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2 results

  • Chapter Six - Images of the Suicidal Brain

  • Kees van Heeringen
  • Book:
    The Neuroscience of Suicidal Behavior
    Published online:
    22 May 2019
    Print publication:
    23 August 2018, pp 102-124

  • Summary

    In addition to neurocognitive studies, neuroimaging techniques provide a unique opportunity to study brain characteristics. Structural imaging studies clearly demonstrate volumetric differences in particular brain areas between individuals with a history of nonfatal suicidal behavior and those without such a history. Functional imaging studies show a reduced prefrontal perfusion or metabolism and a blunted increase in activation when challenged in the brains of individuals with a history of suicide attempts. Moreover, impairment of the prefrontal serotonergic system in association with suicidal behavior is demonstrated in a number of studies. Recent structural and functional imaging studies show changes in cortical and subcortical areas and their connections in association with suicidal behavior and risk factors such as mental pain, hopelessness, and impulsivity. The global picture that emerges from these studies reflects the involvement of a particular circuit in the development of suicidal behavior, the so-called frontothalamic network.

  • 6 - Structural and functional brain imaging in treatment-resistant depression

  • from Part II - Biological basis
  • Edited by Jay D. Amsterdam, University of Pennsylvania, Mady Hornig, University of California, Irvine, Andrew A. Nierenberg
  • Book:
    Treatment-Resistant Mood Disorders
    Published online:
    25 March 2010
    Print publication:
    28 June 2001, pp 111-141

  • Summary

    This chapter shows that structural and functional brain imaging methods have offered into the neural substrates of affective processes as well as the current and possible future utility of these methods in the evaluation and management of patients with treatment-resistant mood disorders. Neuroanatomic models of the substrates of affective processes were originally derived from non-human animal studies in addition to postmortem and in vivo studies of humans with brain trauma, neurologic, and psychiatric disorders. The chapter reviews brain imaging studies in mood disorders, which in many cases demonstrate disruptions in anterior paralimbic structures and anterior basal ganglia-thalamocortical circuits. Many of these studies involved treatment-resistant patients or patients in tertiary care institutions and thus may be particularly indicative of the neurobiology of treatment-resistant mood disorders. Thus, a useful initial approach to the treatment-resistant mood disorder patient is to reassess whether the disorder is primary or secondary.