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 [(18)F]-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.
a Departments of Molecular Imaging and Neuropathology , New York State Psychiatric Institute , New York , New York , USA.
M Elizabeth
ME
Sublette
Matthew S
MS
Milak
Hanga C
HC
Galfalvy
Maria A
MA
Oquendo
Kevin M
KM
Malone
J John
JJ
Mann
D000328:Adult; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000378:metabolism; D016022:Case-Control Studies; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D005277:Fenfluramine / Q000494:pharmacology; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000378:metabolism; D011699:Putamen / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology; D016037:Single-Blind Method; D013406:Suicide, Attempted; D055815:Young Adult
D005277:Fenfluramine; D019788:Fluorodeoxyglucose F18; D005947:Glucose; D019275:Radiopharmaceuticals; D017367:Selective Serotonin Reuptake Inhibitors