Colle Romain, Chupin Marie, Cury Claire, Vandendrie Christophe, Gressier Florence, Hardy Patrick, Falissard Bruno, Colliot Olivier, Ducreux Denis, Corruble Emmanuelle
INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France.
INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France.
J Psychiatr Res. 2015 Feb;61:13-8. doi: 10.1016/j.jpsychires.2014.12.010. Epub 2014 Dec 24.
Despite known relationship between hippocampal volumes and major depressive episodes (MDE) and the increased suicidality in MDE, the links between hippocampal volumes and suicidality remain unclear in major depressive disorders (MDD). If the hippocampus could be a biomarker of suicide attempts in depression, it could be useful for prevention matters. This study assessed the association between hippocampal volumes and suicide attempts in MDD.
Hippocampal volumes assessed with automatic segmentation were compared in 63 patients with MDD, with (n = 24) or without (n = 39) suicide attempts. Acute (<one month) and past (>one month) suicide attempts were studied.
Although not different in terms of socio-demographic, MDD and MDE clinical features, suicide attempters had lower total hippocampus volumes than non-attempters (4.61 (± 1.15) cm(3) vs 5.22 (± 0.99) cm(3); w = 625.5; p = 0.03), especially for acute suicide attempts (4.19 (± 0.81) cm(3) vs 5.22 (± 0.99) cm(3); w = 334; p = 0.005), even after adjustment on brain volumes, sex, age, Hamilton Depression Rating Scale (HDRS) scores and MDD duration. A ROC analysis showed that a total hippocampal volume threshold of 5.00 cm(3) had a 98.2% negative predictive value for acute suicide attempts.
Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts, independently from socio-demographics and MDD characteristics. This difference is related to acute suicide attempts but neither to past suicide attempts nor to duration since the first suicide attempt, suggesting that hippocampal volume could be a suicidal state marker in MDE. Further studies are required to better understand this association.
尽管已知海马体积与重度抑郁发作（MDE）之间存在关联，且MDE患者的自杀倾向增加，但在重度抑郁症（MDD）中，海马体积与自杀倾向之间的联系仍不明确。如果海马体可以作为抑郁症患者自杀企图的生物标志物，那么它可能对预防工作有用。本研究评估了MDD患者海马体积与自杀企图之间的关联。
对63例MDD患者进行自动分割评估海马体积，其中有自杀企图的患者24例，无自杀企图的患者39例。研究了急性（<1个月）和既往（>1个月）自杀企图。
尽管在社会人口统计学、MDD和MDE临床特征方面没有差异，但有自杀企图的患者海马总体积低于无自杀企图的患者（4.61（±1.15）cm³对5.22（±0.99）cm³；w = 625.5；p = 0.03），尤其是急性自杀企图患者（4.19（±0.81）cm³对5.22（±0.99）cm³；w = 334；p = 0.005），即使在对脑体积、性别、年龄、汉密尔顿抑郁量表（HDRS）评分和MDD病程进行调整后也是如此。ROC分析显示，海马总体积阈值为5.00 cm³对急性自杀企图的阴性预测值为98.2%。
抑郁的自杀企图者比无自杀企图的抑郁患者海马体更小，这与社会人口统计学和MDD特征无关。这种差异与急性自杀企图有关，但与既往自杀企图及首次自杀企图后的持续时间均无关，提示海马体积可能是MDE中自杀状态的标志物。需要进一步研究以更好地理解这种关联。
