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Subcortical nuclei volumes in suicidal behavior: nucleus accumbens may modulate the lethality of acts.

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Abstract

Previously, studies have demonstrated cortical impairments in those who complete or attempt suicide. Subcortical nuclei have less often been implicated in the suicidal vulnerability. In the present study, we investigated, with a specific design in a large population, variations in the volume of subcortical structures in patients with mood disorders who have attempted suicide. We recruited 253 participants: 73 suicide attempters with a past history of both mood disorders and suicidal act, 89 patient controls with a past history of mood disorders but no history of suicidal act, and 91 healthy controls. We collected 1.5 T magnetic resonance imaging data from the caudate, pallidum, putamen, nucleus accumbens, hippocampus, amygdala, ventral diencephalon, and thalamus. Surface-based morphometry (Freesurfer) analysis was used to comprehensively evaluate gray matter volumes. In comparison to controls, suicide attempters showed no difference in subcortical volumes when controlled for intracranial volume. However, within attempters negative correlations between the left (r = −0.35, p = 0.002), and right (r = −0.41, p < 0.0005) nucleus accumbens volumes and the lethality of the last suicidal act were found. Our study found no differences in the volume of eight subcortical nuclei between suicide attempters and controls, suggesting a lack of association between these regions and suicidal behavior in general. However, individual variations in nucleus accumbens structure and functioning may modulate the lethality of suicidal acts during a suicidal crisis. The known role of nucleus accumbens in action selection toward goals determined by the prefrontal cortex, decision-making or mental pain processing are hypothesized to be potential explanations.

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Acknowledgments

The authors would like to thank Mrs Corina Nagy for her help in the revision on the manuscript.

Study 1 was supported by the American Foundation for Suicide Prevention (Dr. Jollant), Fondation pour la Recherche Médicale (Action Dynamique en Psychiatrie to Dr Jollant), and the Royal Society and University of London Central Research Fund (to Dr. Lawrence). Study 2 was funded by a Projet Hospitalier de Recherche Clinique (to Drs. Jollant and Courtet). Dr. Olié received a grant from Académie Nationale de Médecine. Study 3 was funded by the Institut Servier (to Dr. Jollant). Dr Cyprien received an MSc grant from Institut Servier.

Mr. Ding currently holds a Fond de Recherche du Québec - Santé (FRQS) Ph.D. Grant # 24117. Dr. Jollant currently holds a “FRQS chercheur-boursier clinicien” salary Award.

Disclosures

Anthony J. Gifuni, Yang Ding, Emilie Olié, Natalia Lawrence, Fabienne Cyprien, Emmanuelle Le Bars, Alain Bonafé, Mary L. Phillips, Philippe Courtet, and Fabrice Jollant declare no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. McGill Group for Suicide Studies, McGill University and Douglas Mental Health University Institute, 6875 boulevard Lasalle, Montréal, Québec, H4H 1R3, Canada

    Anthony J. Gifuni, Yang Ding & Fabrice Jollant

  2. Mood Disorders Centre, School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK

    Natalia Lawrence

  3. Department of Psychiatry & Inserm, Université Montpellier I & CHU Montpellier, U1061, Montpellier, France

    Emilie Olié, Fabienne Cyprien & Philippe Courtet

  4. Department of Radiology, Université Montpellier I & CHU Montpellier, Montpellier, France

    Emmanuelle Le Bars & Alain Bonafé

  5. Clinical and Translational Affective Neuroscience Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Mary L. Phillips

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  1. Anthony J. Gifuni
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Correspondence to Fabrice Jollant.

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Gifuni, A.J., Ding, Y., Olié, E. et al. Subcortical nuclei volumes in suicidal behavior: nucleus accumbens may modulate the lethality of acts.. Brain Imaging and Behavior 10, 96–104 (2016). https://doi.org/10.1007/s11682-015-9369-5

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