Structural and Functional Abnormities of Amygdala and Prefrontal Cortex in Major Depressive Disorder With Suicide Attempts.

Lifei Wang,Lingtao Kong,Yifang Zhou,Xiaowei Jiang,Pengfei Zhao,Feng Wu,Yimeng Zhao,Ran Zhang,Yanqing Tang,Shengnan Wei,Elliot K Edmiston,Fay Y Womer

doi:10.3389/fpsyt.2019.00923

Abstract

Finding neural features of suicide attempts (SA) in major depressive disorder (MDD) may be helpful in preventing suicidal behavior. The ventral and medial prefrontal cortex (PFC), as well as the amygdala form a circuit implicated in emotion regulation and the pathogenesis of MDD. The aim of this study was to identify whether patients with MDD who had a history of SA show structural and functional connectivity abnormalities in the amygdala and PFC relative to MDD patients without a history of SA. We measured gray matter volume in the amygdala and PFC and amygdala-PFC functional connectivity using structural and functional magnetic resonance imaging (MRI) in 158 participants [38 MDD patients with a history of SA, 60 MDD patients without a history of SA, and 60 healthy control (HC)]. MDD patients with a history of SA had decreased gray matter volume in the right and left amygdala (F = 30.270, P = 0.000), ventral/medial/dorsal PFC (F = 15.349, P = 0.000), and diminished functional connectivity between the bilateral amygdala and ventral and medial PFC regions (F = 22.467, P = 0.000), compared with individuals who had MDD without a history of SA, and the HC group. These findings provide evidence that the amygdala and PFC may be closely related to the pathogenesis of suicidal behavior in MDD and implicate the amygdala-ventral/medial PFC circuit as a potential target for suicide intervention.

Highlights

Major depressive disorder (MDD) is one of the most common mental disorders [1], which is commonly associated with a higher suicide risk [2, 3]
Post hoc analyses found the major depressive disorder (MDD) with and without a history of suicide attempts (SA) groups showed significantly higher Hamilton Depression Rating Scale (HAM-D) scores and Young Mania Rating Scale (YMRS) scores than the healthy control (HC) group, HAM-D and YMRS scores demonstrated no significant differences between the two MDD groups
We report that MDD patients with a history of SA have decreased gray matter volume in the amygdala and prefrontal cortex (PFC), and reduced functional connectivity from the amygdala to PFC, compared to both HC and individuals with MDD without a history of SA

Summary

Introduction

Major depressive disorder (MDD) is one of the most common mental disorders [1], which is commonly associated with a higher suicide risk [2, 3]. Recent structural and functional magnetic resonance imaging (MRI) studies demonstrate that the amygdala and PFC have been strongly implicated in MDD [10,11,12,13,14,15,16,17]. Regarding the PFC, morphological and functional alterations have been shown primarily in the orbitofrontal cortex, dorsolateral and ventrolateral PFC in MDD patients [12, 15,16,17]. Depressed individuals display decreased relationships between amygdala and dorsolateral PFC activity [12]

Objectives

Methods

Results

Conclusion