Hu Changchun, Jiang Wenhao, Huang Jie, Lin Jian, Huang Jialing, Wang Mei, Xie Jian, Yuan Yonggui
Department of Clinical Psychology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China.
Front Psychiatry. 2023 Jul 28;14:1228260. doi: 10.3389/fpsyt.2023.1228260. eCollection 2023.
The amplitude of low-frequency fluctuation (ALFF) is a measure of spontaneous brain activity derived from resting-state functional magnetic resonance imaging (rs-fMRI). Previous research has suggested that abnormal ALFF values may be associated with major depressive disorder (MDD) and suicide attempts in adolescents. In this study, our aim was to investigate the differences in ALFF values between adolescent MDD patients with and without a history of suicide attempts, and to explore the potential utility of ALFF as a neuroimaging biomarker for aiding in the diagnosis and prediction of suicide attempts in this population.
The study included 34 adolescent depression patients with suicide attempts (SU group), 43 depression patients without suicide attempts (NSU group), and 36 healthy controls (HC group). Depression was diagnosed using a threshold score greater than 17 on the Hamilton Depression Rating Scale (HDRS). The rs-fMRI was employed to calculate zALFF values and compare differences among the groups. Associations between zALFF values in specific brain regions and clinical variables such as emotion regulation difficulties were explored using Pearson partial correlation analysis. Receiver-Operating Characteristics (ROC) analysis assessed the ability of mean zALFF values to differentiate between SU and NSU groups.
Significant differences in zALFF values were observed in the left and right inferior temporal gyrus (l-ITG, r-ITG) and right fusiform gyrus (r-FG) among the three groups (GRF corrected). Both SU and NSU groups exhibited increased zALFF values in the inferior temporal gyrus compared to the HC group. Furthermore, the SU group showed significantly higher zALFF values in the l-ITG and r-FG compared to both the NSU group and the HC group. Partial correlation analysis revealed a negative correlation between zALFF values in the left superior and middle frontal gyrus (l-SFG, l-MFG) and the degree of emotional dysregulation in the SU group ( = -0.496, = 0.003; = -0.484, = 0.005). Combining zALFF values from the l-ITG and r-FG achieved successful discrimination between depressed adolescents with and without suicide attempts (AUC = 0.855) with high sensitivity (86%) and specificity (71%).
Depressed adolescents with suicidal behavior exhibit unique neural activity patterns in the inferior temporal gyrus and fusiform gyrus. These findings highlight the potential utility of these specific brain regions as biomarkers for identifying suicide risk in depressed adolescents. Furthermore, associations between emotion dysregulation and activity in their frontal gyrus regions were observed. These findings provide preliminary yet pertinent insights into the pathophysiology of suicide in depressed adolescents.
低频振幅（ALFF）是一种从静息态功能磁共振成像（rs-fMRI）得出的自发脑活动测量指标。先前的研究表明，异常的ALFF值可能与青少年重度抑郁症（MDD）及自杀未遂有关。在本研究中，我们的目的是调查有自杀未遂史和无自杀未遂史的青少年MDD患者之间ALFF值的差异，并探索ALFF作为神经影像学生物标志物在辅助诊断和预测该人群自杀未遂方面的潜在效用。
该研究纳入了34名有自杀未遂的青少年抑郁症患者（SU组）、43名无自杀未遂的抑郁症患者（NSU组）和36名健康对照者（HC组）。使用汉密尔顿抑郁量表（HDRS）中大于17分的阈值分数来诊断抑郁症。采用rs-fMRI计算zALFF值并比较组间差异。使用Pearson偏相关分析探索特定脑区的zALFF值与诸如情绪调节困难等临床变量之间的关联。采用受试者工作特征（ROC）分析评估平均zALFF值区分SU组和NSU组的能力。
三组之间在左侧和右侧颞下回（l-ITG，r-ITG）以及右侧梭状回（r-FG）观察到zALFF值存在显著差异（GRF校正）。与HC组相比，SU组和NSU组在颞下回的zALFF值均升高。此外，与NSU组和HC组相比，SU组在l-ITG和r-FG中的zALFF值显著更高。偏相关分析显示，SU组左侧额上回和额中回（l-SFG，l-MFG）的zALFF值与情绪失调程度呈负相关（r = -0.496，p = 0.003；r = -0.484，p = 0.005）。结合l-ITG和r-FG的zALFF值能够成功区分有和无自杀未遂的抑郁青少年（AUC = 0.855），具有高敏感性（86%）和特异性（71%）。
有自杀行为的抑郁青少年在颞下回和梭状回表现出独特的神经活动模式。这些发现突出了这些特定脑区作为识别抑郁青少年自杀风险生物标志物的潜在效用。此外，还观察到情绪失调与额叶区域活动之间的关联。这些发现为抑郁青少年自杀的病理生理学提供了初步但相关的见解。
