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Left rostrolateral prefrontal cortex lesions reduce suicidal ideation in penetrating traumatic brain injury

Published online by Cambridge University Press:  10 April 2019

Matteo Pardini Open the ORCID record for Matteo Pardini [Opens in a new window] ,
Jordan Grafman ,
Vanessa Raymont ,
Mario Amore ,
Gianluca Serafini ,
Michael Koenigs  and
Frank Krueger Open the ORCID record for Frank Krueger [Opens in a new window]
Matteo Pardini
Affiliation:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa
Jordan Grafman*
Affiliation:
Ospedale Policlinico S. Martino-IRCCS, Genova
Vanessa Raymont
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, United Kingdom Centre for Dementia Prevention, University of Edinburgh, United Kingdom
Mario Amore
Affiliation:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa
Gianluca Serafini
Affiliation:
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa
Michael Koenigs
Affiliation:
Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
Frank Krueger*
Affiliation:
School of Systems Biology, George Mason University, Fairfax, VA, USA
*
*Address correspondence to: Frank Krueger, PhD, School of Systems Biology, George Mason University, 4400 University Drive, Fairfax, MS 2A1, VA 22030, USA. (Email: fkrueger@gmu.edu). For general information regarding the Vietnam Head Injury Study (VHIS) registry please contact: Jordan Grafman, PhD, Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA. (Email: jgrafman@northwestern.edu)
*Address correspondence to: Frank Krueger, PhD, School of Systems Biology, George Mason University, 4400 University Drive, Fairfax, MS 2A1, VA 22030, USA. (Email: fkrueger@gmu.edu). For general information regarding the Vietnam Head Injury Study (VHIS) registry please contact: Jordan Grafman, PhD, Cognitive Neuroscience Laboratory, Shirley Ryan AbilityLab, Chicago, IL, USA. (Email: jgrafman@northwestern.edu)
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Abstract

Objectives.

The objective of this study is to evaluate the relationship between suicidal ideation (SI), structural brain damage, and cognitive deficits in patients with penetrating traumatic brain injury (pTBI).

Methods.

Vietnam War veterans (n = 142) with pTBI to the prefrontal cortex (PFC) underwent combination of neuropsychological and psychiatric examinations and non-contrast CT brain scan. Patients were divided into SI positive (SI+) and SI negative (SI−) groups according to the SI item of the Beck Depression Inventory.

Results.

Lesions to the left rostrolateral PFC (rlPFC) were associated with a lower risk of SI independent of depression and global functioning. Left rlPFC lesion also reduced abstract reasoning skills, which mediated the lesion effects on suicide ideation.

Conclusions.

The left rlPFC plays a crucial role in SI independently of depression and global functioning.

Keywords

Suicidalitytraumatic brain injurycognitionfrontal lobe
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 1 , February 2020 , pp. 24 - 31
Copyright
© Cambridge University Press 2019

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Footnotes

This work was supported by the National Institute of Neurological Disorders and Stroke intramural research program and a project grant from the United Sates Army Medical Research and Material Command administered by the Henry M. Jackson Foundation (Vietnam Head Injury Study Phase III: A 30 Year Post-Injury Follow-Up Study, Grant number DAMD17-01-1-0675). We are grateful to S. Bonifant, B. Cheon, C. Ngo, A. Greathouse, K. Reding, and G. Tasick for their invaluable help with the testing of participants and organization of this study. We thank Sergio Paradiso, MD, for his insights on the possible effects of pTBI on SI.

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