Zhang Haoran, Liu Xinyu, Su Ziyao, Wang Yingtan, Chen Bingxu, Zhang Zhizhen, Wang Bin, Zhou Jia, Zhang Ling, Zhao Xixi
Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Front Neurosci. 2024 Aug 7;18:1429019. doi: 10.3389/fnins.2024.1429019. eCollection 2024.
The aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressive-anxiety symptoms, and the risk of suicide in MDD.
350 MDD patients' demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses' Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, -tests, Pearson's correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model.
The regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk.
The severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk.
The relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk.
我们研究的目的是探讨脑电图中神经振荡功率变化、抑郁焦虑症状严重程度与重度抑郁症（MDD）自杀风险之间的关系。
收集了350例MDD患者的人口统计学和临床数据，使用17项汉密尔顿抑郁量表（HDRS - 17）和14项汉密尔顿焦虑量表（HAMA - 14）评估他们的抑郁和焦虑症状，同时使用护士自杀风险综合评估量表（NGASR）进行自杀风险评估。采集、处理和分析脑电图数据，以研究与MDD相关的脑活动模式。根据自杀风险水平对参与者进行分组，并使用卡方检验、t检验、Pearson相关性分析等统计方法来探讨脑活动、症状严重程度和自杀风险之间的关联。确定密切相关的变量，并最终采用向前逐步回归分析筛选出最优模型，进一步使用中介效应来确定回归模型中变量之间可能的相互作用。
回归模型显示，HDRS - 17和枕叶内侧皮质（MOC）的α波功率对自杀风险有显著影响，HDRS - 17升高会增加自杀风险，而α波功率升高会降低自杀风险。中介效应分析表明，MOC的α波功率部分介导了抑郁水平对自杀风险的影响，抑郁严重程度增加可能导致MOC的α波功率降低，而MOC的α波功率降低可能导致自杀风险增加。
抑郁严重程度直接增加自杀风险，而MOC较高的α波功率作为保护因素可降低这种风险。值得注意的是，MOC的α波功率不仅直接影响自杀风险，还介导了抑郁严重程度和焦虑水平对该风险的影响。
本研究相对较小的样本量可能限制了对整个MDD患者群体的代表性以及对不同亚组的详细分析。本研究未深入探讨MDD患者认知症状严重程度与自杀风险之间的关系。
