The Neural Circuitry of Suicidality in Adolescent Depression

Alterations in brain structure may help explain why some individuals are more vulnerable to suicidal thoughts and behaviors (STBs), but past studies have often been too small or inconsistent to provide clear answers. White matter, which is the tissue that connects different brain regions, has been a focus of research, with some studies suggesting it may function differently in people with a history of suicide attempt. However, it's been difficult to tell whether these brain differences are linked to suicide risk itself or to mental illness more broadly. Larger, better-coordinated studies are needed to identify patterns in white matter that may play a role in STBs, and to determine whether they offer potential targets for prevention or intervention.

As part of the ENIGMA-STB consortium, Dr. Hilary Blumberg analyzed brain imaging data from over 6,000 individuals across 40 international cohorts. Dr. Blumberg compared white matter microstructure in people with and without a psychiatric diagnosis, focusing on those with a history of suicide attempt or recent suicidal ideation. Subtle but significant differences in white matter structure were found in individuals with a history of suicide attempt, even after accounting for psychiatric diagnosis. These effects were most evident in tracts linked to emotional regulation, attention, and cognitive control, including the corona radiata, corpus callosum, and superior longitudinal fasciculus. No significant differences were found for suicidal ideation alone or for severity of ideation. While the effects were small and not clinically predictive on their own, these findings suggest that white matter alterations may be one piece of the complex puzzle of risk for suicidal behavior and highlight the importance of future longitudinal studies to determine their role as potential risk markers.

Citation: van Velzen, L. S., Colic, L., Ceja, Z., Dauvermann, M. R., Villa, L. M., Savage, H. S., Toenders, Y. J., Dehestani, N., Zhu, A. H., Campos, A. I., Salminen, L. E., Agartz, I., Alexander, N., Ayesa-Arriola, R., Ballard, E. D., Banaj, N., Barkhau, C., Başgöze, Z., Bauer, J., Benedetti, F., … Schmaal, L. (2024). Transdiagnostic alterations in white matter microstructure associated with suicidal thoughts and behaviours in the ENIGMA Suicidal Thoughts and Behaviours consortium. medRxiv : the preprint server for health sciences, 2024.11.07.24316876. https://doi.org/10.1101/2024.11.07.24316876