Cognitive dysfunction in suicide attempters with charcoal burning may not be attributed to a single mechanism: a combined SPECT and MRS study

Objectives The aim of this study was designed to find the underlying mechanisms of cognitive dysfunction in suicide attempters with charcoal burning.

Methods Eighteen suicide attempters (SAs) and 18 sex- and age- matched healthy controls (HCs) were recruited. Each subject received one single photon emission computed tomography with ^99mTc-TRODAT for measuring striatal dopamine transporter (DAT) availability and proton magnetic resonance spectroscopy for measuring the metabolic markers included N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI) and creatine (Cr) in left parietal white matter and mid-occipital gray matter, separately. A psychological battery including attention, memory, and executive function was administered.

Results The SAs had significant lower bilateral DAT availability, lower ratio of NAA/Cr and higher ratio of Cho/Cr compared with those data in HCs in both measured regions. The psychological test showed the SAs had worse memory and executive function. Multiple regressions with two way interaction analysis showed that left striatal DAT availability and Cho/Cr in gray matter contributed to executive dysfunctions in SAs.

Conclusions our data indicate that the cognitive dysfunction in SAs may not be attributed to single mechanism but, at least, via two different pathways.