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Published on: April 20, 2022
Modulation of suicide-related neural circuits by transcranial magnetic stimulation and its role in reducing suicide
Shiying Wang1,2, Chengfeng Chen3, Jiang Wang4
1Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 300222, Tianjin, China.
Abstract:
Suicide remains a critical public health issue, frequently linked to dysfunction in specific neural circuits. Disruption of these circuits may contribute to the onset of suicide. Accordingly, this study investigates the therapeutic potential of transcranial magnetic stimulation (TMS) in modulating suicide-related damaged networks. A total of 473 major depressive disorder patients were included, comprising 369 suicidal and 104 non-suicidal individuals. Deviations in functional connectivity strength (FCS) within the suicide-related damaged network were calculated using a normative model based on 943 healthy controls. Suicidal patients showed significantly higher deviations within the suicide-related damaged network compared to non-suicidal patients (z = 3.02, p = 0.003). Following TMS treatment, the mean deviations significantly decreased (z = 2.23, p = 0.026), particularly in responders (z = 2.29, p = 0.020). Furthermore, a classifier based on these deviations predicted treatment response with an accuracy of 75% and an area under the curve of 0.72. These findings suggest that deviations in FCS may serve as a neural marker of suicide risk and a potential predictor of treatment response to TMS. TMS may reduce suicide risk by modulating neuroplasticity within the suicide-related damaged network.
Insights
Transcranial magnetic stimulation (TMS) may help reduce suicide risk by improving brain network function. This study found that abnormal brain connectivity in suicidal patients improved after TMS treatment, suggesting it could be a potential biomarker.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Suicide is a major public health concern linked to neural circuit dysfunction.
- Identifying neural markers for suicide risk and treatment response is crucial.
Purpose of the Study:
- To investigate the therapeutic potential of transcranial magnetic stimulation (TMS) for suicide risk.
- To explore functional connectivity strength (FCS) deviations as a neural marker for suicide and TMS treatment response.
Main Methods:
- Analyzed functional connectivity strength (FCS) deviations in the suicide-related damaged network of 473 major depressive disorder patients (369 suicidal, 104 non-suicidal) using a normative model from 943 healthy controls.
- Assessed changes in FCS deviations following TMS treatment and evaluated a classifier's ability to predict treatment response.
Main Results:
- Suicidal patients exhibited significantly higher FCS deviations in the target network compared to non-suicidal patients (p=0.003).
- TMS treatment significantly decreased these deviations (p=0.026), especially in treatment responders (p=0.020).
- A classifier based on FCS deviations predicted TMS treatment response with 75% accuracy (AUC=0.72).
Conclusions:
- Deviations in FCS within the suicide-related damaged network may serve as a neural marker for suicide risk.
- These deviations show potential as a predictor of treatment response to TMS.
- TMS may mitigate suicide risk by enhancing neuroplasticity in relevant brain networks.
