Structural brain alterations associated with suicidal thoughts and behaviors in young people: results from 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 E. , 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 ,   ENIGMA Suicidal Thoughts and Behaviours Consortium, van Velzen Laura S. , van der Wee Nic J. A. , van der Werff Steven J. , van Harmelen Anne-Laura , Schmaal Lianne 
Published: September 2022

Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving 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. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen’s d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.