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. 2014 Oct 31;18(1):pyu069.
doi: 10.1093/ijnp/pyu069.

Neural correlates of suicidal ideation and its reduction in depression

Elizabeth D Ballard  1 , Níall Lally  2 , Allison C Nugent  2 , Maura L Furey  2 , David A Luckenbaugh  2 , Carlos A Zarate Jr  2
Affiliations

Neural correlates of suicidal ideation and its reduction in depression

Elizabeth D Ballard et al. Int J Neuropsychopharmacol. .

Abstract

Background: The neural correlates of suicidal ideation and its reduction after treatment are unknown. We hypothesized that increased regional cerebral glucose metabolism in the infralimbic cortex (Brodmann area 25), amygdala, and subgenual anterior cingulate cortex would be associated with suicidal ideation and its reduction after ketamine infusion.

Methods: Medication-free patients (n=19) with treatment-resistant major depressive disorder underwent positron emission tomography imaging at baseline and 230 minutes after an open-label ketamine infusion (0.5 mg/kg for 40 minutes).

Results: Baseline suicidal ideation and regional cerebral glucose metabolism in the infralimbic cortex were significantly correlated (r=.59, P=.007); but not overall mood scores (r=-.07, P=.79). Reductions in suicidal ideation after ketamine infusion were correlated with decreased regional cerebral glucose metabolism in the infralimbic cortex (r=.54, P=.02). Metabolism in other areas of interest was not significantly correlated with suicidal ideation or depression.

Conclusion: The infralimbic cortex may be implicated in suicidal ideation.

Keywords: PET imaging; depression; ketamine; suicidal ideation.

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Figures

Figure 1.
Figure 1.
(A) Regional placement of the infralimbic cortex (in red) and subgenual cingulate cortex (in blue) overlaid on template. (B) Scatterplot depicting the relationship between baseline suicidal ideation (suicide item from Hamilton Depression Rating Scale [HAMD]) and normalized rate of metabolic change (rMRGlu) in infralimbic cortex. (C) Scatterplot depicting the relationship between baseline depression (all other items from HAMD) and rMRGlu in infralimbic cortex. (D) Statistical parametric map illustrating the voxelwise correlation between change in metabolism and change in suicidal ideation 230 minutes following ketamine infusion, relative to baseline. The color bar depicts the corresponding voxel t statistic value. Only the cluster surviving family wise error cluster correction is presented.
See this image and copyright information in PMC

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