jeudi 29 octobre 2015

RECHERCHE ETUDE FRANCE CANADA Traitement de la prise de décision et la menace sociale chez les patients ayant des antécédents de tentative de suicide: une étude de réplication de la neuro-imagerie

Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.
Olié E1, Ding Y2, Le Bars E3, de Champfleur NM3, Mura T4, Bonafé A5, Courtet P6, Jollant F2.

1Department of Emergency Psychiatry & Post Acute Care Academic Hospital of Montpellier & Montpellier University, INSERM U1061, Montpellier, France. Electronic address: e-olie@chu-montpellier.fr.
2McGill University, Department of Psychiatry, and Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada.
3Department of Neuroradiology, Academic Hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France; I2FH / CNRS UMR 5221, Montpellier University Montpellier, France.
4Clinical Investigation Center, Academic Hospital Montpellier & Inserm, CIC 1411, Montpellier, France.
5Department of Neuroradiology, Academic Hospital of Montpellier & U1051, Institut of Neurosciences of Montpellier, Montpellier, France.
6Department of Emergency Psychiatry & Post Acute Care Academic Hospital of Montpellier & Montpellier University, INSERM U1061, Montpellier, France.
 Psychiatry Res. 2015 Oct 16. pii: S0925-4927(15)30113-X. doi: 10.1016/j.pscychresns.2015.09.020.

Abstract
Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Magnetic resonance imaging; Prefrontal cortex; Suicide
http://www.ncbi.nlm.nih.gov/pubmed/26483212

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