title: Positron emission tomography quantification of serotonin transporter in suicide attempters with major depressive disorder.
abstract: BACKGROUND
  Several lines of evidence implicate abnormal serotonergic function in suicidal behavior and completed suicide, including low serotonin transporter binding in postmortem studies of completed suicide. We have also reported low in vivo serotonin transporter binding in major depressive disorder (MDD) during a major depressive episode using positron emission tomography (PET) with [(11)C]McN5652. We quantified regional brain serotonin transporter binding in vivo in depressed suicide attempters, depressed nonattempters, and healthy controls using PET and a superior radiotracer, [(11)C]DASB.
  
  
  METHODS
  Fifty-one subjects with DSM-IV current MDD, 15 of whom were past suicide attempters, and 32 healthy control subjects underwent PET scanning with [(11)C]DASB to quantify in vivo regional brain serotonin transporter binding. Metabolite-corrected arterial input functions and plasma free-fraction were acquired to improve quantification.
  
  
  RESULTS
  Depressed suicide attempters had lower serotonin transporter binding in midbrain compared with depressed nonattempters (p = .031) and control subjects (p = .0093). There was no difference in serotonin transporter binding comparing all depressed subjects with healthy control subjects considering six a priori regions of interest simultaneously (p = .41).
  
  
  CONCLUSIONS
  Low midbrain serotonin transporter binding appears to be related to the pathophysiology of suicidal behavior rather than of major depressive disorder. This is consistent with postmortem work showing low midbrain serotonin transporter binding capacity in depressed suicides and may partially explain discrepant in vivo findings quantifying serotonin transporter in depression. Future studies should investigate midbrain serotonin transporter binding as a predictor of suicidal behavior in MDD and determine the cause of low binding.
authors: Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY 10043, USA. jm2233@columbia.edu
authors: Jeffrey M
authors: JM
authors: Miller
authors: Natalie
authors: N
authors: Hesselgrave
authors: R Todd
authors: RT
authors: Ogden
authors: Gregory M
authors: GM
authors: Sullivan
authors: Maria A
authors: MA
authors: Oquendo
authors: J John
authors: JJ
authors: Mann
authors: Ramin V
authors: RV
authors: Parsey
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D050486:Serotonin Plasma Membrane Transport Proteins / Q000032:analysis*; D013406:Suicide, Attempted
chemical_list: D050486:Serotonin Plasma Membrane Transport Proteins
keywords: PET; [(11)C]DASB; depression; midbrain; pathophysiology; serotonin transporter; suicide