Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China.
Psychol Med. 2023 Jul;53(9):3837-3848. doi: 10.1017/S0033291722000484. Epub 2022 Mar 8.
Mounting evidence showed that insula contributed to the neurobiological mechanism of suicidal behaviors in bipolar disorder (BD). However, no studies have analyzed the dynamic functional connectivity (dFC) of insular Mubregions and its association with personality traits in BD with suicidal behaviors. Therefore, we investigated the alterations of dFC variability in insular subregions and personality characteristics in BD patients with a recent suicide attempt (SA).
Thirty unmedicated BD patients with SA, 38 patients without SA (NSA) and 35 demographically matched healthy controls (HCs) were included. The sliding-window analysis was used to evaluate whole-brain dFC for each insular subregion seed. We assessed between-group differences of psychological characteristics on the Minnesota Multiphasic Personality Inventory-2. Finally, a multivariate regression model was adopted to predict the severity of suicidality.
Compared to NSA and HCs, the SA group exhibited decreased dFC variability values between the left dorsal anterior insula and the left anterior cerebellum. These dFC variability values could also be utilized to predict the severity of suicidality ( = 0.456, = 0.031), while static functional connectivity values were not appropriate for this prediction. Besides, the SA group scored significantly higher on the schizophrenia clinical scales ( < 0.001) compared with the NSA group.
Our findings indicated that the dysfunction of insula-cerebellum connectivity may underlie the neural basis of SA in BD patients, and highlighted the dFC variability values could be considered a neuromarker for predictive models of the severity of suicidality. Moreover, the psychiatric features may increase the vulnerability of suicidal behavior.
越来越多的证据表明，脑岛参与了双相障碍（BD）自杀行为的神经生物学机制。然而，目前还没有研究分析过有自杀行为的 BD 患者脑岛 Mubrain 区的动态功能连接（dFC）及其与人格特质的关系。因此，我们研究了有近期自杀尝试（SA）的 BD 患者脑岛亚区 dFC 变异性和人格特征的变化。
本研究共纳入 30 名未经药物治疗的有 SA 的 BD 患者、38 名无 SA（NSA）的患者和 35 名年龄、性别匹配的健康对照者（HCs）。采用滑动窗口分析评估每个脑岛亚区种子的全脑 dFC。我们在明尼苏达多相人格问卷-2 上评估了组间心理特征的差异。最后，采用多元回归模型来预测自杀的严重程度。
与 NSA 和 HCs 相比，SA 组左侧背侧前脑岛和左侧前脑小脑之间的 dFC 变异性值降低。这些 dFC 变异性值也可以用于预测自杀的严重程度（ = 0.456， = 0.031），而静态功能连接值不适合这种预测。此外，SA 组在精神分裂症临床量表上的评分明显高于 NSA 组（ < 0.001）。
我们的研究结果表明，脑岛-小脑连接的功能障碍可能是 BD 患者 SA 的神经基础，并且强调 dFC 变异性值可以作为预测自杀严重程度的神经标志物。此外，精神特征可能会增加自杀行为的易感性。
