Yi Zhiqiang, Xia Luyao, Yi Junfei, Jia Yanfei, Wei Luhua, Shen Shengli, Wu Nan, Wang Dongmei, Zhou Huixia, Li Xingxing, Yan Chao-Gan, Zhang Xiang-Yang
Department of Neurosurgery, Peking University First Hospital, Beijing, China.
Department of Psychology, Teachers' college of Beijing Union University, Beijing, China.
Psychol Med. 2025 Feb 7;55:e24. doi: 10.1017/S0033291724003283.
Suicidal ideation (SI) is very common in patients with major depressive disorder (MDD). However, its neural mechanisms remain unclear. The anterior cingulate cortex (ACC) region may be associated with SI in MDD patients. This study aimed to elucidate the neural mechanisms of SI in MDD patients by analyzing changes in gray matter volume (GMV) in brain structures in the ACC region, which has not been adequately studied to date.
According to the REST-meta-MDD project, this study subjects consisted of 235 healthy controls and 246 MDD patients, including 123 MDD patients with and 123 without SI, and their structural magnetic resonance imaging data were analyzed. The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms. Correlation analysis and logistic regression analysis were used to determine whether there was a correlation between GMV of ACC and SI in MDD patients.
MDD patients with SI had higher HAMD scores and greater GMV in bilateral ACC compared to MDD patients without SI (all p < 0.001). GMV of bilateral ACC was positively correlated with SI in MDD patients and entered the regression equation in the subsequent logistic regression analysis.
Our findings suggest that GMV of ACC may be associated with SI in patients with MDD and is a sensitive biomarker of SI.
自杀观念（SI）在重度抑郁症（MDD）患者中非常常见。然而，其神经机制仍不清楚。前扣带回皮质（ACC）区域可能与MDD患者的自杀观念有关。本研究旨在通过分析ACC区域脑结构中的灰质体积（GMV）变化来阐明MDD患者自杀观念的神经机制，该区域迄今为止尚未得到充分研究。
根据REST-meta-MDD项目，本研究的受试者包括235名健康对照者和246名MDD患者，其中包括123名有自杀观念的MDD患者和123名无自杀观念的MDD患者，并对他们的结构磁共振成像数据进行了分析。采用17项汉密尔顿抑郁量表（HAMD）评估抑郁症状。采用相关性分析和逻辑回归分析来确定MDD患者ACC的GMV与自杀观念之间是否存在相关性。
与无自杀观念的MDD患者相比，有自杀观念的MDD患者的HAMD评分更高，双侧ACC的GMV更大（所有p<0.001）。MDD患者双侧ACC的GMV与自杀观念呈正相关，并在随后的逻辑回归分析中进入回归方程。
我们的研究结果表明，ACC的GMV可能与MDD患者的自杀观念有关，并且是自杀观念的一个敏感生物标志物。
