title: Multimodal Neuroimaging of Frontolimbic Structure and Function Associated With Suicide Attempts in Adolescents and Young Adults With Bipolar Disorder.
abstract: Bipolar disorder is associated with high risk for suicidal behavior that often develops in adolescence and young adulthood. Elucidation of involved neural systems is critical for prevention. This study of adolescents and young adults with bipolar disorder with and without a history of suicide attempts combines structural, diffusion tensor, and functional MR imaging methods to investigate implicated abnormalities in the morphology and structural and functional connectivity within frontolimbic systems.
  
  
  
  The study had 26 participants with bipolar disorder who had a prior suicide attempt (the attempter group) and 42 participants with bipolar disorder without a suicide attempt (the nonattempter group). Regional gray matter volume, white matter integrity, and functional connectivity during processing of emotional stimuli were compared between groups, and differences were explored for relationships between imaging modalities and associations with suicide-related symptoms and behaviors.
  
  
  
  Compared with the nonattempter group, the attempter group showed significant reductions in gray matter volume in the orbitofrontal cortex, hippocampus, and cerebellum; white matter integrity in the uncinate fasciculus, ventral frontal, and right cerebellum regions; and amygdala functional connectivity to the left ventral and right rostral prefrontal cortex. In exploratory analyses, among attempters, there was a significant negative correlation between right rostral prefrontal connectivity and suicidal ideation and between left ventral prefrontal connectivity and attempt lethality.
  
  
  
  Adolescent and young adult suicide attempters with bipolar disorder demonstrate less gray matter volume and decreased structural and functional connectivity in a ventral frontolimbic neural system subserving emotion regulation. Among attempters, reductions in amygdala-prefrontal functional connectivity may be associated with severity of suicidal ideation and attempt lethality.
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Jennifer A Y
authors.initials: JAY
authors.lastname: Johnston
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Blond
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Amanda
authors.initials: A
authors.lastname: Wallace
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Jiacheng
authors.initials: J
authors.lastname: Liu
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Linda
authors.initials: L
authors.lastname: Spencer
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Cox Lippard
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Kirstin L
authors.initials: KL
authors.lastname: Purves
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Angeli
authors.initials: A
authors.lastname: Landeros-Weisenberger
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Eric
authors.initials: E
authors.lastname: Hermes
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Brian
authors.initials: B
authors.lastname: Pittman
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: King
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Andrés
authors.initials: A
authors.lastname: Martin
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.affiliation: From the Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Conn.; the Division of Psychology and Language Sciences, University College London; and the Department of Psychiatry, Columbia University Medical Center, New York.
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000000981:diagnostic imaging; D001714:Bipolar Disorder / Q000000981:diagnostic imaging*; D002531:Cerebellum / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005625:Frontal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D066128:Gray Matter / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000000981:diagnostic imaging; D006801:Humans; D008032:Limbic System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000000981:diagnostic imaging; D018570:Risk Assessment; D013223:Statistics as Topic; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D066127:White Matter / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Adolescents; Brain Imaging Techniques; DTI; MRI; Mood Disorders-Bipolar; Suicide; fMRI