Citation

Jollant F. Adv. Biol. Psychiatry (Basel) 2015; 30: 110-122.

Copyright

(Copyright © 2015, Karger)

DOI

10.1159/000434744

PMID

unavailable

Abstract

Over the last 15 years, an increasing number of studies have been conducted to investigate the neural basis of suicidal behavior in vivo, using neuroimaging. In this chapter, we will review the literature on the topic before proposing an updated version of our neurocognitive model. Review shows that few studies have used pharmacological neuroimaging to investigate brain receptors. Moreover, these studies present methodological issues including small sample size, thus limiting their interpretation. Spectroscopy has also been used too rarely to draw any firm conclusion so far. In contrast, structural neuroimaging has been extensively used and suggests reduced volumes, mainly in different parts of the prefrontal cortex, in addition to parietal and temporal cortices and possibly some subcortical nuclei. In addition, several studies have reported white matter lesions in individuals with histories of suicidal acts and mood disorders from adolescents to the elderly, suggesting impaired brain connectivity. Diffusion tensor imaging has not been used often to date but supports impaired connectivity, notably to the orbitofrontal cortex. Finally, functional neuroimaging studies have highlighted impaired responses in suicide attempters to various conditions, including decision making, social threat, cognitive control, verbal fluency, mental pain, and resting state. We propose that the vulnerability to suicidal behavior and the triggering of the suicidal crisis is related to a combination of trait and state deficits, including valuation processes on one side and cognitive control and self-referential processes on the other side. This would be underlain by a dysfunctional network of regions, including the ventral and dorsal parts of the prefrontal cortex and the parietal and temporal lobes. Future research should develop interventions targeting these neurocognitive alterations for the prevention of suicide.

Language: en