Based on diffusion tensor imaging (DTI) studies, brain white matter (WM) abnormalities have been recently suggested to play a critical role in the pathophysiology of major depressive disorder (MDD) and suicidal behavior. DTI studies reported the presence of altered WM integrity both in subjects with MDD and suicidal behavior. Microstructural WM abnormalities located in neural circuits critically involved in emotional processes and mood regulation may result in enhanced vulnerability to psychiatric morbidity contributing to functional impairments. However, the role and significance of WM alterations as well as their possible implications in patients with major affective disorders and suicidal behavior are still poorly understood. The present chapter aims to comprehensively review the current literature about the association between microstructural WM alterations as assessed by DTI techniques, MDD and suicide behavior.
Keywords: Diffusion tensor imaging techniques, Early-onset depression, Fractional anisotropy, Magnetic resonance images, Major depression, Microstructural white matter lesions, Mood disorders, Suicidal behavior.