Yi Yun, Huang Yuanyuan, Wei Yuhua, Wei Xin, Zou Zhenyou, Pan Limei, Xie Xinfeng, Luo Lanfang, Jiang Wenhua, Wu Fengchun
Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China.
Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
J Psychiatr Res. 2025 Nov;191:95-106. doi: 10.1016/j.jpsychires.2025.09.013. Epub 2025 Sep 6.
Accumulating evidence indicates that resting-state brain oscillations are altered in patients with major depressive disorder (MDD). However, the neurophysiology and neuropathology of patients with MDD with or without suicidal ideation (MDD-SI or MDD-NSI) are poorly understood.
Ninety first-episode and drug-naïve patients with MDD (FEDN) and forty-four healthy control participants were recruited for this study. The Beck Scale for Suicide Ideation (BSSI) was employed to evaluate suicidal ideation. The MATRICS Consensus Cognitive Battery (MCCB) was used to assess neurocognitive function. Resting-state electroencephalography (EEG) was recorded for 10 min with eyes closed.
A reduction in relative alpha power in the occipital region was observed in patients with major depressive disorder (MDD), both with and without suicidal ideation (SI), compared to healthy controls (HCs). No significant differences in occipital relative alpha power were found between the MDD-SI and MDD-NSI groups. Additionally, MDD patients without SI exhibited increased relative delta power in both the left and right occipital regions (Relative-LO-delta: p = 0.013; Relative-RO-delta: p = 0.002) compared to HCs. Compared to HCs, MDD-SI exhibited significantly increased relative gamma power in the right occipital region (Relative-RO-gamma: p = 0.027), while MDD-NSI showed elevated relative gamma power in the left frontal region (Relative-LF-gamma: p = 0.011). A significant reduction in frontal alpha asymmetry (FAA) was observed in MDD-NSI patients compared to HCs. Furthermore, negative correlations were found between relative alpha power in occipital regions and attention performance in the MDD-NSI group, but not in the MDD-SI group or HCs.
The relatively small sample size and the cross-sectional nature of the study may limit the generalizability of these findings.
Our findings indicate that brain oscillations are altered in first-episode, drug-naïve MDD patients regardless of suicidal ideation status. However, based on the present study, rsEEG is not a suitable biomarker for screening MDD-SI from MDD-NSI in drug-treatment naïve patients. The utility of rsEEG as a biomarker for distinguishing suicide risk among drug-treated MDD patients remains to be validated. Additionally, cognitive impairment and related alpha power alterations may serve as state-like markers particularly in MDD-NSI patients.
越来越多的证据表明，重度抑郁症（MDD）患者的静息态脑振荡会发生改变。然而，有或无自杀意念（MDD-SI或MDD-NSI）的MDD患者的神经生理学和神经病理学仍知之甚少。
本研究招募了90名首次发作且未接受过药物治疗的MDD患者（FEDN）和44名健康对照参与者。采用贝克自杀意念量表（BSSI）评估自杀意念。使用精神分裂症认知功能成套测验共识版（MCCB）评估神经认知功能。闭眼记录10分钟的静息态脑电图（EEG）。
与健康对照（HCs）相比，有和无自杀意念（SI）的重度抑郁症（MDD）患者枕叶区域的相对阿尔法功率均降低。MDD-SI组和MDD-NSI组之间枕叶相对阿尔法功率无显著差异。此外，与HCs相比，无SI的MDD患者在左右枕叶区域的相对德尔塔功率均增加（相对左枕叶德尔塔：p = 0.013；相对右枕叶德尔塔：p = 0.002）。与HCs相比，MDD-SI患者右枕叶区域的相对伽马功率显著增加（相对右枕叶伽马：p = 0.027），而MDD-NSI患者左额叶区域的相对伽马功率升高（相对左额叶伽马：p = 0.011）。与HCs相比，MDD-NSI患者的额叶阿尔法不对称性（FAA）显著降低。此外，在MDD-NSI组中发现枕叶区域的相对阿尔法功率与注意力表现呈负相关，但在MDD-SI组或HCs中未发现。
相对较小的样本量和研究的横断面性质可能会限制这些发现的普遍性。
我们的研究结果表明，无论自杀意念状态如何，首次发作、未接受过药物治疗的MDD患者的脑振荡都会发生改变。然而，基于本研究，静息态脑电图（rsEEG）不是从未接受过药物治疗的患者中筛选MDD-SI与MDD-NSI的合适生物标志物。rsEEG作为区分接受药物治疗的MDD患者自杀风险的生物标志物的效用仍有待验证。此外，认知障碍和相关的阿尔法功率改变可能是类似状态的标志物，尤其是在MDD-NSI患者中。
