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

CNS Spectr. 2020 Feb;25(1):24-31. doi: 10.1017/S1092852918001694.

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: Suicidality; cognition; frontal lobe; traumatic brain injury.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Brain Injuries, Traumatic / diagnosis
  • Brain Injuries, Traumatic / diagnostic imaging
  • Brain Injuries, Traumatic / psychology*
  • Cognition
  • Head Injuries, Penetrating / diagnosis
  • Head Injuries, Penetrating / diagnostic imaging
  • Head Injuries, Penetrating / psychology*
  • Humans
  • Male
  • Memory
  • Middle Aged
  • Prefrontal Cortex / diagnostic imaging*
  • Suicidal Ideation*
  • Tomography, X-Ray Computed
  • Veterans