Zhang Qi, Hong Su, Cao Jun, Zhou Yi, Xu Xiaoming, Ai Ming, Kuang Li
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
Biomed Res Int. 2021 Apr 12;2021:5524846. doi: 10.1155/2021/5524846. eCollection 2021.
Suicidal behavior is a leading cause of death and often commences during adolescence/young adulthood (15~29 years old). The hippocampus, which consists of multiple functionally specialized subfields, may contribute to the pathophysiology of depression and suicidal behavior. We aimed to investigate the differences of hippocampal subfield volume between major depressive disorder (MDD) patients with and without suicide attempts and healthy controls in adolescents and young adults. A total of 40 MDD suicide attempters (MDD+SA), 27 MDD patients without suicide attempt (MDD-SA), and 37 healthy controls (HC) were recruited. High-resolution T1 MRI images were analyzed with the automated hippocampal substructure module in FreeSurfer 6.0. Volume differences among the groups were analyzed by a generalized linear model controlling for intracranial cavity volume (ICV). The relationship between hippocampal subfield volumes and clinical characteristics (HAM-D and SSI scores) was assessed using two-tailed partial correlation controlling for ICV in MDD+SA and MDD-SA. We found that MDD-SA had significantly smaller bilateral hippocampal fissure volume than HC and MDD+SA. No significant correlation was observed between hippocampal subfield volume and clinical characteristics (HAM-D and SSI scores) in MDD+SA and MDD-SA. Adolescent/young adult suicide attempters with MDD suicide attempters have larger bilateral hippocampal fissures than depressed patients without suicide attempts, independently from clinical characteristics. Within the heterogeneous syndrome of major depressive disorder that holds a risk for suicidality for subgroups, hippocampal morphology may help to explain or possibly predict such risk, yet longitudinal and functional studies are needed for understanding the biological mechanisms underlying.
自杀行为是主要的死亡原因之一,通常始于青少年/青年期(15至29岁)。海马体由多个功能特异的亚区组成,可能在抑郁症和自杀行为的病理生理学中发挥作用。我们旨在调查青少年和青年期有自杀未遂和无自杀未遂的重度抑郁症(MDD)患者与健康对照者之间海马体亚区体积的差异。共招募了40名有自杀未遂的MDD患者(MDD+SA)、27名无自杀未遂的MDD患者(MDD-SA)和37名健康对照者(HC)。使用FreeSurfer 6.0中的自动海马体亚结构模块分析高分辨率T1 MRI图像。通过控制颅内腔体积(ICV)的广义线性模型分析组间体积差异。在MDD+SA和MDD-SA中,使用控制ICV的双尾偏相关评估海马体亚区体积与临床特征(汉密尔顿抑郁量表和自杀意念量表评分)之间的关系。我们发现,MDD-SA的双侧海马裂体积显著小于HC和MDD+SA。在MDD+SA和MDD-SA中,未观察到海马体亚区体积与临床特征(汉密尔顿抑郁量表和自杀意念量表评分)之间存在显著相关性。有自杀未遂的青少年/青年期MDD自杀未遂者的双侧海马裂比无自杀未遂的抑郁症患者更大,且独立于临床特征。在具有自杀风险亚组的重度抑郁症异质综合征中,海马体形态可能有助于解释或预测此类风险,但需要纵向和功能研究来了解其潜在的生物学机制。