Relationship between suicidality and impulsivity in bipolar I disorder: a diffusion tensor imaging study

Authors

  • Katie Mahon,

    1. Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset
    2. Psychiatry Research, The Zucker Hillside Hospital, North Shore–Long Island Jewish (LIJ) Health System, Glen Oaks
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  • Katherine E Burdick,

    1. Department of Psychiatry, Mount Sinai School of Medicine, New York
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  • Jinghui Wu,

    1. Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset
    2. Psychiatry Research, The Zucker Hillside Hospital, North Shore–Long Island Jewish (LIJ) Health System, Glen Oaks
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  • Babak A Ardekani,

    1. Center for Advanced Brain Imaging, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg
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  • Philip R Szeszko

    1. Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset
    2. Psychiatry Research, The Zucker Hillside Hospital, North Shore–Long Island Jewish (LIJ) Health System, Glen Oaks
    3. Departments of Psychiatry and Molecular Medicine, Hofstra North Shore–LIJ School of Medicine, Hempstead, NY, USA
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Corresponding author:
Philip R. Szeszko, Ph.D.
Psychiatry Research
The Zucker Hillside Hospital
75-59 263rd Street
Glen Oaks, NY 11004
USA
Fax: 718-343-1659
E-mail: szeszko@lij.edu

Abstract

Mahon K, Burdick KE, Wu J, Ardekani BA, Szeszko PR. Relationship between suicidality and impulsivity in bipolar I disorder: a diffusion tensor imaging study.
Bipolar Disord 2012: 14: 80–89. © 2012 The Authors.
Journal compilation © 2012 John Wiley & Sons A/S.

Background:  Impulsivity is characteristic of individuals with bipolar disorder and may be a contributing factor to the high rate of suicide in patients with this disorder. Although white matter abnormalities have been implicated in the pathophysiology of bipolar disorder, their relationship to impulsivity and suicidality in this disorder has not been well-investigated.

Methods:  Diffusion tensor imaging scans were acquired in 14 bipolar disorder patients with a prior suicide attempt, 15 bipolar disorder patients with no prior suicide attempt, and 15 healthy volunteers. Bipolar disorder patients received clinical assessments including measures of impulsivity, depression, mania, and anxiety. Images were processed using the Tract-Based Spatial Statistics method in the FSL software package.

Results:  Bipolar disorder patients with a prior suicide attempt had lower fractional anisotropy (FA) within the left orbital frontal white matter (p < 0.05, corrected) and higher overall impulsivity compared to patients without a previous suicide attempt. Among patients with a prior suicide attempt, FA in the orbital frontal white matter region correlated inversely with motor impulsivity.

Conclusions:  Abnormal orbital frontal white matter may play a role in impulsive and suicidal behavior among patients with bipolar disorder.

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