Regional Brain Glucose Uptake Distinguishes Suicide Attempters from Non-Attempters in Major Depression

This study compared regional cerebral metabolic rates of glucose (rCMRglu) determined by [18F]-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in suicide attempters and non-attempters. Medication-free patients with major depression (n = 29) had FDG-PET after single-blind administration of placebo (day 1) and fenfluramine (day 2). Suicide attempt history was obtained before scanning and at assessments over 2 subsequent years. Statistical parametric mapping evaluated associations between attempt status and rCMRglu, controlling for age. The study included 13 patients with and 16 without a history of suicide attempt within 2 years before or after scanning. After placebo, rCMRglu in attempters was lower in right dorsolateral prefrontal regions and higher in ventromedial regions than in non-attempters. After fenfluramine, relatively hypometabolic areas enlarged, and no hypermetabolic areas were detected. Distinct rCMRglu patterns may be serotonin-sensitive biomarkers of suicide risk.

[1]  A. Simmons,et al.  Combat-Exposed War Veterans at Risk for Suicide Show Hyperactivation of Prefrontal Cortex and Anterior Cingulate During Error Processing , 2012, Psychosomatic medicine.

[2]  Daniella J. Furman,et al.  Default-Mode and Task-Positive Network Activity in Major Depressive Disorder: Implications for Adaptive and Maladaptive Rumination , 2011, Biological Psychiatry.

[3]  M. Phillips,et al.  Dissociable patterns of neural activity during response inhibition in depressed adolescents with and without suicidal behavior. , 2011, Journal of the American Academy of Child and Adolescent Psychiatry.

[4]  R. Wiest,et al.  An fMRI study on mental pain and suicidal behavior. , 2010, Journal of affective disorders.

[5]  R. Parsey,et al.  Regional brain metabolic correlates of self-reported depression severity contrasted with clinician ratings. , 2010, Journal of affective disorders.

[6]  A. Strafella,et al.  Continuous theta burst stimulation of right dorsolateral prefrontal cortex induces changes in impulsivity level , 2010, Brain Stimulation.

[7]  E. Neidhart,et al.  Simultaneous analysis of serotonin transporter, tryptophan hydroxylase 1 and 2 gene expression in the ventral prefrontal cortex of suicide victims , 2010, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[8]  T. Cooper,et al.  Future Suicide Attempt and Responses to Serotonergic Challenge , 2010, Neuropsychopharmacology.

[9]  R. Parsey,et al.  Pretreatment regional brain glucose uptake in the midbrain on PET may predict remission from a major depressive episode after three months of treatment , 2009, Psychiatry Research: Neuroimaging.

[10]  D. Schutter,et al.  The Cerebellum in Emotion Regulation: A Repetitive Transcranial Magnetic Stimulation Study , 2009, The Cerebellum.

[11]  R. Morrison,et al.  A systematic review of the relationship between rumination and suicidality. , 2008, Suicide & life-threatening behavior.

[12]  M. Phillips,et al.  Orbitofrontal cortex response to angry faces in men with histories of suicide attempts. , 2008, The American journal of psychiatry.

[13]  C. Waternaux,et al.  Classification trees distinguish suicide attempters in major psychiatric disorders: a model of clinical decision making. , 2008, The Journal of clinical psychiatry.

[14]  J. Mann,et al.  Can biological tests assist prediction of suicide in mood disorders? , 2006, The international journal of neuropsychopharmacology.

[15]  C. Benkelfat,et al.  α-[11C]Methyl-l-tryptophan trapping in the orbital and ventral medial prefrontal cortex of suicide attempters , 2006, European Neuropsychopharmacology.

[16]  R. Parsey,et al.  Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder , 2005, Neuropsychopharmacology.

[17]  R. Parsey,et al.  Neuroanatomic correlates of psychopathologic components of major depressive disorder. , 2005, Archives of general psychiatry.

[18]  R. Parsey,et al.  Regional brain responses to serotonin in major depressive disorder. , 2004, Journal of affective disorders.

[19]  G. Slegers,et al.  Prefrontal 5-HT2a receptor binding index, hopelessness and personality characteristics in attempted suicide. , 2003, Journal of Affective Disorders.

[20]  K. Van Laere,et al.  SPECT neuropsychological activation procedure with the Verbal Fluency Test in attempted suicide patients , 2002, Nuclear medicine communications.

[21]  Marcus E Raichle,et al.  Glucose metabolism in the amygdala in depression: Relationship to diagnostic subtype and plasma cortisol levels , 2002, Pharmacology Biochemistry and Behavior.

[22]  Peter Herscovitch,et al.  Regional cerebral glucose utilization in patients with a range of severities of unipolar depression , 2002, Biological Psychiatry.

[23]  M E Phelps,et al.  Regional brain metabolic changes in patients with major depression treated with either paroxetine or interpersonal therapy: preliminary findings. , 2001, Archives of general psychiatry.

[24]  S. Houle,et al.  Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. , 2001, The American journal of psychiatry.

[25]  A L Brody,et al.  Prefrontal-subcortical and limbic circuit mediation of major depressive disorder. , 2001, Seminars in clinical neuropsychiatry.

[26]  M. Frye,et al.  Effects of mood and subtype on cerebral glucose metabolism in treatment-resistant bipolar disorder , 2001, Biological Psychiatry.

[27]  J L Lancaster,et al.  Automated Talairach Atlas labels for functional brain mapping , 2000, Human brain mapping.

[28]  J. Macher,et al.  Prolactin response to d-fenfluramine and suicidal behavior in depressed patients , 2000, Psychiatry Research.

[29]  C Waternaux,et al.  Toward a clinical model of suicidal behavior in psychiatric patients. , 1999, The American journal of psychiatry.

[30]  M. Åsberg,et al.  Neurotransmitters and Suicidal Behavior , 1997, Annals of the New York Academy of Sciences.

[31]  V. Arango,et al.  Postmortem Findings in Suicide Victims. Implications for in Vivo Imaging Studies a , 1997, Annals of the New York Academy of Sciences.

[32]  C. Frith,et al.  Prefrontal dysfunction in depressed patients performing a complex planning task: a study using positron emission tomography , 1997, Psychological Medicine.

[33]  Thomas E. Nichols,et al.  Positron Emission Tomographic Imaging of Serotonin Activation Effects on Prefrontal Cortex in Healthy Volunteers , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[34]  J. Mann,et al.  Prolactin Response to Fenfluramine and Suicide Attempt Lethality in Major Depression , 1996, British Journal of Psychiatry.

[35]  M. Mintun,et al.  Demonstration in vivo of reduced serotonin responsivity in the brain of untreated depressed patients. , 1996, The American journal of psychiatry.

[36]  André Luxen,et al.  Frontal and parietal metabolic disturbances in unipolar depression , 1994, Biological Psychiatry.

[37]  T. Cooper,et al.  Abnormal behavioral responses to fenfluramine in patients with affective and personality disorders Correlation with increased serotonergic responsivity , 1994, Biological Psychiatry.

[38]  J. Mazziotta,et al.  Rapid Automated Algorithm for Aligning and Reslicing PET Images , 1992, Journal of computer assisted tomography.

[39]  V. Arango,et al.  Autoradiographic demonstration of increased serotonin 5-HT2 and beta-adrenergic receptor binding sites in the brain of suicide victims. , 1990, Archives of general psychiatry.

[40]  B. Pate,et al.  Regional Cerebral Glucose Metabolism in Major Depressive Disorder * , 1990, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[41]  S. Pappatà,et al.  Left prefrontal glucose hypometabolism in the depressed state: a confirmation. , 1990, The American journal of psychiatry.

[42]  J. Mazziotta,et al.  Reduction of prefrontal cortex glucose metabolism common to three types of depression. , 1989, Archives of general psychiatry.

[43]  A. Beck,et al.  Assessment of suicidal intention: the Scale for Suicide Ideation. , 1979, Journal of consulting and clinical psychology.

[44]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[45]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[46]  E. Coccaro,et al.  Aggression, Suicidality, and Intermittent Explosive Disorder: Serotonergic Correlates in Personality Disorder and Healthy Control Subjects , 2010, Neuropsychopharmacology.

[47]  R. Parsey,et al.  Plasma polyunsaturated fatty acids and regional cerebral glucose metabolism in major depression. , 2009, Prostaglandins, leukotrienes, and essential fatty acids.

[48]  Ramin V Parsey,et al.  Positron emission tomography of regional brain metabolic responses to a serotonergic challenge and lethality of suicide attempts in major depression. , 2003, Archives of general psychiatry.

[49]  M. First,et al.  Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet , 1997 .

[50]  M. First,et al.  Structured Clinical Interview for DSM-IV Axis I Disorders , 1997 .

[51]  Karl J. Friston,et al.  Statistical parametric maps in functional imaging: A general linear approach , 1994 .

[52]  H. Krebs,et al.  Determination of fenfluramine and norfenfluramine in plasma using a nitrogen-sensitive detector. , 1984, Journal of chromatography.