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Li J, Wang D, Xia J, Zhang C, Meng Y, Xu S, Chen H, Liao W. Divergent suicidal symptomatic activations converge on somato-cognitive action network in depression. Mol Psychiatry 2024:10.1038/s41380-024-02450-7. [PMID: 38351174 DOI: 10.1038/s41380-024-02450-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/16/2024]
Abstract
Individuals with depression have the highest lifetime prevalence of suicide attempts (SA) among mental illnesses. Numerous neuroimaging studies have developed biomarkers from task-related neural activation in depressive patients with SA, but the findings are inconsistent. Empowered by the contemporary interconnected view of depression as a neural system disorder, we sought to identify a specific brain circuit utilizing published heterogeneous neural activations. We systematically reviewed all published cognitive and emotional task-related functional MRI studies that investigated differences in the location of neural activations between depressive patients with and without SA. We subsequently mapped an underlying brain circuit functionally connecting to each experimental activation using a large normative connectome database (n = 1000). The identified SA-related functional network was compared to the network derived from the disease control group. Finally, we decoded this convergent functional connectivity network using microscale transcriptomic and chemo-architectures, and macroscale psychological processes. We enrolled 11 experimental tasks from eight studies, including depressive patients with SA (n = 147) and without SA (n = 196). The heterogeneous SA-related neural activations localized to the somato-cognitive action network (SCAN), exhibiting robustness to little perturbations and specificity for depression. Furthermore, the SA-related functional network was colocalized with brain-wide gene expression involved in inflammatory and immunity-related biological processes and aligned with the distribution of the GABA and noradrenaline neurotransmitter systems. The findings demonstrate that the SA-related functional network of depression is predominantly located at the SCAN, which is an essential implication for understanding depressive patients with SA.
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Affiliation(s)
- Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
| | - Dajing Wang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Jie Xia
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Chao Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Yao Meng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Shuo Xu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 611731, P.R. China.
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Dobbertin M, Blair KS, Aloi J, Bajaj S, Bashford-Largo J, Mathur A, Zhang R, Carollo E, Schwartz A, Elowsky J, Ringle JL, Tyler P, Blair RJ. Neural correlates of automatic emotion regulation and their association with suicidal ideation in adolescents during the first 90-days of residential care. Transl Psychiatry 2024; 14:54. [PMID: 38263400 PMCID: PMC10806086 DOI: 10.1038/s41398-023-02723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death for adolescents in the United States. However, relatively little is known about the forms of atypical neuro-cognitive function that are correlates of suicidal ideation (SI). One form of cognitive/affective function that, when dysfunctional, is associated with SI is emotion regulation. However, very little work has investigated the neural correlates of emotion dysregulation in adolescents with SI. METHODS Participants (N = 111 aged 12-18, 32 females, 31 [27.9%] reporting SI) were recruited shortly after their arrival at a residential care facility where they had been referred for behavioral and mental health problems. Daily reports of SI were collected during the participants' first 90-days in residential care. Participants were presented with a task-fMRI measure of emotion regulation - the Affective Number Stroop task shortly after recruitment. Participants were divided into two groups matched for age, sex and IQ based on whether they demonstrated SI. RESULTS Participants who demonstrated SI showed increased recruitment of regions including dorsomedial prefrontal cortex/supplemental motor area and parietal cortex during task (congruent and incongruent) relative to view trials in the context of emotional relative to neutral distracters. CONCLUSIONS Participants with SI showed increased recruitment of regions implicated in executive control during the performance of a task indexing automatic emotion regulation. Such data might suggest a relative inefficiency in the recruitment of these regions in individuals with SI.
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Affiliation(s)
- Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA.
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sahil Bajaj
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Johannah Bashford-Largo
- Multimodal Clinical Neuroimaging Laboratory, Institute for Human Neuroscience, Boys Town, NE, USA
| | - Avantika Mathur
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Ru Zhang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Erin Carollo
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | | | - Jaimie Elowsky
- University of Nebraska Department of Psychology, Lincoln, NE, USA
| | - J L Ringle
- Child and Family Translational Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Patrick Tyler
- Child and Family Translational Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - R James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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Zhu W, Liu F, Fu J, Qin W, Xue K, Tang J, Zhang Y, Yu C. Genes associated with spontaneous brain activity changes in clinically different patients with major depressive disorder: A transcription-neuroimaging association study. CNS Neurosci Ther 2023; 29:3913-3924. [PMID: 37311691 PMCID: PMC10651976 DOI: 10.1111/cns.14311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/19/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023] Open
Abstract
AIMS The amplitude of low-frequency fluctuations (ALFF) of resting-state functional MRI signals is a reliable neuroimaging measure of spontaneous brain activity. Inconsistent ALFF alterations have been reported in major depressive disorder (MDD) possibly due to clinical heterogeneity. This study was designed to investigate clinically sensitive and insensitive genes associated with ALFF alterations in MDD and the potential mechanisms. METHODS Transcription-neuroimaging association analyses of case-control ALFF differences from two independent neuroimaging datasets with gene expression data from Allen Human Brain Atlas were performed to identify the two gene sets. Various enrichment analyses were conducted to characterize their preference in biological functions, cell types, temporal stages, and shared effects with other psychiatric disorders. RESULTS Compared with controls, first-episode and drug-naïve patients showed more extensive ALFF alterations than patients with varied clinical features. We identified 903 clinically sensitive genes and 633 clinically insensitive genes, and the former was enriched for genes with down-regulated expression in the cerebral cortex of MDD patients. Despite shared functions of cell communication, signaling, and transport, clinically sensitive genes were enriched for cell differentiation and development whereas clinically insensitive genes were for ion transport and synaptic signaling. Clinically sensitive genes showed enrichment for microglia and macrophage from childhood to young adulthood in contrast to clinically insensitive genes for neurons before early infancy. Clinically sensitive genes (15.2%) were less likely correlated with ALFF alterations in schizophrenia than clinically insensitive genes (66.8%), and both were not relevant to bipolar disorder and adult attention deficit and hyperactivity disorder based on a third independent neuroimaging dataset. CONCLUSIONS Present results provide novel insights into the molecular mechanisms of spontaneous brain activity changes in clinically different patients with MDD.
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Affiliation(s)
- Wenshuang Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Feng Liu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Jilian Fu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Kaizhong Xue
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | - Jie Tang
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
| | | | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional ImagingTianjin Medical University General HospitalTianjinChina
- CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of SciencesShanghaiChina
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Thompson MF, Ghahramanlou-Holloway M, Murphy MA, Perera KU, Benca-Bachman C, Palmer RHC, Gray JC. Resting-state network analysis of suicide attempt history in the UK Biobank. Psychol Med 2023; 53:7591-7600. [PMID: 37254555 DOI: 10.1017/s0033291723001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Prior research has identified altered brain structure and function in individuals at risk for self-directed violence thoughts and behaviors. However, these studies have largely utilized healthy controls and findings have been inconsistent. Thus, this study examined differences in resting-state functional network connectivity among individuals with lifetime suicide attempt(s) v. lifetime self-directed violence thoughts alone. METHODS Using data from the UK Biobank, this study utilized a series of linear regressions to compare individuals with lifetime suicide attempt(s) (n = 566) v. lifetime self-directed violence thoughts alone (n = 3447) on within- and between- network resting-state functional connectivity subnetworks. RESULTS There were no significant between-group differences for between-network, within-network, or whole-brain functional connectivity after adjusting for age, sex, ethnicity, and body mass index and performing statistical corrections for multiple comparisons. Resting-state network measures may not differentiate between individuals with lifetime suicide attempt(s) and lifetime self-directed violence thoughts alone. CONCLUSIONS Null findings diverge from results reported in smaller neuroimaging studies of suicide risk, but are consistent with null findings in other large-scale studies and meta-analyses. Strengths of the study include its large sample size and stringent control group. Future research on a wider array of imaging, genetic, and psychosocial risk factors can clarify relative contributions of individual and combined variables to suicide risk and inform scientific understanding of ideation-to-action framework.
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Affiliation(s)
- Matthew F Thompson
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Marjan Ghahramanlou-Holloway
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Mikela A Murphy
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Psychology, Fordham University, New York, NY, USA
| | - Kanchana U Perera
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Chelsie Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Joshua C Gray
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Cai M, Zhu Y, Shanley MR, Morel C, Ku SM, Zhang H, Shen Y, Friedman AK, Han MH. HCN channel inhibitor induces ketamine-like rapid and sustained antidepressant effects in chronic social defeat stress model. Neurobiol Stress 2023; 26:100565. [PMID: 37664876 PMCID: PMC10468802 DOI: 10.1016/j.ynstr.2023.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023] Open
Abstract
Repeated, long-term (weeks to months) exposure to standard antidepressant medications is required to achieve treatment efficacy. In contrast, acute ketamine quickly improves mood for an extended time. Recent work implicates that hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are involved in mediating ketamine's antidepressant effects. In this study, we directly targeted HCN channels and achieved ketamine-like rapid and sustained antidepressant efficacy. Our in vitro electrophysiological recordings first showed that HCN inhibitor DK-AH 269 (also called cilobradine) decreased the pathological HCN-mediated current (Ih) and abnormal hyperactivity of ventral tegmental area (VTA) dopamine (DA) neurons in a depressive-like model produced by chronic social defeat stress (CSDS). Our in vivo studies further showed that acute intra-VTA or acute systemic administration of DK-AH 269 normalized social behavior and rescued sucrose preference in CSDS-susceptible mice. The single-dose of DK-AH 269, both by intra-VTA microinfusion and intraperitoneal (ip) approaches, could produce an extended 13-day duration of antidepressant-like efficacy. Animals treated with acute DK-AH 269 spent less time immobile than vehicle-treated mice during forced swim test. A social behavioral reversal lasted up to 13 days following the acute DK-AH 269 ip injection, and this rapid and sustained antidepressant-like response is paralleled with a single-dose treatment of ketamine. This study provides a novel ion channel target for acutely acting, long-lasting antidepressant-like effects.
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Affiliation(s)
- Min Cai
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yingbo Zhu
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- China Shenzhen Naowunao Network Technology Co.,Ltd., Shenzhen, Guangdong, China
| | - Mary Regis Shanley
- Department of Biological Sciences, Hunter College, Biology and Biochemistry PhD Program, Graduate Center, The City University of New York, New York, NY, USA
| | - Carole Morel
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stacy M. Ku
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hongxing Zhang
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yuan Shen
- Anesthesia and Brain Research Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Allyson K. Friedman
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ming-Hu Han
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Mental Health and Public Health, Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Shenzhen, Guangdong, China
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Vieira R, Faria AR, Ribeiro D, Picó-Pérez M, Bessa JM. Structural and functional brain correlates of suicidal ideation and behaviors in depression: A scoping review of MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110799. [PMID: 37207727 DOI: 10.1016/j.pnpbp.2023.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Identifying and integrating the neural correlates of suicidal ideation and behaviors is crucial to expand the knowledge and develop targeted strategies to prevent suicide. This review aimed to describe the neural correlates of suicidal ideation, behavior and the transition between them, using different magnetic resonance imaging (MRI) modalities, providing an up-to-date overview of the literature. To be included, the observational, experimental, or quasi-experimental studies must include adult patients currently diagnosed with major depressive disorder and investigate the neural correlates of suicidal ideation, behavior and/or the transition using MRI. The searches were conducted on PubMed, ISI Web of Knowledge and Scopus. Fifty articles were included in this review: 22 on suicidal ideation, 26 on suicide behaviors and two on the transition between them. The qualitative analysis of the included studies suggested alterations in the frontal, limbic and temporal lobes in suicidal ideation associated with deficits in emotional processing and regulation, and in the frontal, limbic, parietal lobes, and basal ganglia in suicide behaviors associated with impairments in decision-making. Gaps in the literature and methodological concerns were identified and might be addressed in future studies.
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Affiliation(s)
- Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | | | - Diogo Ribeiro
- Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - João M Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
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Ai H, Duan L, Huang L, Luo Y, Aleman A, Xu P. Dissociated deficits of anticipated and experienced regret in at-risk suicidal individuals. Front Psychiatry 2023; 14:1121194. [PMID: 36970290 PMCID: PMC10034165 DOI: 10.3389/fpsyt.2023.1121194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundsDecision-making deficits have been reported as trans-diagnostic characteristics of vulnerability to suicidal behaviors, independent of co-existing psychiatric disorders. Individuals with suicidal behaviors often regret their decision to attempt suicide and may have impairments in future-oriented processing. However, it is not clear how people with suicidal dispositions use future-oriented cognition and past experience of regret to guide decision-making. Here, we examined the processes of regret anticipation and experience in subclinical youth with and without suicidal ideation during value-based decision-making.MethodsIn total, 80 young adults with suicidal ideation and 79 healthy controls completed a computational counterfactual thinking task and self-reported measures of suicidal behaviors, depression, anxiety, impulsivity, rumination, hopelessness, and childhood maltreatment.ResultsIndividuals with suicidal ideation showed a reduced ability to anticipate regret compared to healthy controls. Specifically, suicidal ideators’ experience of regret/relief was significantly different from that of healthy controls upon obtained outcomes, while their disappointment/pleasure experience was not significantly different from healthy controls.ConclusionThese findings suggest that young adults with suicidal ideation have difficulty predicting the consequences or the future value of their behavior. Individuals with suicidal ideation showed impairments in value comparison and flat affect to retrospective rewards, whereas individuals with high suicidality showed blunted affect to immediate rewards. Identifying the counterfactual decision-making characteristics of at-risk suicidal individuals may help to elucidate measurable markers of suicidal vulnerability and identify future intervention targets.
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Affiliation(s)
- Hui Ai
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Lian Duan
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- *Correspondence: Lian Duan, ; Pengfei Xu,
| | - Lin Huang
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
| | - Yuejia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - André Aleman
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- Section Cognitive Neuroscience, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China
- Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
- *Correspondence: Lian Duan, ; Pengfei Xu,
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Bajaj S, Blair KS, Dobbertin M, Patil KR, Tyler PM, Ringle JL, Bashford-Largo J, Mathur A, Elowsky J, Dominguez A, Schmaal L, Blair RJR. Machine learning based identification of structural brain alterations underlying suicide risk in adolescents. DISCOVER MENTAL HEALTH 2023; 3:6. [PMID: 37861863 PMCID: PMC10501026 DOI: 10.1007/s44192-023-00033-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 10/21/2023]
Abstract
Suicide is the third leading cause of death for individuals between 15 and 19 years of age. The high suicide mortality rate and limited prior success in identifying neuroimaging biomarkers indicate that it is crucial to improve the accuracy of clinical neural signatures underlying suicide risk. The current study implements machine-learning (ML) algorithms to examine structural brain alterations in adolescents that can discriminate individuals with suicide risk from typically developing (TD) adolescents at the individual level. Structural MRI data were collected from 79 adolescents who demonstrated clinical levels of suicide risk and 79 demographically matched TD adolescents. Region-specific cortical/subcortical volume (CV/SCV) was evaluated following whole-brain parcellation into 1000 cortical and 12 subcortical regions. CV/SCV parameters were used as inputs for feature selection and three ML algorithms (i.e., support vector machine [SVM], K-nearest neighbors, and ensemble) to classify adolescents at suicide risk from TD adolescents. The highest classification accuracy of 74.79% (with sensitivity = 75.90%, specificity = 74.07%, and area under the receiver operating characteristic curve = 87.18%) was obtained for CV/SCV data using the SVM classifier. Identified bilateral regions that contributed to the classification mainly included reduced CV within the frontal and temporal cortices but increased volume within the cuneus/precuneus for adolescents at suicide risk relative to TD adolescents. The current data demonstrate an unbiased region-specific ML framework to effectively assess the structural biomarkers of suicide risk. Future studies with larger sample sizes and the inclusion of clinical controls and independent validation data sets are needed to confirm our findings.
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Affiliation(s)
- Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA.
| | - Karina S Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
- Child and Adolescent Psychiatric Inpatient Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Kaustubh R Patil
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Patrick M Tyler
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jay L Ringle
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Johannah Bashford-Largo
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
- Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Avantika Mathur
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Jaimie Elowsky
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Ahria Dominguez
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE, USA
| | - Lianne Schmaal
- Center for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, Australia
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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Dobbertin M, Blair KS, Carollo E, Blair JR, Dominguez A, Bajaj S. Neuroimaging alterations of the suicidal brain and its relevance to practice: an updated review of MRI studies. Front Psychiatry 2023; 14:1083244. [PMID: 37181903 PMCID: PMC10174251 DOI: 10.3389/fpsyt.2023.1083244] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Suicide is a leading cause of death in the United States. Historically, scientific inquiry has focused on psychological theory. However, more recent studies have started to shed light on complex biosignatures using MRI techniques, including task-based and resting-state functional MRI, brain morphometry, and diffusion tensor imaging. Here, we review recent research across these modalities, with a focus on participants with depression and Suicidal Thoughts and Behavior (STB). A PubMed search identified 149 articles specific to our population of study, and this was further refined to rule out more diffuse pathologies such as psychotic disorders and organic brain injury and illness. This left 69 articles which are reviewed in the current study. The collated articles reviewed point to a complex impairment showing atypical functional activation in areas associated with perception of reward, social/affective stimuli, top-down control, and reward-based learning. This is broadly supported by the atypical morphometric and diffusion-weighted alterations and, most significantly, in the network-based resting-state functional connectivity data that extrapolates network functions from well validated psychological paradigms using functional MRI analysis. We see an emerging picture of cognitive dysfunction evident in task-based and resting state fMRI and network neuroscience studies, likely preceded by structural changes best demonstrated in morphometric and diffusion-weighted studies. We propose a clinically-oriented chronology of the diathesis-stress model of suicide and link other areas of research that may be useful to the practicing clinician, while helping to advance the translational study of the neurobiology of suicide.
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Affiliation(s)
- Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
- Child and Adolescent Psychiatric Inpatient Center, Boys Town National Research Hospital, Boys Town, NE, United States
- *Correspondence: Matthew Dobbertin,
| | - Karina S. Blair
- Program for Trauma and Anxiety in Children (PTAC), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Erin Carollo
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL, United States
| | - James R. Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Copenhagen, Denmark
| | - Ahria Dominguez
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
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10
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Yang J, Liu Z, Tao H, Cheng Y, Fan Z, Sun F, Ouyang X, Yang J. Aberrant brain dynamics in major depressive disorder with suicidal ideation. J Affect Disord 2022; 314:263-270. [PMID: 35878840 DOI: 10.1016/j.jad.2022.07.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Suicidal ideation (SI) is a common symptom of major depressive disorder (MDD). Accumulating studies demonstrated that MDD with SI was associated with static alterations in brain activity and functional connectivity. However, given that brain is a highly dynamic system, the changes of brain dynamic patterns in MDD with SI remain unknown. METHODS We included 60 MDD patients with SI (MDD-SI), 58 MDD patients without SI (MDD-NSI), and 58 healthy controls (HCs) who underwent resting-state functional magnetic resonance imaging. The sliding-window approach was used to calculate the dynamic fractional amplitude of low-frequency fluctuation (dfALFF) and dynamic degree centrality (dDC) to characterize the temporal dynamic regional activity and distant functional connectivity. We compared dfALFF and dDC across groups and further conducted correlations between abnormal dynamic metrics and the severity of suicidality. RESULTS In terms of the dynamic regional activity, MDD-SI showed decreased dfALFF in the left lingual gyrus and right middle occipital gyrus compared with MDD-NSI; in terms of the dynamic distant connectivity, MDD-SI showed decreased dDC in the right middle frontal gyrus compared with MDD-NSI. The decreased dDC in the right middle frontal gyrus was correlated with increased severity of suicidality. LIMITATIONS The relatively small sample size. CONCLUSIONS We demonstrate the specific brain dynamic patterns of MDD-SI in regional activity and distant functional connectivity compared to MDD-NSI. Especially the decreased temporal variability of the distant connectivity in the middle frontal gyrus was associated with SI. These altered dynamic patterns may represent a potential neurobiological diathesis of SI in MDD.
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Affiliation(s)
- Jun Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haojuan Tao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yixin Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zebin Fan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Fuping Sun
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuan Ouyang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jie Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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11
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Xu M, Zhang X, Li Y, Chen S, Zhang Y, Zhou Z, Lin S, Dong T, Hou G, Qiu Y. Identification of suicidality in patients with major depressive disorder via dynamic functional network connectivity signatures and machine learning. Transl Psychiatry 2022; 12:383. [PMID: 36097160 PMCID: PMC9467986 DOI: 10.1038/s41398-022-02147-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/24/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
Major depressive disorder (MDD) is a severe brain disease associated with a significant risk of suicide. Identification of suicidality is sometimes life-saving for MDD patients. We aimed to explore the use of dynamic functional network connectivity (dFNC) for suicidality detection in MDD patients. A total of 173 MDD patients, including 48 without suicide risk (NS), 74 with suicide ideation (SI), and 51 having attempted suicide (SA), participated in the present study. Thirty-eight healthy controls were also recruited for comparison. A sliding window approach was used to derive the dFNC, and the K-means clustering method was used to cluster the windowed dFNC. A linear support vector machine was used for classification, and leave-one-out cross-validation was performed for validation. Other machine learning methods were also used for comparison. MDD patients had widespread hypoconnectivity in both the strongly connected states (states 2 and 5) and the weakly connected state (state 4), while the dysfunctional connectivity within the weakly connected state (state 4) was mainly driven by suicidal attempts. Furthermore, dFNC matrices, especially the weakly connected state, could be used to distinguish MDD from healthy controls (area under curve [AUC] = 82), and even to identify suicidality in MDD patients (AUC = 78 for NS vs. SI, AUC = 88 for NS vs. SA, and AUC = 74 for SA vs. SI), with vision-related and default-related inter-network connectivity serving as important features. Thus, the dFNC abnormalities observed in this study might further improve our understanding of the neural substrates of suicidality in MDD patients.
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Affiliation(s)
- Manxi Xu
- grid.410737.60000 0000 8653 1072Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou, People’s Republic of China ,grid.33199.310000 0004 0368 7223Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518000 People’s Republic of China
| | - Xiaojing Zhang
- grid.263488.30000 0001 0472 9649Guangdong Provincial Key Laboratory of Genome Stability and Disease Prevention and Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, 518060 People’s Republic of China
| | - Yanqing Li
- grid.410737.60000 0000 8653 1072Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou, People’s Republic of China
| | - Shengli Chen
- grid.33199.310000 0004 0368 7223Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518000 People’s Republic of China
| | - Yingli Zhang
- grid.452897.50000 0004 6091 8446Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, 518020 People’s Republic of China
| | - Zhifeng Zhou
- grid.452897.50000 0004 6091 8446Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, 518020 People’s Republic of China
| | - Shiwei Lin
- grid.33199.310000 0004 0368 7223Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518000 People’s Republic of China
| | - Tianfa Dong
- grid.410737.60000 0000 8653 1072Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Duobao AVE 56, Liwan district, Guangzhou, People’s Republic of China
| | - Gangqiang Hou
- Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, 518020, People's Republic of China.
| | - Yingwei Qiu
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518000, People's Republic of China.
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12
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Functional alterations of the suicidal brain: a coordinate-based meta-analysis of functional imaging studies. Brain Imaging Behav 2021; 16:291-304. [PMID: 34351557 DOI: 10.1007/s11682-021-00503-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/22/2023]
Abstract
Altered brain activities in suicidal subjects have been reported in a number of neuroimaging studies. However, the activity aberrances were inconsistent in previous investigations. Thus, we aimed to address activity abnormalities in suicidal individuals. Databases were searched to perform a meta-analysis of whole-brain functional MRI studies of suicidal individuals through January 14, 2020. Meta-analyses were conducted using Seed-based d Mapping software. Based on a meta-analysis of 17 studies comprising 381 suicidal individuals and 642 controls, we mainly found that increased activity in the bilateral superior temporal gyrus, left middle temporal gyrus, and bilateral middle occipital gyrus, along with decreased activity in the right putamen and left insula, were detected in suicidal individuals compared with nonsuicidal subjects. To reduce methodological heterogeneity between the included studies, subanalyses of behavioral domains were conducted, and the right superior temporal gyrus was found to increase in all subanalyses of domains. In subanalyses of suicidal attempters and ideators, suicide attempters displayed hyperactivation in the bilateral superior temporal gyrus and left middle temporal gyrus and blunted responses in the left insula relative to controls. Suicidal ideators demonstrated elevated activation in the right middle occipital gyrus and reduced activity in the right putamen relative to controls. The bilateral superior temporal gyrus was the most robust finding, replicable in all data sets in the jackknife sensitive analysis. Moreover, increased activity in the right superior temporal gyrus, left middle temporal gyrus, and right middle occipital gyrus was found to be involved with higher suicide ideation scores. This study revealed several brain regions associated with suicidality. These findings may contribute to our understanding of the pathophysiology of suicide and have important implications for suicide prevention and interventions.
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13
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van Tol MJ, van der Wee NJA, Veltman DJ. Fifteen years of NESDA Neuroimaging: An overview of results related to clinical profile and bio-social risk factors of major depressive disorder and common anxiety disorders. J Affect Disord 2021; 289:31-45. [PMID: 33933910 DOI: 10.1016/j.jad.2021.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
The longitudinal Netherlands Study of Depression and Anxiety (NESDA) Neuroimaging study was set up in 2003 to investigate whether neuroanatomical and functional abnormalities during tasks of primary emotional processing, executive planning and memory formation, and intrinsic brain connectivity are i) shared by individuals with major depressive disorder (MDD) and common anxiety disorders; and ii) characterized by symptomatology-specific abnormalities. Furthermore, questions related to individual variations in vulnerability for onset, comorbidity, and longitudinal course could be investigated. Between 2005 and 2007, 233 individuals fulfilling a diagnosis of MDD, panic disorder, social anxiety disorder and/or generalized anxiety disorder and 68 healthy controls aging between 18 and 57 were invited from the NESDA main sample (n = 2981). An emotional faces processing task, an emotional word-encoding task, and an executive planning task were administered during 3T BOLD-fMRI acquisitions. In addition, resting state BOLD-fMRI was acquired and T1-weighted structural imaging was performed. All participants were invited to participate in the two-year and nine-year follow-up MRI measurement. Fifteen years of NESDA Neuroimaging demonstrated common morphological and neurocognitive abnormalities across individuals with depression and anxiety disorders. It however provided limited support for the idea of more extensive abnormalities in patients suffering from both depression and anxiety, despite their worse prognosis. Risk factors including childhood maltreatment and specific risk genes had an emotion processing modulating effect, apparently stronger than effects of diagnostic labels. Furthermore, brain imaging data, especially during emotion processing seemed valuable for predicting the long-term course of affective disorders, outperforming prediction based on clinical information alone.
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Affiliation(s)
- M J van Tol
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, the Netherlands.
| | - N J A van der Wee
- Department of Psychiatry and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Department of Psychiatry, Leiden, the Netherlands
| | - D J Veltman
- Department of Psychiatry, Amsterdam University Medical Center, Location VUMC and Amsterdam Neuroscience, Amsterdam, the Netherlands
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14
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Li X, Wang J. Abnormal neural activities in adults and youths with major depressive disorder during emotional processing: a meta-analysis. Brain Imaging Behav 2021; 15:1134-1154. [PMID: 32710330 DOI: 10.1007/s11682-020-00299-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Abnormal neural activities during emotional processing have been found in both adults and youths with major depressive disorder. However, findings were inconsistent in each group and cannot be compared to each other. METHODS We first identified neuroimaging experiments that revealed abnormal neural activities during emotional processing in patients with major depressive disorder published from January 1997 to January 2019. Then we conducted voxel-wise meta-analyses on adult and youth patients separately and compared the two age groups using direct meta-comparison. RESULTS Fifty-four studies comprising 1141 patients and 1242 healthy controls were identified. Both adult and youth patients showed abnormal neural activities in anterior cingulate cortex, insula, superior and middle temporal gyrus, and occipital cortex compared to healthy controls. However, hyperactivities in the superior and middle frontal gyrus, amygdala, and hippocampus were only observed in adult patients, while hyperactivity in the striatum was only found in youth patients compared to controls. In addition, compared with youths, adult patients exhibited significantly greater abnormal activities in insula, middle frontal gyrus, and hippocampus, and significantly lower abnormal activities in middle temporal gyrus, middle occipital gyrus, lingual gyrus, and striatum. CONCLUSIONS The common alterations confirmed the negative processing bias in major depressive disorder. Both adult and youth patients were suggested to have disturbed emotional perception, appraisal, and reactivity. However, adult patients might be more subject to the impaired appraisal and reactivity processes, while youth patients were more subject to the impaired perception process. These findings help us understand the progressive pathophysiology of major depressive disorder.
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Affiliation(s)
- Xuqian Li
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, 510006, China.,School of Psychology, The University of Queensland, Brisbane, 4067, Australia
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, 510006, China.
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15
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Wiebenga JXM, Dickhoff J, Mérelle SYM, Eikelenboom M, Heering HD, Gilissen R, van Oppen P, Penninx BWJH. Prevalence, course, and determinants of suicide ideation and attempts in patients with a depressive and/or anxiety disorder: A review of NESDA findings. J Affect Disord 2021; 283:267-277. [PMID: 33571797 DOI: 10.1016/j.jad.2021.01.053] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/18/2020] [Accepted: 01/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depressive and anxiety disorders are often associated with suicide ideation (SI) and attempt (SA). However, analyses of prevalence, course, and more specific risk mechanisms are needed to improve knowledge and detection of high risk individuals with depressive and anxiety disorders. Previous studies often lacked statistical power, assessment of detailed determinants and follow-up measurements. METHODS The Netherlands Study of Depression and Anxiety (NESDA), a large cohort study, overcomes some earlier limitations. Scale for Suicide Ideation and Compositive Interview Diagnostic Instrument data were analyzed to report on prevalence of SI and SA. Additionally, important sociodemographic, clinical, psychological, environmental, and neurobiological determinants and course of SI and SA identified in depressive and/or anxiety disorder respondents in 16 NESDA articles were summarized. RESULTS Within respondents with 12-month diagnosis (n=1,783), SI and 12-month SA prevalence ranged from 17.1-20.1% and 0.8-3.0% respectively across 5 waves during 9-year follow-up and SI was highly recurrent. Both SI and SA were especially associated with comorbid depression and anxiety, higher clinical severity, sleep dysfunctions, higher aggression and hopelessness, and childhood trauma. In the (neuro)biological domain, SI was linked with immune dysregulation and SA with abnormal brain activity during emotion processing and genetic risk. LIMITATIONS Most articles were cross-sectional in nature, preventing causal inferences and no conclusions could be drawn about the overall magnitude of results. CONCLUSION SI and SA are multifactorial phenomena and especially prevalent amongst comorbid depressive and anxiety respondents. Considering many overlapping SI and SA determinants, more neurobiological determinants and use of innovative methodological techniques are desirable.
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Affiliation(s)
- Jasper X M Wiebenga
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Justine Dickhoff
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, The Netherlands
| | | | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Henriette D Heering
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | | | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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16
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Zhang R, Zhang L, Wei S, Wang P, Jiang X, Tang Y, Wang F. Increased Amygdala-Paracentral Lobule/Precuneus Functional Connectivity Associated With Patients With Mood Disorder and Suicidal Behavior. Front Hum Neurosci 2021; 14:585664. [PMID: 33519398 PMCID: PMC7843440 DOI: 10.3389/fnhum.2020.585664] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
Mood disorder patients have greater suicide risk than members of the general population, but how suicidal behavior relates to brain functions has not been fully elucidated. This study investigated how functional connectivity (FC) values between the right/left amygdala and the whole brain relate to suicidal behavior in patients with mood disorder. The participants in this study were 100 mood disorder patients with suicidal behavior (SB group), 120 mood disorder patients with non-suicidal behavior (NSB group), and 138 age- and gender-matched healthy controls (HC group). Whole-brain FC values among the three groups were compared using an analysis of covariance (ANCOVA). Compared to the NSB and HC groups, increased FC values in the right amygdala-bilateral paracentral lobule/precuneus circuit were observed in the SB group (Bonferroni-corrected, p < 0.017). The FC values in the NSB group did not differ significantly from those in the HC group (Bonferroni-corrected, p > 0.017). Moreover, there were no significant differences in FC values between mood disorder patients with suicide attempt (SA group) and mood disorder patients with suicidal ideation (SI group), while the FC values between the right amygdala and bilateral paracentral lobule/precuneus in the SA group were higher than the mean in the SI group. These findings suggest that right amygdala-paracentral lobule/precuneus dysfunction has an important role in patients with mood disorder and suicidal behavior.
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Affiliation(s)
- Ran Zhang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Luheng Zhang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Pengshuo Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, China.,Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, China.,Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, China
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17
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Cao J, Ai M, Chen X, Chen J, Wang W, Kuang L. Altered resting-state functional network connectivity is associated with suicide attempt in young depressed patients. Psychiatry Res 2020; 285:112713. [PMID: 31810745 DOI: 10.1016/j.psychres.2019.112713] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/20/2019] [Accepted: 11/27/2019] [Indexed: 01/16/2023]
Abstract
The purpose of this study was to investigate the changes in resting-state brain functional network connectivity (FNC) in young depressed patients with and without suicidal behavior, and the relationship between FNC and suicidal attempts in depressed youths using resting-state fMRI (RS-fMRI). We conducted independent component analysis (ICA) to identify intrinsically connected neural networks and analyze the alterations of intra- and inter-network connectivity using FNC analysis in 35 depressed youth with suicidal attempts (SU group), 18 patients without suicidal attempts (NSU group) and 47 healthy controls (HC), and investigate brain-behavior associations between the FNC coefficients and clinical behavior in the SU group. SU group showed significantly decreased internetwork connectivity between anterior default mode network (aDMN) and salience network (SN), as well as the right frontal-parietal network (rFPN). However, the internetwork connectivity between the SN and rFPN in SU group was higher than that in NSU group. Moreover, decreased aDMN-rFPN connectivity was negatively correlated with BHS scores, and the differences in SN-rFPN and aDMN-pDMN connectivity were negatively associated with the HAMD score in the SU group. Our findings may provide new insights into the patterns of functional organization in the brain of suicidal depressed patients.
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Affiliation(s)
- Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Xiaorong Chen
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Jianmei Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing 400016, China.
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18
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Courtet P, Guillaume S. Learning From Artemisia's Lucretia: Embodied Suffering and Interoception in Suicide. Front Psychiatry 2020; 11:758. [PMID: 32848933 PMCID: PMC7412131 DOI: 10.3389/fpsyt.2020.00758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
In the painting "Lucretia," Artemisia Gentileschi, one of the major painters of the 17th century, depicts Lucretia's suicide. This artwork empathic vision offers the spectator the apprehension of a unique phenomenon where psychological pain is transformed into self-aggression. To understand why the body becomes an object to attack, it is important to study the role of interoception and self-awareness in the suicidal process. This essay discusses how bodily representations are crucial for interacting efficiently and safely with the outside world and for establishing the sense of self. It presents some of the available evidence showing that alterations in the body representation and in the sensations perceived by it contribute to suicide. Indeed, neuroimaging studies show that social environmental factors and their biological consequences in the body (e.g., increased neuroinflammation) can alter the neural networks of suicidal behavior by increasing the sensitivity to psychological pain and the disconnection from self-awareness. Therefore, body image, sensations and awareness as well as psychological pain should be examined to improve the understanding of the dynamic interactions between body, brain, and mind that underly suicidal behavior. This conceptualization brings clinical and therapeutic perspectives in a domain where they are urgently needed.
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Affiliation(s)
- Philippe Courtet
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Sébastien Guillaume
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
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19
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Ferrer I, Alacreu-Crespo A, Salvador A, Genty C, Dubois J, Sénèque M, Courtet P, Olié E. I Cannot Read Your Eye Expression: Suicide Attempters Have Difficulties in Interpreting Complex Social Emotions. Front Psychiatry 2020; 11:543889. [PMID: 33240116 PMCID: PMC7683427 DOI: 10.3389/fpsyt.2020.543889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
Abstract
Background: The ability to differentiate emotions in social contexts is important for dealing with challenging social situations. Suicide attempters show some difficulties in emotion recognition that may result in hypersensitivity to social stress. However, other studies on the recognition of social complex emotions found that suicide attempters have similar performances as depressed non-attempters. Objectives: To investigate differences in social emotion recognition in patients with current Major Depressive Episode (MDE) with and without history of suicide attempt. Methods: Two hundred and ten patients with MDE were recruited among whom 115 had lifetime history of suicide attempt (suicide attempters, SA) and 95 did not (affective controls, AC). Recognition of complex social emotions was assessed using the Reading the Mind in the Eyes Test (RMET). Emotions were separated in three valence categories: positive, negative, and neutral. Verbal intelligence quotient (IQ) and attention were measured with the National Adult Reading Task (NART) and the d2 test, respectively. Results: Mixed logistic regression models adjusted for sex, lifetime bipolar disorder, verbal IQ and attention showed that the RMET performance for neutral emotions was worse in the SA than AC group (OR = 0.87 [0.75, 0.99]). Furthermore, when violent/serious SA were compared to non-violent/non-serious SA and AC, the RMET neutral valence category showed a trend for group factor (p < 0.059) and RMET scores were lower in the violent/serious SA than AC group (OR = 0.79 [0.64, 0.96]). Conclusion: Recognition of neutral emotions is poor in SA and this may complicate their daily life. Interventions to improve the understanding of complex emotions may be helpful to prevent suicidal risk in patients with depression.
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Affiliation(s)
- Inés Ferrer
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Adrián Alacreu-Crespo
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Catherine Genty
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Jonathan Dubois
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Maude Sénèque
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Philippe Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Emilie Olié
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,FondaMental Foundation, Créteil, France
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Voxel-wise meta-analysis of task-related brain activation abnormalities in major depressive disorder with suicide behavior. Brain Imaging Behav 2019; 14:1298-1308. [DOI: 10.1007/s11682-019-00045-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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