Home > In process > Transcranial sonography of the brainstem raphe: A rapid tool to assess the long-term risk of violent suicidal behavior in patients with major depression. > print

001     284362
005     20260130151922.0
024 7 _ |a 10.1016/j.jad.2026.121175
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024 7 _ |a 0165-0327
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024 7 _ |a 1573-2517
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037 _ _ |a DZNE-2026-00130
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Walter, Uwe
|0 P:(DE-2719)9000336
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245 _ _ |a Transcranial sonography of the brainstem raphe: A rapid tool to assess the long-term risk of violent suicidal behavior in patients with major depression.
260 _ _ |a Amsterdam [u.a.]
|c 2026
|b Elsevier Science
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520 _ _ |a To assess the relationship between ultrasonographic changes in midbrain structures and subsequent violent suicidal behavior.We conducted a retrospective analysis of a previously reported cohort of 46 patients (36 women; age 54.9 ± 11.7 years) with major depression who had been prospectively observed over a ten-year period to assess the risk of developing Parkinson's disease. At study entry, all patients underwent transcranial B-mode sonography to grade the echogenicity of the midbrain raphe and substantia nigra. The outcome measure was the first occurrence of violent suicidal behavior, i.e. a serious suicide attempt or completed suicide.At baseline, four patients were found to have grade 1 raphe echogenicity (invisible), 23 had grade 2 (weakly echogenic), and 19 had normal grade 3 (strongly echogenic). The visually graded echogenicity correlated well with the digitally analyzed echo-intensity (p < 0.001). Three (75%) patients with echogenicity grade 1 subsequently attempted or completed suicide, as did five (22%) with grade 2, but none with grade 3 (Kaplan-Meier analysis, log-rank test, p < 0.001). The latency period did not differ between echogenicity grade 1 and 2 (34.7 ± 30.9 vs. 22.6 ± 19.7 months, p = 0.59). Overall, patients with reduced raphe echogenicity were less likely to be free of subsequent violent suicidal behavior (3 years: RR, 0.78; 95% CI, 0.64-0.95; p = 0.034; 10 years: 0.70; 0.55-0.90; p = 0.014). No sex differences were found. Echogenicity of the substantia nigra did not improve the prediction of suicidal behavior.Reduced echogenicity of the midbrain raphe indicates an increased risk of subsequent violent suicidal behavior in patients with major depression.
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588 _ _ |a Dataset connected to CrossRef, PubMed, , Journals: pub.dzne.de
650 _ 7 |a Depressive disorder
|2 Other
650 _ 7 |a Diagnostic ultrasound
|2 Other
650 _ 7 |a Fatal suicide
|2 Other
650 _ 7 |a Midbrain raphe
|2 Other
650 _ 7 |a Substantia nigra
|2 Other
650 _ 7 |a Suicide prevention
|2 Other
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Major Depressive Disorder: diagnostic imaging
|2 MeSH
650 _ 2 |a Major Depressive Disorder: psychology
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Ultrasonography, Doppler, Transcranial
|2 MeSH
650 _ 2 |a Suicide, Attempted: psychology
|2 MeSH
650 _ 2 |a Suicide, Attempted: statistics & numerical data
|2 MeSH
650 _ 2 |a Retrospective Studies
|2 MeSH
650 _ 2 |a Raphe Nuclei: diagnostic imaging
|2 MeSH
650 _ 2 |a Adult
|2 MeSH
650 _ 2 |a Suicide, Completed: psychology
|2 MeSH
650 _ 2 |a Suicide, Completed: statistics & numerical data
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Substantia Nigra: diagnostic imaging
|2 MeSH
650 _ 2 |a Risk Factors
|2 MeSH
650 _ 2 |a Violence: psychology
|2 MeSH
650 _ 2 |a Parkinson Disease: diagnostic imaging
|2 MeSH
700 1 _ |a Kaulitz, Lara
|b 1
700 1 _ |a Heilmann, Robert
|b 2
700 1 _ |a Školoudík, David
|b 3
700 1 _ |a Höppner-Buchmann, Jacqueline
|b 4
773 _ _ |a 10.1016/j.jad.2026.121175
|g Vol. 399, p. 121175 -
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910 1 _ |a Deutsches Zentrum für Neurodegenerative Erkrankungen
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