Dissociable Patterns of Neural Activity During Response Inhibition in Depressed Adolescents With and Without Suicidal Behavior

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 50; no. 6; pp. 602 - 611.e3
• Main Authors: Pan, Lisa A., Batezati-Alves, Silvia C., Almeida, Jorge R.C., Segreti, AnnaMaria, Akkal, Dalila, Hassel, Stefanie, Lakdawala, Sara, Brent, David A., Phillips, Mary L.
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01.06.2011; Elsevier; Elsevier BV
• Subjects: adolescence; Adolescent; Adolescents; Adult and adolescent clinical studies; Anticonvulsants - therapeutic use; Antidepressive Agents - therapeutic use; Antipsychotic Agents - therapeutic use; Attention - physiology; Attention Control; Biological and medical sciences; Brain; Brain - physiopathology; Brain Hemisphere Functions; Brain Mapping; Cerebral Cortex - physiopathology; Child clinical studies; Child psychology; cingulate; Control Groups; Depression; Depression (Psychology); Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - physiopathology; Depressive Disorder, Major - psychology; Depressive personality disorders; Diagnostic Tests; Dominance, Cerebral - physiology; Female; Frontal Lobe - physiopathology; Gyrus Cinguli - physiopathology; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Inhibition; Inhibition, Psychological; Integrity; Magnetic Resonance Imaging; Male; Medical sciences; Mental depression; Mesencephalon - physiopathology; Mood disorders; Motor Reactions; Nerve Net - physiopathology; NMR; Nuclear magnetic resonance; Oxygen Consumption - physiology; Parietal Lobe - physiopathology; Pattern Recognition, Visual - physiology; Pediatrics; prefrontal cortex; Prefrontal Cortex - physiopathology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance - physiology; Psychopathology. Psychiatry; Reference Values; Response inhibition; Suicidal behaviour; Suicidal Ideation; Suicide; Suicide, Attempted - psychology; Suicides & suicide attempts; Symptoms; Task Analysis; Teenagers; Temporal Lobe - physiopathology; adolescence; cingulate; prefrontal cortex; response inhibition; suicide; Human; Mood disorder; Central nervous system; Depression; Prefrontal cortex; Suicide; Encephalon; Suicide attempt; Cingulate cortex; Adolescent; Inhibition; Comparative study
• ISSN: 0890-8567; 1527-5418; 1527-5418
• DOI: 10.1016/j.jaac.2011.03.018

Impaired attentional control and behavioral control are implicated in adult suicidal behavior. Little is known about the functional integrity of neural circuitry supporting these processes in suicidal behavior in adolescence. Functional magnetic resonance imaging was used in 15 adolescent suicide attempters with a history of major depressive disorder (ATTs), 15 adolescents with a history of depressive disorder but no suicide attempt (NATs), and 14 healthy controls (HCs) during the performance of a well-validated go-no-go response inhibition and motor control task that measures attentional and behavioral control and has been shown to activate prefrontal, anterior cingulate, and parietal cortical circuitries. Questionnaires assessed symptoms and standardized interviews characterized suicide attempts. A 3 group by 2 condition (go-no-go response inhibition versus go motor control blocks) block-design whole-brain analysis ( p < .05, corrected) showed that NATs showed greater activity than ATTs in the right anterior cingulate gyrus ( p = .008), and that NATs, but not ATTs, showed significantly greater activity than HCs in the left insula ( p = .004) to go-no-go response inhibition blocks. Although ATTs did not show differential patterns of neural activity from HCs during the go-no-go response inhibition blocks, ATTs and NATs showed differential activation of the right anterior cingulate gyrus during response inhibition. These findings indicate that suicide attempts during adolescence are not associated with abnormal activity in response inhibition neural circuitry. The differential patterns of activity in response inhibition neural circuitry in ATTs and NATs, however, suggest different neural mechanisms for suicide attempt versus major depressive disorder in general in adolescence that should be a focus of further study.