School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China.
Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
J Affect Disord. 2020 Oct 1;275:202-209. doi: 10.1016/j.jad.2020.07.016. Epub 2020 Jul 10.
The physiological mechanism of suicide attempt (SA) in bipolar II disorder (BD-II) remains only partially understood. The study seeks to identify the dysfunction pattern in suicide brain for BD-II patients.
Graph theory was utilized to explore topological properties at whole-brain, module and region levels based on resting-state functional MRI (rs-fMRI) data, which acquired from 38 un-medicated BD-II patients with at least one SA, 60 none SA (NSA) patients and 69 healthy controls (HCs). Finally, the correlation relationship between graph metrics and clinical variables were estimated.
Compared with NSA patients and HCs, the functional connectivity strength between limbic/sub-cortical (LIMB/SubC) and frontoparietal network (FPN) were significantly weakened. Nodal strength in left head of caudate nucleus (HCN), raphe nucleus (RN), right nucleus accumbens (NAcc), right subgenual anterior cingulate cortex (sgACC) and nodal efficiency in right sgACC, right HCN for SA patients were significantly reduced relative to NSA and HCs. In particular, nodal strength in RN and nodal efficiency in right sgACC showed a significant negative correlation with Nurses' Global Assessment of Suicide Risk (NGASR) scores.
This is a single-mode cross-sectional study, the results were not verified by multi-center data.
The abnormal disrupted FC between LIMB/SubC and FPN is associated with SA in BD-II patients, which increased the susceptibility of suicide. Especially, the dysfunction in RN and right sgACC predict a higher suicide risk in BD-II patients.The results can help us to understand the suicide mechanism and early judgment of suicidal behaviors for BD-II patients.
双相情感障碍 II 型（BD-II）患者自杀未遂（SA）的生理机制仍不完全清楚。本研究旨在确定 BD-II 患者自杀大脑的功能障碍模式。
利用图论方法，基于静息态功能磁共振成像（rs-fMRI）数据，从 38 名未经治疗的至少有一次 SA 的 BD-II 患者、60 名无 SA（NSA）患者和 69 名健康对照（HC）中，分别在全脑、模块和区域水平上探讨拓扑特性。最后，估计了图度量与临床变量之间的相关性。
与 NSA 患者和 HCs 相比，边缘/皮质下（LIMB/SubC）和额顶叶网络（FPN）之间的功能连接强度明显减弱。SA 患者左侧尾状核头部（HCN）、中缝核（RN）、右侧伏隔核（NAcc）、右侧扣带回前下皮质（sgACC）的节点强度和右侧 sgACC、右侧 HCN 的节点效率明显低于 NSA 患者和 HCs。特别是，RN 的节点强度和右侧 sgACC 的节点效率与护士全球评估自杀风险（NGASR）评分呈显著负相关。
这是一项单模态横断面研究，结果未通过多中心数据验证。
BD-II 患者 LIMB/SubC 和 FPN 之间异常的 FC 中断与 SA 有关，增加了自杀的易感性。特别是，RN 和右侧 sgACC 的功能障碍预示着 BD-II 患者自杀风险较高。研究结果有助于我们理解 BD-II 患者的自杀机制和自杀行为的早期判断。
