Structural brain alterations associated with suicidal thoughts and behaviors in young people: results across 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium
Authors: van Velzen Laura S. , Dauvermann Maria R. , Colic Lejla , Villa Luca M. , Savage Hannah S. , Toenders Yara J. , Zhu Alyssa H. , Bright Joanna K. , Campos Adrián I. , Salminen Lauren , Ambrogi Sonia , Ayesa-Arriola Rosa , Banaj Nerisa , Başgöze Zeynep , Bauer Jochen , Blair Karina , Blair Robert James , Brosch Katharina , Cheng Yuqi , Colle Romain , Connolly Colm G. , Corruble Emmanuelle , Couvy-Duchesne Baptiste , Crespo-Facorro Benedicto , Cullen Kathryn R. , Dannlowski Udo , Davey Christopher G. , Dohm Katharina , Fullerton Janice M. , Gonul Ali Saffet , Gotlib Ian H. , Grotegerd Dominik , Hahn Tim , Harrison Ben J. , He Mengxin , Hickie Ian B. , Ho Tiffany C. , Iorfino Frank , Jansen Andreas , Jollant Fabrice , Kircher Tilo , Klimes-Dougan Bonnie , Klug Melissa , Leehr Elisabeth J. , Lippard Elizabeth T.C. , McLaughlin Katie A. , Meinert Susanne , Miller Adam Bryant , Mitchell Philip B. , Mwangi Benson , Nenadić Igor , Ojha Amar , Overs Bronwyn J. , Pfarr Julia-Katharina , Piras Fabrizio , Ringwald Kai G. , Roberts Gloria , Romer Georg , Sanches Marsal , Sheridan Margaret A. , Soares Jair C , Spalletta Gianfranco , Stein Frederike , Teresi Giana I. , Tordesillas-Gutiérrez Diana , Uyar-Demir Aslihan , van der Wee Nic J.A. , van der Werff Steven J. , Vermeiren Robert R.J.M. , Winter Alexandra , Wu Mon-Ju , Yang Tony T. , Thompson Paul M. , Rentería Miguel E. , Jahanshad Neda , Blumberg Hilary P. , van Harmelen Anne-Laura , Schmaal Lianne 
Published: September 2021

Objective

Identifying brain differences associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and generating effective approaches to early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth.

Methods

First, we examined associations among regional brain structure and STBs, which were assessed in six samples of youth with mood disorders, using the Columbia Suicide Severity Rating Scale (C-SSRS;N=577). Second, we combined this sample with a larger sample (total 21 sites) in which STBs were assessed using various instruments. MRI metrics were compared among healthy controls without STBs (HC;N=688), clinical controls without STBs (CC;N=648), and young people with psychiatric diagnoses and current suicidal ideation (N=406). In separate analyses, MRI metrics were compared among HCs (N=335), CCs (N=768), and suicide attempters (N=254).

Results

In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and history of actual suicide attempts (N=163) than those without (N=394; FDR-p<.001; Cohen’sd=.334). When expanding to more clinically heterogeneous samples, we also found lower surface area of the frontal pole in those with a history of suicide attempts (Cohen’sd=.22).

Conclusions

Lower frontal pole surface area may represent a vulnerability for a suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.