Reduced ventromedial prefrontal cortex volume and impaired attention associated with past suicide attempts in patients with mood disorders

INTRODUCTION: Patients with mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD) are at heightened risk of suicidal behavior. Therefore, there is an urgent need for biomarkers to enable enhanced prevention approaches in high-risk individuals. Among potential biomarkers, brain structural measures and cognitive function are particularly promising.

OBJECTIVES: This study aims to replicate the role of ventromedial prefrontal cortex (vmPFC) in suicidal behavior across patients with mood disorders (MD) and to examine cognitive domains that may be impaired in this population.

METHODS: Data on prior suicide attempts (SA) were obtained from the Danish Registers in a sample of 307 patients with MD who had magnetic resonance imaging (MRI) data (22 patients with MD and SA [MDSA], 285 patients with MD and no SA [MDNSA]) and an overlapping sample of 489 patients with neurocognitive assessments (31 MDSA, 458 MDNSA).

RESULTS: MDSA showed lower vmPFC volume compared to MDNSA (p = 0.04). Secondarily, it was found that MDSA show greater attention deficits in comparison with MDNSA (p = 0.03), with no significant differences in the other neurocognitive functions.

CONCLUSIONS: Reduced vmPFC volume and deficits in attention may be associated with history of suicidal behaviors in patients with MD. These findings support previous research highlighting the role of vmPFC in suicidal behavior and suggest that there may be specific cognitive subdomains that are particularly affected, offering potential intervention targets for future evaluation.