Voxel-wise meta-analysis of task-related brain activation abnormalities in major depressive disorder with suicide behavior.

Previous task-fMRI studies have reported the abnormal brain activations in major depressive disorders (MDD) with suicidal behavior. However, there is no consensus of opinion on task-fMRI imaging findings of the suicidal brain. We performed a meta-analysis to integrate the results of reported studies to find the consistent task-related alteration pattern of brain activations in MDD patients with suicidal behavior, aiming to investigate brain functional alterations in association with a vulnerability to suicidal behavior. Using the SDM (Seed-based d Mapping) method, we conducted a meta-analysis of the task-fMRI studies to compare the brain activations between major depressive disorder (MDD) patients with a history of suicidal behavior (suicide attempter, ATT) and the MDD patients without suicidal behavior (non-attempters, NAT) during tasks. Our systematic search identified 7 task-fMRI studies comprising 366 individuals, i.e., 150 ATT and 216 NAT. We found that brain activation in ATT increased in the left insula, while decreased in the bilateral fusiform gyrus compared to NAT during the fMRI tasks. We found the brain activation changes in the insula and fusiform gyrus in MDD patients with a history of suicide attempt during fMRI tasks. The brain activation changes in these regions were associated with the dysfunction of emotion regulation, processing negative information and self-awareness which may increase the vulnerability of suicidal behavior in MDD patients.