Wei Shengnan, Chang Miao, Zhang Ran, Jiang Xiaowei, Wang Fei, Tang Yanqing
1Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning People's Republic of China.
2Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning People's Republic of China.
Ann Gen Psychiatry. 2018 Sep 12;17:37. doi: 10.1186/s12991-018-0208-0. eCollection 2018.
Major depressive disorder (MDD) is a known major risk factor for suicide and is one of the most common mental disorders. Meanwhile, gender differences in suicidal behavior have long been recognized including the finding that women have higher rates of suicidal ideation and/or suicidal behavior than men. The mechanism underlying suicide ideation in female patients with MDD remains poorly understood. The aim of the present study was to examine possible suicidal behavior-related neural circuitry in female MDD.
In this study, 15 female participants with the first-episode MDD with suicidal ideation and 24 participants with the first-episode MDD without suicidal ideation as well as 39 female participants in a healthy control (HC) group, ranging in age from 18 to 50 years, underwent resting-state functional magnetic resonance imaging. The whole-brain amygdala resting-state functional connectivity (rsFC) was compared among these three groups.
Compared with female participants with the first-episode MDD without suicidal ideation and those in the HC group, female participants with the first-episode MDD with suicidal ideation showed a significant difference in rsFC between the amygdala and precuneus/cuneus ( < 0.05, corrected). No significant difference in amygdala-precuneus/cuneus rsFC was observed between female patients with the first-episode MDD without suicidal ideation and the HC group ( < 0.05, corrected).
Our findings suggest that suicidal ideation in female patients with the first-episode MDD may be related to an abnormality in amygdala neural circuitry. The abnormality in amygdala-precuneus/cuneus functional connectivity might present the trait feature for suicide in women with the first-episode MDD. The precuneus/cuneus may be an important region related to suicide and require future study.
重度抑郁症（MDD）是已知的自杀主要危险因素，也是最常见的精神障碍之一。同时，自杀行为中的性别差异早已为人所知，包括女性自杀意念和/或自杀行为发生率高于男性这一发现。女性MDD患者自杀意念背后的机制仍知之甚少。本研究的目的是检查女性MDD患者中可能与自杀行为相关的神经回路。
在本研究中，15名有自杀意念的首发MDD女性参与者、24名无自杀意念的首发MDD参与者以及39名年龄在18至50岁之间的健康对照（HC）组女性参与者接受了静息态功能磁共振成像检查。比较了这三组之间全脑杏仁核静息态功能连接（rsFC）。
与无自杀意念的首发MDD女性参与者和HC组相比，有自杀意念的首发MDD女性参与者在杏仁核与楔前叶/楔叶之间的rsFC存在显著差异（<0.05，校正）。在无自杀意念的首发MDD女性患者和HC组之间，未观察到杏仁核-楔前叶/楔叶rsFC有显著差异（<0.05，校正）。
我们的研究结果表明，首发MDD女性患者的自杀意念可能与杏仁核神经回路异常有关。杏仁核-楔前叶/楔叶功能连接异常可能是首发MDD女性自杀的特质特征。楔前叶/楔叶可能是与自杀相关的重要区域，需要未来进一步研究。
