Journal of affective disorders · 2026
Transcranial sonography of the brainstem raphe: A rapid tool to assess the long-term risk of violent suicidal behavior in patients with major depression.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Walter Uwe, Kaulitz Lara, Heilmann Robert, Školoudík David, Höppner-Buchmann Jacqueline
Аннотация
OBJECTIVE: To assess the relationship between ultrasonographic changes in midbrain structures and subsequent violent suicidal behavior.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Reduced echogenicity of the midbrain raphe indicates an increased risk of subsequent violent suicidal behavior in patients with major depression.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Reduced echogenicity of the midbrain raphe indicates an increased risk of subsequent violent suicidal behavior in patients with major depression.