Exploring neural changes associated with suicidal ideation and attempts in major depressive disorder: A multimodal...

Area of Science:

• Neuroscience
• Psychiatry
• Radiology

Background:

• Suicidal ideation (SI) and suicide attempts (SA) are significant concerns in major depressive disorder (MDD).
• Understanding the neural underpinnings of SI and SA is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate the structural and functional brain alterations associated with SI and SA in MDD patients.
• To identify specific brain regions and networks involved in the progression from SI to SA.

Main Methods:

• Multimodal Magnetic Resonance Imaging (MRI) including Voxel-Based Morphometry (VBM) for gray matter volume (GMV) and seed-based resting-state functional connectivity (rsFC) analysis.
• Analysis of 159 participants: MDD with suicide attempts (SA group), MDD with suicidal ideation (SI group), MDD without suicidal ideation (NSI group), and healthy controls (HC).

Main Results:

• The SI group showed decreased GMV in the left dorsolateral prefrontal cortex (DLPFC), insula, and cerebellum compared to HC and NSI groups.
• The SA group exhibited altered GMV in the superior medial frontal gyrus (SFGmed) and superior temporal gyrus (STG) compared to HC and SI groups.
• rsFC analysis revealed distinct network differences between groups, particularly involving the insula, SFG, cerebellum, and STG.

Conclusions:

• Structural and functional changes in the insula, DLPFC, and cerebellum are associated with the development and worsening of SI in MDD.
• Alterations in SFGmed and STG are critical for the transition from SI to SA in MDD.
• These findings highlight specific neurobiological targets for understanding and treating suicidal behavior in MDD.