Department of Psychiatry, Vagelos College of Physicians and Surgeons at Columbia University, New York, New York.
Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York.
J Clin Psychiatry. 2022 Mar 30;83(3):21m14054. doi: 10.4088/JCP.21m14054.
Suicidal ideation (SI) is a risk factor for completed suicide. Our previous resting state functional magnetic resonance imaging (fMRI) study found that higher amplitude of low frequency fluctuation (ALFF) in right hippocampus and thalamus was associated with SI in major depressive disorder (MDD). The present study aimed to evaluate that association in participants with bipolar disorder (BD). Thirty depressed, adult participants with a diagnosis of BD had resting state fMRI scans. Region-of-interest (ROI) analyses used ALFF values within areas that were previously associated with SI in MDD. Spearman rank correlation and ordinal regression analyses were performed to assess associations between ALFF values and the SI item of the Montgomery-Asberg Depression Rating Scale. Exploratory whole-brain analyses identified regions where ALFF was associated with SI. Within the right hippocampus region, SI was positively associated with ALFF (Spearman = 0.490, = .0060). Ordinal regression analysis indicated that for every 0.1-unit increase in ALFF in that region, the odds of having higher SI were increased by 35% (odds ratio = 1.35; 95% confidence interval, 1.08-1.73; = .012). Within the previously identified thalamus cluster, SI was associated with ALFF only at a trend level (Spearman = 0.310, = .069). Whole-brain analyses identified 3 clusters of positive association between SI and ALFF, 1 of which was located in the right hippocampus. This study found that our previous finding of positive association between SI and ALFF in the right hippocampus extended to bipolar depression. Future studies should examine the clinical utility of this association, and the role of the hippocampus in SI. Data used for this secondary analysis came from studies with ClinicalTrials.gov identifiers NCT02239094 (January 2015 through September 2016) and NCT02473250 (January 2015 through December 2019).
自杀意念（SI）是自杀的危险因素。我们之前的静息态功能磁共振成像（fMRI）研究发现，右海马和丘脑的低频振幅（ALFF）与重度抑郁症（MDD）中的 SI 有关。本研究旨在评估双相情感障碍（BD）患者中的这种关联。30 名患有 BD 的抑郁成年参与者进行了静息态 fMRI 扫描。使用先前与 MDD 中的 SI 相关的区域的 ALFF 值进行了感兴趣区域（ROI）分析。Spearman 秩相关和有序回归分析用于评估 ALFF 值与 Montgomery-Asberg 抑郁评定量表 SI 项之间的关联。探索性全脑分析确定了与 SI 相关的 ALFF 区域。在右海马区域内，SI 与 ALFF 呈正相关（Spearman = 0.490， = .0060）。有序回归分析表明，该区域的 ALFF 每增加 0.1 个单位，SI 更高的几率增加 35%（优势比 = 1.35；95%置信区间，1.08-1.73； = .012）。在先前确定的丘脑簇中，SI 与 ALFF 仅呈趋势相关（Spearman = 0.310， = .069）。全脑分析确定了 3 个 SI 与 ALFF 之间呈正相关的簇，其中 1 个位于右海马。本研究发现，我们之前在右海马中发现的 SI 与 ALFF 之间的正相关扩展到了双相抑郁。未来的研究应该检验这种关联的临床实用性，以及海马在 SI 中的作用。本二次分析使用的数据集来自临床试验.gov 标识符 NCT02239094（2015 年 1 月至 2016 年 9 月）和 NCT02473250（2015 年 1 月至 2019 年 12 月）的研究。
