Fmri Features in Recent Suicide Attempters Performing the Future Imagination Task Publisher



M Esmaeilzadeh MILAD ; M Fattahi MORTEZA ; N Rasouli NAFEE ; H Soltanianzadeh HAMID ; Ma Sisara Majid ABBASI ; E Rajab EHSAN ; A Jafari AMIRHOSSEIN ; Sk Malakouti Seyed KAZEM
Source: Psychiatry Research - Neuroimaging Published:2025

Abstract

Background: A negative future outlook increases vulnerability to depression and suicide. Understanding neural mechanisms of future-oriented thinking may reveal insights into suicide risk. This study used fMRI to identify brain activation patterns during future imagination in individuals with recent suicide attempts. Methods: Sixty-two participants were grouped as recent suicide attempters with major depressive disorder (SA+MDD), depressed individuals without suicide history (MDD), and healthy controls (HC). Diagnoses were confirmed via SCID-5-RV. Participants performed a block-designed future imagination task with positive and negative scenarios during fMRI. Results: Compared to MDD, the SA+MDD group showed increased activation in the left orbitofrontal cortex, bilateral cingulate, insula, and inferior frontal gyrus, but decreased activity in the left parahippocampus and postcentral gyrus. During positive imagination, greater activation was observed in the right orbitofrontal cortex, supramarginal gyrus, and left superior temporal regions. Psychologically, SA+MDD individuals had lower “reasons for living” and higher suicidal ideation. Conclusion: Recent suicide attempters exhibit heightened neural responses to negative future events, reflecting increased threat perception and emotion dysregulation. Hyperactivation in reward-related areas may facilitate suicidal behavior as escape from psychological pain, while reduced episodic memory engagement impairs adaptive planning. Targeting hemispheric imbalances offers potential for suicide prevention. © 2025 Elsevier B.V., All rights reserved.