectivity in the suicide attempt group, both before and after their attempt, and comparing it with the control group, the team uncovered a critical finding. The connectivity between cognitive control and self-referential processing networks was dysregulated in the suicide attempt group. This abnormality was present before and after the suicide attempt, suggesting it could serve as a specific risk factor for suicide.
“As a result, interventions to reduce suicide risk are limited to people who feel comfortable enough to disclose (self-report) suicidal thoughts and behaviors. Identifying measures that do not require self-disclosure of suicidal thoughts and behaviors may help us identify people who are overlooked, and may also aid in the development of novel treatments targeting the brain mechanisms underlying suicidal thoughts and behaviors,” said Jagger-Rickels.
The research further revealed that the connectivity of the right amygdala, a brain region pivotal for fear learning and trauma, differed between the suicide attempt group and the control group. However, this difference only emerged after a suicide attempt was reported.
The left and right amygdala regions of interest (red and green, respectively) as defined in the automated anatomical labeling atlas. (CREDIT: Nature)
“This suggests that there are brain changes that occur after a suicide attempt, which could be related to the stressors surrounding a suicide attempt or due to the trauma of the suicide attempt itself. This would indicate that suicide attempts themselves impact the brain, which could increase future suicide risk,” Jagger-Rickels explained.
This revolutionary study offers a beacon of hope in the field of suicide prevention and treatment. By uncovering novel brain markers for suicide risk, it opens up the possibility of lifesaving interventions and treatments that could change the trajectory of countless lives. With further research, these findings could herald a new era in suicide prevention, shifting the paradigm from a reactive model to a proactive one.
This research was supported by the Department of Veteran s Affairs (VA) Translational Research Center for TBI and Stress Disorders (TRACTS), a VA Rehabilitation Research and Development National Network Center for TBI Research (B3001- C) to RM , a Merit Review Award from the VA Clinical Sciences Research and Development (I01CX001653) to ME , a SPiRE Award from VA Rehabilitation Research and Development (I21RX002737) to ME, a T32 post-doctoral training award from the National Institutes of Health (2T32MH01983621) and a Career Development Award from the VA Clinical Sciences Research and Development (IK1CX002541) to AJR.
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