Conflict-Related Anterior Cingulate Functional Connectivity Is Associated With Past Suicidal Ideation and Behavior in Recent-Onset Psychotic Major Mood Disorders

Suicidal ideation and behavior are highly prevalent in psychotic major mood disorders, yet their relationship to brain function remains unclear. Thirty patients with recent-onset of bipolar disorder type I (N=21) or major depressive disorder (N=9) with past psychosis were evaluated for past suicidal ideation/behavior and functional MRI during conflict-monitoring. Suicidal ideation was related to relatively higher dorsal anterior cingulate cortex (dACC)-seeded functional connectivity with dorsal fronto-parietal and inferior temporal-occipital cortex, as well as lower dACC connectivity with bilateral ventrolateral prefrontal cortex (PFC) and adjacent fronto-striatal regions. Past suicidal behavior was associated with lower dACC functional connectivity with dorsolateral PFC and premotor cortex, as well as temporal-parietal cortex.