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Reduced lateral orbitofrontal cortex volume and suicide behavior in youth with bipolar disorder
Author(s) -
Huber Rebekah S,
Subramaniam Punitha,
Kondo Douglas G,
Shi Xianfeng,
Renshaw Perry F,
YurgelunTodd Deborah A
Publication year - 2019
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12729
Subject(s) - bipolar disorder , orbitofrontal cortex , impulsivity , psychology , suicidal ideation , mood , psychiatry , bipolar i disorder , suicide attempt , mood disorders , prefrontal cortex , poison control , clinical psychology , medicine , mania , injury prevention , cognition , anxiety , environmental health
Objectives Structural abnormalities in cortical and subcortical regions, including the orbitofrontal cortex ( OFC ), are altered during brain development in adolescents with bipolar disorder ( BD ), which may increase risk for suicide. Few studies have examined the neural substrates of suicidal behavior in BD youth. The aim of the present study was to investigate the relationship between suicide behavior and the OFC in youth with BD . Methods Thirty‐seven participants with BD and 26 non‐psychiatric controls, ages 13‐21 years, completed a diagnostic interview and mood rating scales. Lifetime symptoms of suicide ideation and behavior were examined using the Columbia Suicide Severity Rating Scale. Participants underwent magnetic resonance imaging on a 3T Siemens Verio scanner. Morphometric analysis of brain images was performed using FreeSurfer. Results Eighteen participants with BD had a history of suicide attempt ( SA ). Bipolar youth with a history of SA showed reduced left lateral OFC volumes compared to controls, but there was no difference between BD attempters and non‐attempters. Controls and BD non‐attempters had significantly greater OFC cortical thickness than BD attempters. Additionally, there was a significant negative correlation between OFC volumes and suicide lethality, demonstrating that as suicide lethality increased, OFC volume in BD youth was reduced. Conclusions The OFC is involved in decision‐making, impulsivity, and reward circuitry which have shown to be impaired in BD . Reduced OFC volume and its association with lethality of suicide suggest that suicide behavior in BD may be related to the emerging neuroanatomical substrates of the disorder, particularly abnormalities of the OFC .