Jung JeYoung, Choi Sunyoung, Han Kyu-Man, Kim Aram, Kang Wooyoung, Paik Jong-Woo, Lee Hae-Woo, Ham Byung-Joo
School of Psychology, University of Nottingham, Nottingham, UK.
Clinical Research Division, Korean Institute of Oriental Medicine, Daejeon, Republic of Korea.
Neuropsychopharmacology. 2020 May;45(6):964-974. doi: 10.1038/s41386-019-0560-z. Epub 2019 Oct 31.
Suicide is a major challenge in public health and is strongly associated with major depressive disorder (MDD). Despite recent neuroimaging developments, the neural correlates of suicide behavior in patients with MDD remain unclear. Independent component analysis (ICA) for neuroimaging data allows the identification of functional brain networks without prior regions of interest and may help to identify neurobiological markers of specific disorders. Using ICA, we investigated the differences in resting-state brain networks in patients with MDD who had or did not have a history of suicide attempts and in healthy controls (HCs). Suicidal depressed (SD) patients, non-suicidal depressed (NSD) patients, and HCs significantly differed from each other in the pattern of connectivity of multiple functional networks, network synchronization, and functional network connectivity (FNC). The patient groups had a decreased network synchronization in the insular, cerebellum, basal ganglia, thalamus, operculum, frontoparietal cortices, and sensory cortices relative to the HCs. The decreased FNC between these networks (insular-default mode network and insular-cerebellum) was found in the SD group compared to the NSD and HC groups. These differences were not related to illness duration and medication status differences between SD and NSD. Furthermore, the degree of FNC in these networks was associated with the suicide ideation and stress level. Our results demonstrated that widespread but discrete network changes in brain networks and their interconnectivity was associated with suicide attempts in patients with MDD. Our results suggest that the neural basis underlying the psychopathology of attempted suicide in patients with MDD involves multiple brain networks and their interaction.
自杀是公共卫生领域的一项重大挑战，且与重度抑郁症（MDD）密切相关。尽管神经影像学近来有所发展，但MDD患者自杀行为的神经关联仍不明确。对神经影像学数据进行独立成分分析（ICA）可在无需预先设定感兴趣区域的情况下识别大脑功能网络，可能有助于识别特定疾病的神经生物学标志物。我们使用ICA研究了有或无自杀未遂史的MDD患者以及健康对照者（HCs）静息态脑网络的差异。自杀性抑郁（SD）患者、非自杀性抑郁（NSD）患者和HCs在多个功能网络的连接模式、网络同步性和功能网络连接性（FNC）方面存在显著差异。相对于HCs，患者组在岛叶、小脑、基底神经节、丘脑、脑盖、额顶叶皮质和感觉皮质的网络同步性降低。与NSD组和HC组相比，SD组中这些网络（岛叶-默认模式网络和岛叶-小脑）之间的FNC降低。这些差异与SD组和NSD组之间的病程及用药状态差异无关。此外，这些网络中FNC的程度与自杀意念和应激水平相关。我们的结果表明，MDD患者脑网络中广泛但离散的网络变化及其相互连接性与自杀未遂有关。我们的结果表明，MDD患者自杀未遂心理病理学的神经基础涉及多个脑网络及其相互作用。
