Charles P. Lewis, M.D.

Fellow In Child & Adolescent Depression

Project Details

Project Title

Neurometabolite Markers of Suicide-Related Cognition in Adolescents

Project Summary

Suicide is the second-leading cause of death in adolescence, and rates of suicides and suicidal behavior among youth are increasing. However, current treatments are not based on the growing evidence of brain dysfunction in suicidality. Neurobiological treatments that correct disruptions in brain networks involved in suicidal behavior are desperately needed. Previous research has implicated the brain’s primary excitatory and inhibitory neurotransmitters, glutamate and γ-aminobutyric acid (GABA), respectively, in suicidality. Concentrations of glutamate, GABA, and related metabolites can be measured noninvasively using proton magnetic resonance spectroscopy (1H-MRS). Our prior 1H-MRS research found that glutamatergic metabolism was disrupted in the anterior cingulate cortex (ACC), a brain region critical to emotion regulation, interpreting relevance to the self, and implicit cognitive associations. Other previous research has found that ACC-related cognitive functions are deficient in suicidal youth, and may predict future suicidal behavior. This study will obtain 1H-MRS measurements of ACC metabolites and will measure implicit cognitive associations with suicide-related stimuli in 30 depressed adolescent participants with and without suicidal behavior. Additionally, we will use more advanced imaging methods (1H-MRS at 7 Tesla, necessary for reliable measurement of the excitatory and inhibitory neurometabolites of interest) and directly examine the link between ACC excitatory–inhibitory neurochemistry and performance on a cognitive task with known relevance to suicidal behavior. Findings from this study will support future work that will evaluate noninvasive interventions that can modulate ACC functioning, such as transcranial magnetic stimulation, for treatment of adolescents with suicidal behavior.

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