History of Suicide Attempt Is Associated with Reduced Medial Prefrontal Cortex Activity during Emotional Decision-Makingamong Men with Schizophrenia: An Exploratory fMRI Study

Despite the high prevalence of suicidal ideas/attempts in schizophrenia, only a handful of neuroimaging studies have examined theneurobiological differences associated with suicide risk in this population. The main objective of the current exploratory study is toexamine the neurofunctional correlates associated with a history of suicide attempt in schizophrenia, using a risky decision-makingtask, in order to show alterations in brain reward regions in this population. Thirty-two male outpatients with schizophrenia wererecruited: 13 patients with (SCZ + S) and 19 without a history of suicidal attempt (SCZ−S). Twenty-one healthy men with nohistory of mental disorders or suicidal attempt/idea were also recruited. Participants were scanned using fMRI while performingtheBalloon Analogue Risk Task. A rapid event-related fMRI paradigm was used, separating decision and outcome events, and theexplosion probabilities were included as parametric modulators. The most important finding of this study is that SCZ + S patientshad reduced activations of the medial prefrontal cortex during the success outcome event (with parametric modulation), relative toboth SCZ−S patients and controls, as illustrated by a spatial conjunction analysis. These exploratory results suggest that a historyof suicidal attempt in schizophrenia is associated with blunted brain reward activity during emotional decision-making.