Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China.
Brain Imaging Behav. 2020 Dec;14(6):2542-2552. doi: 10.1007/s11682-019-00206-4.
Although structural and functional brain abnormalities have been observed in depressed suicide attempters (DS), structural deficits and functional impairments together with their relationship in DS remain unclear. To clarify this issue, we aimed to examine the differences in gray matter (GM) alteration, corresponding functional connectivity (FC) change, and their relationship between DS and depressed non-suicide attempters (NDS). Sixty-eight DS, 119 NDS and 103 healthy controls were enrolled and subjected to magnetic resonance imaging scans. The patients were evaluated using the 17-item Hamilton Rating Scale for Depression (HRSD) and Nurses' Global Assessment of Suicide Risk (NGASR) scale. Both voxel-based morphometry and resting-state FC analyses were performed based on functional and structural imaging data. Compared with NDS, the DS group showed reduced GM volume in the right inferior frontal orbital gyrus (IFOG) and left caudate (CAU) but increased GM volume in the left calcarine fissure, weaker negative right IFOG-left rectus gyrus (REG) FC, and weaker positive right IFOG-left inferior parietal lobule (IPL) FC. In DS, the GM volume of the right IFOG and left CAU was negatively correlated with NGASR and HRSD scores, respectively; the right IFOG-left IPL FC was negatively correlated with cognitive factor scores; and the GM volume of the right IFOG was positively correlated with IFOG-REG and IFOG-IPL FC. Our findings indicate that structural deficit with its related functional alterations in brain circuits converged in right IFOG centralized pathways and may play a central role in suicidal behaviors in depression.
虽然在抑郁自杀未遂者 (DS) 中观察到结构和功能脑异常，但结构缺陷和功能障碍及其在 DS 中的关系仍不清楚。为了阐明这个问题，我们旨在检查 DS 和抑郁非自杀未遂者 (NDS) 之间灰质 (GM) 改变、相应功能连接 (FC) 变化及其关系的差异。纳入 68 名 DS、119 名 NDS 和 103 名健康对照者，并进行磁共振成像扫描。使用汉密尔顿抑郁量表 (HRSD) 和护士全球评估自杀风险量表 (NGASR) 量表对患者进行评估。基于功能和结构成像数据进行基于体素形态测量和静息状态 FC 分析。与 NDS 相比，DS 组显示右侧下额眶回 (IFOG) 和左侧尾状核 (CAU) 的 GM 体积减少，左侧楔前回 (CAU) 的 GM 体积增加，右侧 IFOG-左侧直回 (REG) FC 呈负性减弱，右侧 IFOG-左侧顶下小叶 (IPL) FC 呈正性减弱。在 DS 中，右侧 IFOG 和左侧 CAU 的 GM 体积与 NGASR 和 HRSD 评分呈负相关；右侧 IFOG-左侧 IPL FC 与认知因子评分呈负相关；右侧 IFOG 的 GM 体积与 IFOG-REG 和 IFOG-IPL FC 呈正相关。我们的研究结果表明，大脑回路中以右侧 IFOG 为中心的通路的结构缺陷及其相关的功能改变可能在抑郁中的自杀行为中起核心作用。
