Structural brain changes are found in suicide attempters and in patients with mental disorders. It remains unclear whether the suicidal behaviors are related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. The sample consisted of 56 patients hospitalized after first suicide attempt (first SA) (n = 29), more than one suicide attempt (SA > 1) (n = 27) and 54 healthy controls (HC). Brain volume was measured using FreeSurfer 6.0 automatic segmentation technique. In comparison to HC, patients with first SA had significantly lower cortical thickness of the superior and rostral middle frontal areas, the inferior, middle and superior temporal areas of the left hemisphere and superior frontal area of the right hemisphere. In comparison to HC, patients after SA > 1 had a significantly lower cortical thickness in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere. The comparison of hippocampus volume showed a significantly lower mean volume of left and right parts in patients with SA > 1, but not in patients with first SA. The atrophy of frontal, temporal cortex and hippocampus parts was significantly higher in repeated suicide attempters than in patients with first suicide attempt.

In 2016, the World Health Organisation Classification (WHO) of Tumours was updated with diffuse leptomeningeal glioneuronal tumour (DLGNT) as a provisional unit of mixed neuronal and glial tumours. Here, we report a DLGNT that has been re-diagnosed with the updated WHO classification, with clinical features, imaging, and histopathological findings and a 9-year follow-up. A 16-year-old girl presented with headache, vomiting, and vertigo. Magnetic resonance imaging (MRI) demonstrated a hyperintense mass with heterogenous enhancement in the right cerebellopontine angle and internal auditory canal. No leptomeningeal involvement was seen. The histological examination revealed neoplastic tissue of moderate cellularity formed mostly by oligodendrocyte-like cells. Follow-up MRI scans demonstrated cystic lesions in the subarachnoid spaces in the brain with vivid leptomeningeal enhancement. Later spread of the tumour was found in the spinal canal. On demand biopsy samples were re-examined, and pathological diagnosis was identified as DLGNT. In contrast to most reported DLGNTs, the tumour described in this manuscript did not present with diffuse leptomeningeal spread, but later presented with leptomeningeal involvement in the brain and spinal cord. Our case expands the spectrum of radiological features, provides a long-term clinical and radiological follow-up, and highlights the major role of molecular genetic testing in unusual cases.

We implemented a multimodal approach to examine associations between structural and neurochemical changes that could signify neurodegenerative processes related to mild cognitive impairment (MCI). Fifty-nine older adults (60–85 years; 22 MCI) underwent whole-brain structural 3T MRI (T1W, T2W, DTI) and proton magnetic resonance spectroscopy (¹H-MRS). The regions of interest (ROIs) for ¹H-MRS measurements were the dorsal posterior cingulate cortex, left hippocampal cortex, left medial temporal cortex, left primary sensorimotor cortex, and right dorsolateral prefrontal cortex. The findings revealed that subjects in the MCI group showed moderate to strong positive associations between the total N-acetylaspartate to total creatine and the total N-acetylaspartate to myo-inositol ratios in the hippocampus and dorsal posterior cingulate cortex and fractional anisotropy (FA) of WM tracts crossing these regions—specifically, the left temporal tapetum, right corona radiata, and right posterior cingulate gyri. In addition, negative associations between the myo-inositol to total creatine ratio and FA of the left temporal tapetum and right posterior cingulate gyri were observed. These observations suggest that the biochemical integrity of the hippocampus and cingulate cortex is associated with a microstructural organization of ipsilateral WM tracts originating in the hippocampus. Specifically, elevated myo-inositol might be an underlying mechanism for decreased connectivity between the hippocampus and the prefrontal/cingulate cortex in MCI.

Background Structural brain changes are found in suicide attempters, as well as in patients with mental disorders. It remains unclear whether the suicidal behavior is related to atrophy of brain regions and how the morphology of specific brain areas is changing with each suicide attempt. This cross-sectional study examined volumetric differences in brain regions among patients with history of first and repeated suicide attempts in comparison to healthy controls (HC). Methods The sample consisted of 56 adults, non-psychotic patients without cognitive impairment and any organic brain disorders hospitalized after first suicide attempt (first SA) (n=29) and more than one suicide attempt (SA>1) during the lifetime (n=27); and 54 adult volunteers without history of mental disorder and suicide attempts, designated as HC. The MRI data were collected using 1.5 T Siemens Avanto scanner. Brain cortical thickness, grey and white matter volumes were measured using FreeSurfer 6.0 automatic segmentation technique. Results In comparison to HC, patients with first SA had 3.5, 3.58 and 4.19% significantly lower mean cortical thickness of the superior and rostral middle frontal areas of the left hemisphere and superior frontal area of the right hemisphere, respectively; 4.09, 4.02 and 4.49% lower mean cortical thickness of the inferior, middle and superior temporal areas of the left hemisphere, respectively. In comparison to HC, patients after SA>1 had a significantly lower mean cortical thickness (from 4.02 to 8.33%) in ten areas of frontal cortex of the left hemisphere and seven areas of the right hemisphere; from 3.90 to 6.04% difference in six areas of temporal cortex in both hemispheres. The comparison of hippocampus volume showed a significantly lower mean volume (7.86 to 9.89%) of left and right parts in patients with SA>1, but not in patients with first SA. Conclusions Hospitalized suicide attempters had lower frontal and temporal cortical thickness and smaller parts of hippocampus than HC; these differences were significantly higher in repeated suicide attempters than in patients with first SA. Our findings suggest that repeated suicidal behavior is associated with intensifying atrophy of specific brain structures, independently of diagnosis of depressive disorders.