A potential neural pathway for explaining suicidal behaviour: Does it exist?

Abstract

Suicide is a major health problem, with a lack of decline in suicide rates over the past few decades suggesting that existing treatment methods are insufficient for dealing with suicidal behaviour. A review of the existing neuroimaging literature on suicidal behaviour suggests that a core, “skeleton” neural pathway exists in most suicidal individuals, who tend to have structural and functional alterations in the anterior cingulate cortex, orbitofrontal cortex, and insular cortex. This altered neural pathway explains the two main cognitive-behavioural characteristics observed in suicidal individuals: impaired decision-making, and emotional dysregulation. Abnormalities in other brain regions may exist in certain suicidal individuals; most notably, the presence of a comorbid mental disorder may be correlated with impairments of specific brain structures depending on the disorder present. Future neuroscientific and psychological research should aim to increase the replicability of neuroimaging studies, determine the extent that a comorbid mental disorder impacts an observed location of neural abnormality, and unify terminology definitions used in the study of suicide to increase validity and compatibility across suicidology research.