Alteration of Whole Brain ALFF/fALFF and Degree Centrality in Adolescents With Depression and Suicidal Ideation After Electroconvulsive Therapy: A Resting-State fMRI Study.

Xiao Li,Yi Zhou,Linqi Dai,Renqiang Yu,Xiaolu Chen,Qian Huang,Li Kuang,Ming Ai,Xiaoyue Qin

doi:10.3389/fnhum.2021.762343

Abstract

Major depressive disorder (MDD) is one of the most widespread mental disorders and can result in suicide. Suicidal ideation (SI) is strongly predictive of death by suicide, and electroconvulsive therapy (ECT) is effective for MDD, especially in patients with SI. In the present study, we aimed to determine differences in resting-state functional magnetic resonance imaging (rs-fMRI) in 14 adolescents aged 12–17 with MDD and SI at baseline and after ECT. All participants were administered the Hamilton Depression Scale (HAMD) and Beck Scale for Suicide Ideation (BSSI) and received rs-fMRI scans at baseline and after ECT. Following ECT, the amplitude of low frequency fluctuation (ALFF) and fractional ALFF (fALFF) significantly decreased in the right precentral gyrus, and the degree centrality (DC) decreased in the left triangular part of the inferior frontal gyrus and increased in the left hippocampus. There were significant negative correlations between the change of HAMD (ΔHAMD) and ALFF in the right precentral gyrus at baseline, and between the change of BSSI and the change of fALFF in the right precentral gyrus. The ΔHAMD was positively correlated with the DC value of the left hippocampus at baseline. We suggest that these brain regions may be indicators of response to ECT in adolescents with MDD and SI.

Highlights

Suicide is an important global health concern cited as the 20th leading cause of death worldwide
Previous studies have found that 2 weeks of repetitive transcranial magnetic stimulation could decrease Hamilton Depression Scale (HAMD) scores significantly in adults with increased regional function in the left dorsolateral prefrontal cortex (Zheng et al, 2020), but did not discuss Suicidal ideation (SI)
PostECT, our present study found changed brain function in the precentral gyrus, hippocampus, and the triangular part of the inferior frontal gyrus, which may indicate the mechanism of action behind the efficacy of electroconvulsive therapy (ECT) in adolescents with Major depressive disorder (MDD) and SI

Summary

Introduction

Suicide is an important global health concern cited as the 20th leading cause of death worldwide. Major depressive disorder (MDD) is a major risk factor for suicide (Kessler et al, 2005); previous research has reported that approximately 15% of patients with MDD die by suicide (Chen and Dilsaver, 1996; Angst et al, 2013). Suicide in adolescents has become a severe public health and social dilemma. MDD with SI is related to higher rates of poor treatment response (Szanto et al, 2003), and is thought to have different neuropsychological correlates compared to MDD without SI (Marzuk et al, 2005). Measuring SI in patients with MDD is necessary and may help determine the risk of suicide

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