Chen Ziqi, Xia Mingrui, Zhao Youjin, Kuang Weihong, Jia Zhiyun, Gong Qiyong
Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
J Magn Reson Imaging. 2021 Dec;54(6):1867-1875. doi: 10.1002/jmri.27784. Epub 2021 Jun 16.
The intrinsic brain functional connectivity of suicide attempts in major depressive disorder (MDD) remains incompletely understood.
To investigate graph-theoretical based functional connectivity strength (FCS) alterations in MDD patients with suicidal behavior.
Prospective.
Fifty medication-free MDD patients, with (suicide attempters, SA, N = 15) and without (non-attempters, nSA, N = 35) a history of a suicide attempt, and 37 healthy controls (HC).
FIELD STRENGTH/SEQUENCE: Resting-state functional magnetic resonance imaging (fMRI) using a gradient-echo imaging sequence was acquired at 3.0 T.
For each individual, voxel-wise whole-brain functional network was constructed and graph-theoretical based FCS map was calculated. For each individual in two patient groups, the seed-based functional connectivity map was constructed.
Non-parameter permutation tests, analysis of covariance, two-sample t-test, Chi-square test, and Pearson correlation analysis. A P value <0.05 was considered statistically significant.
Relative to the HC group, two MDD patient groups showed significantly lower FCS in the left hippocampus, while nSA patients showed additionally lower FCS in more widespread regions (P < 0.05). Importantly, comparing to nSA patients, SA patients had significantly higher FCS in the right orbitofrontal cortex (OFC) and bilateral dorsomedial prefrontal cortex (dmPFC) (P < 0.05). Further seed-based functional connectivity analysis revealed that the right OFC exhibited significantly higher connectivity to right middle frontal gyrus and lower connectivity to the left anterior cingulate cortex and left calcarine sulcus, and the bilateral dmPFC had significantly higher connectivity to the left middle frontal gyrus and right inferior temporal gyrus in the SA patients than in the nSA patients (P < 0.05).
This study identified disconnections of the OFC and dmPFC which were putatively related to a higher risk of suicidal behavior in MDD patients, thus extended the understanding of suicidal behavior at a brain circuit level.
3 TECHNICAL EFFICACY STAGE: 3.
重度抑郁症（MDD）患者自杀未遂的内在脑功能连接仍未完全明确。
研究基于图论的功能连接强度（FCS）在有自杀行为的MDD患者中的改变。
前瞻性研究。
50例未服用药物的MDD患者，其中有自杀未遂史（自杀未遂者，SA，N = 15）和无自杀未遂史（未尝试者，nSA，N = 35），以及37名健康对照者（HC）。
场强/序列：使用梯度回波成像序列在3.0 T下采集静息态功能磁共振成像（fMRI）。
为每个个体构建全脑体素功能网络并计算基于图论的FCS图谱。为两个患者组中的每个个体构建基于种子点的功能连接图谱。
非参数置换检验、协方差分析、两样本t检验、卡方检验和Pearson相关分析。P值<0.05被认为具有统计学意义。
相对于HC组，两个MDD患者组在左侧海马体中显示出显著更低的FCS，而nSA患者在更广泛的区域中还显示出更低的FCS（P < 0.05）。重要的是，与nSA患者相比，SA患者在右侧眶额皮质（OFC）和双侧背内侧前额叶皮质（dmPFC）中具有显著更高的FCS（P < 0.05）。进一步基于种子点的功能连接分析显示，SA患者中右侧OFC与右侧额中回的连接显著更高，与左侧前扣带回皮质和左侧距状沟的连接更低，并且双侧dmPFC与左侧额中回和右侧颞下回的连接在SA患者中比在nSA患者中显著更高（P < 0.05）。
本研究确定了OFC和dmPFC的连接中断，这可能与MDD患者更高的自杀行为风险相关，从而在脑回路水平上扩展了对自杀行为的理解。
3 技术疗效阶段：3。
Zotero 插件