Disclosures: One study author reports support from the Oakley Mental Health Research Foundation. The other authors report no relevant financial disclosures.
January 28, 2021
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Common neuroimaging measures do not detect youths' risk for suicidal thoughts, behaviors

Disclosures: One study author reports support from the Oakley Mental Health Research Foundation. The other authors report no relevant financial disclosures.
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Frequently used neuroimaging measures did not show a discrete brain signature associated with suicidal thoughts and behaviors among youths, according to study results published in American Journal of Psychiatry.

Researchers emphasized the critical need for improved approaches to the neurobiology of suicide.

Teen Sad
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Pablo Vidal-Ribas

“First, it is still unclear whether findings from neuroimaging studies examining suicidal thoughts and behaviors apply to children, because most studies have been conducted using adult samples,” Pablo Vidal-Ribas, PhD, of the Social and Behavioral Sciences Branch at the National Institute of Child Health and Human Development, and colleagues wrote. “Second, results of these studies have been inconsistent. Whereas systematic reviews on the topic suggest that suicidal thoughts and behaviors are associated with abnormalities in regions involved in affective processing and impulsive regulation, the specific regions highlighted in each review differ, and all emphasize the modest sample sizes, heterogeneity and lack of replicability across studies.”

The researchers analyzed data of a U.S. population-based sample of 7,994 unrelated children aged 9 to 10 years who were included in the Adolescent Brain Cognitive study. Specifically, they sought to evaluate this patient population’s suicidal thoughts and behaviors for their classification accuracy of individual, environmental and clinical characteristics, as well as multimodal brain imaging correlates. They implemented quality control procedures and examined structural MRI data of 6,238 participants, resting state functional MRI data of 4,134 participants and task-based functional MRI data of between 4,075 and 4,608 participants.

Results showed participants with lifetime suicidal thoughts and behaviors according to child, caregiver and concordant reports exhibited higher levels and social adversity and psychopathology, which was notable among themselves as well as their caregivers, compared with children who were never suicidal. Caregiver-reported suicidal thoughts and behaviors were linked to a thinner left bank of the superior temporal sulcus, which was the only imaging test to survive statistical correction. According to prespecified bounds of the study, the researchers considered equivalent the approximately 48% of the group mean differences for child-reported suicidal thoughts and behaviors comparison and approximately 22% for caregiver-reported suicidal thoughts and behaviors comparisons. Further, they noted the relatively small nature of all observed effect sizes and that both non-imaging and imaging correlates demonstrated low classification accuracy.

“Suicidal thoughts and behaviors are an extremely complex and multicausal phenomenon with different types of correlates varying through the lifespan,” Vidal-Ribas told Healio Psychiatry. “That neural correlates of suicidality are not visible at young ages does not mean that these could not be visible later in development or in impaired children.”