Abstract
Our study aimed to clarify the neuroimaging correlates of suicide attempt by comparing differences in functional magnetic resonance imaging (fMRI) among depressed suicide attempters, depressed patients without suicide attempt history, and healthy controls through comprehensive and novel fMRI analyses and methods in the same study population. The association between depression severity and aspects of the brain imaging was also discussed. Our study recruited 109 participants who were assigned to three groups: 33 depressed patients with suicide attempt (SA), 32 depressed patients without suicide attempt (NS), and 44 healthy controls (HC). All participants were scanned using a 3 T MRI imaging system to obtain resting-state functional images. In seed-based correlation analysis, we found altered functional connectivity in some brain regions of the SA compared with the NS or HC, especially in the hippocampus and thalamus. In the voxel-based analysis, our results showed differential activation and regional homogeneity of the temporal lobe and several brain regions in the SA compared with the NS and HC. We also found that some brain areas correlated with the Hamilton Depression Rating Scale (HAM-D), anxiety, and depression scores, especially in the frontal and temporal lobes. Graph theoretical analysis (GTA) and network-based statistical (NBS) analyses revealed different topological organization as well as slightly better global integration and worse local segregation of the brain network (i.e., more like a random network) in depressed participants compared with healthy participants. We concluded that the brain function of major depressive disorders with and without suicide attempts changed compared with healthy participants.
Highlights
Suicide is an important and serious public health problem worldwide
The location of the brain regions is not the same, overall, the number of connections in the normal human brain network is more than that in patients with depression. In this Seed-Based Correlation Analysis (SCA), we found altered Functional Connectivity (FC) in some brain regions of the suicide attempt (SA) group compared with the NS or healthy controls (HC) groups, especially in the hippocampus and thalamus
In the voxel-based analysis (VBA), the mean fractional ALFF (mfALFF) and mean ReHo (mReHo) results showed different activation and regional homogeneity of the temporal lobe and several brain regions in the SA compared with the NS and HC
Summary
Suicide is an important and serious public health problem worldwide. The strongest predictor of completed suicide is suicide attempt [2]; suicide risk among those with a history of suicide attempt is hundreds of times higher than in the general population [3,4]. The lifetime prevalence of suicide attempt is high in the general population: 4.6% in the National Comorbidity Survey (NCS) [5] and 4.3% in the earlier epidemiologic catchment area survey (ECA) [6]. Suicide risk evaluation still relies on clinicians’ experiences, but many health-related workers are not familiar with suicide risk assessment. Exploring the quantitative indicators that reflect stable changes in brain function is important for creating more effective preventive treatment programs, for better identifying at-risk individuals, and for developing more specific therapeutic tools [8]. Neurobiological studies have provided further evidence for this concept by demonstrating that suicidal behavior is a state-based condition stored in neural circuitry that can be quickly switched on by the recall of an experience of mental pain [9]
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