Ishikawa Kazuhiro, Nemoto Kiyotaka, Shiratori Yuki, Sodeyama Noriko, Kodama Kikuko, Usuniwa Hitoshi, Yamada Noriko, Yaguchi Chie, Hori Takafumi, Arai Tetsuaki, Tachikawa Hirokazu
Ikeda Hospital Ryugasaki Ibaraki Japan.
Department of Psychiatry, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan.
PCN Rep. 2022 Aug 3;1(3):e35. doi: 10.1002/pcn5.35. eCollection 2022 Sep.
Suicide prevention for depressive patients is an important clinical issue in psychiatry. However, not all depressive patients plan or attempt suicide. In this study, we investigated the differences of functional brain networks between a high-risk group and a low-risk group for suicide by comparing resting-state functional connectivity (rsFC).
The subjects were 29 patients with major depressive disorder, nine of whom had attempted suicide. The suicidal ideation of all subjects was assessed with the Columbia-Suicide Severity Rating Scale, then the subjects were divided into two groups based on the most severe suicidal ideation (MSI) in their lifetime. We compared rsFC between the two groups.
Of the 29 subjects, 16 were in the severe MSI group. We found that the severe MSI group members had significantly smaller rsFC in two networks: one comprised the right dorsolateral prefrontal cortex and the default-mode network, and the other comprised the left rostrolateral prefrontal cortex and the striatum, amygdala, and hippocampus. These regions are reported to be associated with rumination, retrieval suppression, and delay discounting (DD).
Our results suggest that functional networks related to rumination, retrieval suppression, and DD might be impaired in depressive patients with severe suicidal ideation. It might be beneficial for psychiatrists to assess these characteristics in terms of suicide prevention for depressive patients.
抑郁症患者的自杀预防是精神病学中的一个重要临床问题。然而,并非所有抑郁症患者都计划或尝试自杀。在本研究中,我们通过比较静息态功能连接(rsFC),调查了自杀高风险组和低风险组之间大脑功能网络的差异。
研究对象为29例重度抑郁症患者,其中9例曾尝试自杀。使用哥伦比亚自杀严重程度评定量表评估所有受试者的自杀意念,然后根据其一生中最严重的自杀意念(MSI)将受试者分为两组。我们比较了两组之间的rsFC。
在29名受试者中,16名属于严重MSI组。我们发现,严重MSI组的成员在两个网络中的rsFC明显较小:一个网络由右侧背外侧前额叶皮层和默认模式网络组成,另一个网络由左侧喙外侧前额叶皮层以及纹状体、杏仁核和海马体组成。据报道,这些区域与沉思、检索抑制和延迟折扣(DD)有关。
我们的结果表明,在有严重自杀意念的抑郁症患者中,与沉思、检索抑制和DD相关的功能网络可能受损。对于精神科医生而言,从抑郁症患者自杀预防的角度评估这些特征可能是有益的。