Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.
ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.
Acta Psychiatr Scand. 2019 May;139(5):454-463. doi: 10.1111/acps.13022. Epub 2019 Apr 1.
Mood disorders are strongly associated with suicide, the prevention of which is predicated on timely detection of suicidal activity (ideation, behaviour). Building on our previous work, we sought to determine the nature of neural responses to an emotional-cognitive task in patients with varying degrees of suicidal activity.
Seventy-nine patients with mood disorders were assessed clinically and scanned using fMRI. Neural responses to an Emotional Face-Word Stroop task were compared with 66 healthy controls. We identified regions of interest from seven key networks and examined responses to incongruent stimuli (Happy face-'Sad' word; Sad face-'Happy' word).
In comparison with healthy controls, patients had differential activity during both incongruent conditions. When examining for associations with suicidal activity within the patient group, those with higher scores had decreased default mode network activity for Happy face-'Sad' word manipulation, and increased basal ganglia network activity for Sad face-'Happy' word manipulation, after controlling for patient characteristics.
The fMRI findings suggest that suicidal activity in patients with mood disorders may be underpinned by cognitive-emotional deficits. These findings have implications for future suicide research and for achieving a deeper understanding of suicidal activity that may ultimately inform clinical detection and management.
情绪障碍与自杀密切相关，预防自杀的前提是及时发现自杀活动（意念、行为）。基于我们之前的工作，我们试图确定具有不同自杀活动程度的患者对情绪认知任务的神经反应的性质。
对 79 名患有心境障碍的患者进行临床评估并进行 fMRI 扫描。将对情绪面孔-单词斯特鲁普任务的神经反应与 66 名健康对照进行比较。我们从七个关键网络中确定了感兴趣的区域，并检查了对不一致刺激的反应（快乐面孔-“悲伤”词；悲伤面孔-“快乐”词）。
与健康对照组相比，患者在两种不一致条件下均有不同的活动。在对患者组内的自杀活动进行相关性研究时，在控制患者特征后，那些得分较高的患者在处理快乐面孔-悲伤单词时默认模式网络活动减少，而在处理悲伤面孔-快乐单词时基底神经节网络活动增加。
fMRI 研究结果表明，心境障碍患者的自杀活动可能是认知情绪缺陷的结果。这些发现对未来的自杀研究具有影响，有助于深入了解自杀活动，最终可能为临床检测和管理提供信息。
