A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth

Introduction. Risk of suicidal ideation and suicidal behaviors greatly increases during adolescence, and rates have risen dramatically over the past two decades. However, few risk factors or biomarkers predictive of suicidal ideation or attempted suicide have been identified in adolescents. Neuroima...

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Main Authors: Olga Tymofiyeva, Katherine W. Reeves, Chace Shaw, Eric Lopez, Sepehr Aziz, Jeffrey E. Max, Tony T. Yang
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.1155/2023/7254574
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author Olga Tymofiyeva
Katherine W. Reeves
Chace Shaw
Eric Lopez
Sepehr Aziz
Jeffrey E. Max
Tony T. Yang
author_facet Olga Tymofiyeva
Katherine W. Reeves
Chace Shaw
Eric Lopez
Sepehr Aziz
Jeffrey E. Max
Tony T. Yang
author_sort Olga Tymofiyeva
collection DOAJ
description Introduction. Risk of suicidal ideation and suicidal behaviors greatly increases during adolescence, and rates have risen dramatically over the past two decades. However, few risk factors or biomarkers predictive of suicidal ideation or attempted suicide have been identified in adolescents. Neuroimaging correlates hold potential for early identification of adolescents at increased risk of suicidality and risk stratification for those at high risk of suicide attempt. Methods. In this systematic review, we evaluated neural regions and networks associated with suicidal ideation and suicide attempt in adolescents derived from magnetic resonance imaging (MRI) studies. A total of 28 articles were included in this review. Results. After descriptively synthesizing the literature, we propose the Emotional paiN and social Disconnect (END) model of adolescent suicidality and present two key neural circuits: (1) the emotional/mental pain circuit and (2) the social disconnect/distortion circuit. In the END model, the emotional pain circuit—consisting of the cerebellum, amygdala, and hippocampus—shows similar aberrations in adolescents with suicidal ideation as in those with a history of a suicide attempt (but to a smaller degree). The social disconnect circuit is unique to adolescent suicide attempters and includes the lateral orbitofrontal cortex (OFC), the temporal gyri, and the connections between them. Conclusion. Our proposed END brain model of suicidal behavior in youth, if confirmed by future prospective studies, can have implications for clinical goals of early detection, risk stratification, and intervention development. Treatments that target emotional pain and social disconnect may be ideal interventions for reducing suicidality in adolescents.
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spelling doaj-art-e15884dbaa954507b8194e10c74900682025-08-20T03:21:06ZengWileyBehavioural Neurology1875-85842023-01-01202310.1155/2023/7254574A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in YouthOlga Tymofiyeva0Katherine W. Reeves1Chace Shaw2Eric Lopez3Sepehr Aziz4Jeffrey E. Max5Tony T. Yang6Department of Radiology and Biomedical ImagingPhilip R. Lee Institute for Health Policy StudiesDepartment of Psychiatry and Behavioral SciencesDepartment of Psychiatry and Behavioral SciencesDepartment of Psychiatry and Behavioral SciencesDepartment of PsychiatryDepartment of Psychiatry and Behavioral SciencesIntroduction. Risk of suicidal ideation and suicidal behaviors greatly increases during adolescence, and rates have risen dramatically over the past two decades. However, few risk factors or biomarkers predictive of suicidal ideation or attempted suicide have been identified in adolescents. Neuroimaging correlates hold potential for early identification of adolescents at increased risk of suicidality and risk stratification for those at high risk of suicide attempt. Methods. In this systematic review, we evaluated neural regions and networks associated with suicidal ideation and suicide attempt in adolescents derived from magnetic resonance imaging (MRI) studies. A total of 28 articles were included in this review. Results. After descriptively synthesizing the literature, we propose the Emotional paiN and social Disconnect (END) model of adolescent suicidality and present two key neural circuits: (1) the emotional/mental pain circuit and (2) the social disconnect/distortion circuit. In the END model, the emotional pain circuit—consisting of the cerebellum, amygdala, and hippocampus—shows similar aberrations in adolescents with suicidal ideation as in those with a history of a suicide attempt (but to a smaller degree). The social disconnect circuit is unique to adolescent suicide attempters and includes the lateral orbitofrontal cortex (OFC), the temporal gyri, and the connections between them. Conclusion. Our proposed END brain model of suicidal behavior in youth, if confirmed by future prospective studies, can have implications for clinical goals of early detection, risk stratification, and intervention development. Treatments that target emotional pain and social disconnect may be ideal interventions for reducing suicidality in adolescents.http://dx.doi.org/10.1155/2023/7254574
spellingShingle Olga Tymofiyeva
Katherine W. Reeves
Chace Shaw
Eric Lopez
Sepehr Aziz
Jeffrey E. Max
Tony T. Yang
A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
Behavioural Neurology
title A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
title_full A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
title_fullStr A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
title_full_unstemmed A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
title_short A Systematic Review of MRI Studies and the “Emotional paiN and social Disconnect (END)” Brain Model of Suicidal Behavior in Youth
title_sort systematic review of mri studies and the emotional pain and social disconnect end brain model of suicidal behavior in youth
url http://dx.doi.org/10.1155/2023/7254574
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