Potential association between suicide risk, aggression, impulsivity, and the somatosensory system.

Yoojin Lee, Jessica R Gilbert, Laura R Waldman, Carlos A Zarate, Elizabeth D Ballard
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Abstract

Aggression and impulsivity are linked to suicidal behaviors, but their relationship to the suicidal crisis remains unclear. This magnetoencephalography (MEG) study investigated the link between aggression, impulsivity, and resting-state MEG power and connectivity. Four risk groups were enrolled: high-risk (HR; n = 14), who had a recent suicidal crisis; lower-risk (LR; n = 41), who had a history of suicide attempts but no suicide attempt or ideation in the past year; clinical control (CC; n = 38), who had anxiety/mood disorders but no suicidal history; and minimal risk (MR; n = 28), who had no psychiatric/suicidal history. No difference in resting-state MEG power was observed between the groups. Individuals in the HR group with high self-reported aggression and impulsivity scores had reduced MEG power in regions responsible for sensory/emotion regulation vs. those in the HR group with low scores. The HR group also showed downregulated bidirectional glutamatergic feedback between the precuneus (PRE) and insula (INS) compared to the LR, CC, and MR groups. High self-reported impulsivity was linked to reduced PRE to INS feedback, whereas high risk-taking impulsivity was linked to upregulated INS to postcentral gyrus (PCG) and PCG to INS feedback. These preliminary findings suggest that glutamatergic-mediated sensory and emotion-regulation processes may function as potential suicide risk markers.

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自杀风险、攻击性、冲动性和体感系统之间的潜在关联。
攻击性和冲动性与自杀行为有关,但它们与自杀危机的关系仍不清楚。这项脑磁图(MEG)研究调查了攻击性、冲动性与静息态脑磁图功率和连接性之间的联系。研究共分为四个风险组:高风险组(HR,人数=14),即近期有自杀危机的人;低风险组(LR,人数=41),即有自杀未遂史但在过去一年中没有自杀未遂或自杀意念的人;临床对照组(CC,人数=38),即有焦虑/情绪障碍但没有自杀史的人;以及极低风险组(MR,人数=28),即没有精神病/自杀史的人。各组间静息态 MEG 功率无差异。自述攻击性和冲动性得分较高的 HR 组与得分较低的 HR 组相比,负责感觉/情绪调节区域的 MEG 功率有所降低。与 LR、CC 和 MR 组相比,HR 组还显示出楔前(PRE)和脑岛(INS)之间的双向谷氨酸能反馈下调。自我报告的高冲动性与 PRE 对 INS 的反馈减少有关,而高风险冲动性则上调了 INS 对中央后回(PCG)以及 PCG 对 INS 的反馈。这些初步研究结果表明,谷氨酸能介导的感觉和情绪调节过程可能是潜在的自杀风险标记。
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