# Structural and functional neural alterations in suicidality among Veterans with PTSD

> **NIH VA IK2** · VA CONNECTICUT HEALTHCARE SYSTEM · 2021 · —

## Abstract

PROJECT SUMMARY/ABSTRACT
Research: Veterans of the U.S. military die by suicide at a rate of two to six times that of their civilian
counterparts. Suicidal ideation (SI) and suicide attempts (SA), cardinal precursors to death by suicide, occur at
significantly greater frequency than death and cause immense individual and societal burden, yet relatively
little is known about their pathophysiology. This is especially so in posttraumatic stress disorder (PTSD), a
signature injury of the wars in Iraq and Afghanistan. High rates of comorbidity and inflated prevalence of both
suicidality and PTSD in Veterans, highlights the urgency of advancing understanding of the shared and
distinguishing neural mechanisms between these. Evidence of trauma- and stress-related synaptic loss and
large-scale alterations in intrinsic connectivity networks in brain regions implicated in mood, cognition, and
behavior exists in both SI/SA and PTSD literature. However, a major obstacle in field is the scarcity of
neurobiologically-based studies of SI/SA in PTSD cohorts. Preliminary data supports the notion that the
location and pattern of synaptic alterations may interact with individual and environmental characteristics to
affect clinical presentation and symptom severity. Specifically, Veterans with PTSD endorsing SI appear to
have a neural signature of synaptic alterations distinct from PTSD symptom severity, depression, and age.
Extending this work, state-of-the-art multimodal neuroimaging and behavioral assessment sessions will be
conducted in 96 Veterans across 3 study groups (n=32/group): PTSD only; PTSD+SI; PTSD+SA. Robust,
complimentary evidence of a unique pattern and location of synaptic alterations will be demonstrated using (a)
whole-brain vertex-wise structural magnetic resonance imaging (MRI) to measure cortical thickness, (b)
resting-state functional connectivity MRI (rs-fcMRI) to measure global brain connectivity (GBC), and (c)
diffusion MRI to measure diffusion GBC (dGBC), a measure of microstructural architecture and connectivity.
Veterans will be matched on age, sex, PTSD symptom severity, and history of traumatic brain injury. This study
may identify biomarkers of treatment targets in two of the operational priority areas for the VA – suicide and
PTSD, inform novel drug development of efficacious pharmacologic interventions, and ultimately advance the
field making way to alleviate suffering of millions of individuals – Veteran and civilian alike - struggling with
suicidality.
Candidate: Dr. Averill has demonstrated an unwavering commitment to improving Veterans’ mental health
care, with emphasis on PTSD and suicide prevention for well over a decade. Short-term goals include receipt of
the CDA-2 to both advance her expertise through rigorous training objectives (focused on the neurobiology of
SI/SA, multimodal neuroimaging, and statistics) and to provide data for future funding as she establishes a
niche program of research in the National Center for PTSD...

## Key facts

- **NIH application ID:** 9854738
- **Project number:** 5IK2CX001873-02
- **Recipient organization:** VA CONNECTICUT HEALTHCARE SYSTEM
- **Principal Investigator:** Lynnette Astrid Averill
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9854738

## Citation

> US National Institutes of Health, RePORTER application 9854738, Structural and functional neural alterations in suicidality among Veterans with PTSD (5IK2CX001873-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9854738. Licensed CC0.

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