Connectome-based functional connectivity markers of suicide attempt

Abstract Background: Functional brain markers of suicidality can help identify at-risk individuals and uncover underlying neurocognitive mechanism(s). Although some converging evidence has implicated dysfunction in several brain networks, suicide-related neuroimaging markers are inconsistent across studies, due to heterogeneity of neuroimaging approaches, clinical populations, and experimental methods. Methods: The current study aimed to address these limitations by examining resting-fMRI connectivity in a sample of post-9/11 veterans with a past suicide attempt (SAs; n = 16) compared to a psychiatric control group (PCs; n = 124) with no SA history but comparable past and present symptomatology, as well as a trauma control group (TC; n =66) of trauma-exposed healthy veterans. We used both a novel graph analytic and seed-based approach to characterize SA-related connectivity differences across brain networks. Results: First, the graph-analytic approach identified the right amygdala and a region in the cognitive control network (right middle temporal gyrus; MTG) as regional SA-related hubs of dysfunction (HoD), or regions that exhibited a high number of SA-related connections. Aberrant SA-related connectivity between these hubs spanned multiple networks, including the cognitive control, default mode and visual networks. Second, the seed-based connectivity analysis that identifies SA-related differences in the strength of neural connections across the whole brain further implicated the right amygdala. Limitations: Small sample size and potential underreporting of SA. Conclusions: These two analytic approaches preliminarily suggest that the right amygdala and right MTG may be specific neural markers of SA that can be differentiated from neural markers of psychopathology more broadly.