Diffusion tensor imaging studies on subjects with suicidal thoughts and behaviors: A descriptive literature review

OBJECTIVE: Globally, suicide represents the second leading cause of death in young people aged 15–29 years for both sexes, after traffic accidents. Suicide occurs not only in high‐income countries, in high‐income countries but it is a global phenomenon in all regions of the world and it represents a serious public health problem. METHOD: This review was conducted on studies focused on white matter alterations in people who have attempted or thought about suicide. We searched PubMed and Scopus databases and screened references of included studies and reviewed articles for additional citations. From the initial 21 publications, we included only 12 studies that met search criteria and described the association between white matter alterations and suicide. RESULTS: White matter alterations in suicidal behaviors were found in the prefrontal cortex, orbitofrontal cortex, internal capsule, corpus callosum, and default mode networks, which are critical cerebral areas involved in emotion processing and regulation, decision‐making, executive functions, and empathy. CONCLUSIONS: White matter alteration in cerebral areas involving high cognitive process and emotional regulation to confer a heightened vulnerability for suicidal behavior. Suicide is a complex process ranging from suicidal ideation to planning, attempting, or committing suicide. The identification of abnormalities in underlying neural circuitry may help delineate the neurobiological basis for suicide risk.