Exploring Brain Network Dynamics in Suicide Attempt Survivors Using EEG Microstate Analysis

Accumulating evidence has revealed deviations in neural network connectivity among individuals with suicidal ideation (SI). We sought to explore the neural network dynamics of suicide attempt (SA) survivors. We recruited 31 SA survivors, 33 individuals with SI, and 33 normal people controls (NP). To investigate brain network dynamics, we collected 64-channel resting-state EEG recordings and conducted microstate analysis on all participants. Compared to the NP group, both SA survivors and SI group displayed greater coverage and occurrence of microstates A and B. Notably, relative to the SI group, a marked elevation in the occurrence of microstates D and E and a significant increased coverage of microstate E, were observed in the SA group. The SA group exhibited significantly shorter durations of microstates C, D, and E, along with reduced occurrence and coverage of microstate C, compared to the SI group. The SA group exhibited significantly greater transition probabilities from microstate E to any other microstate compared to the SI group. Furthermore, higher suicide risk scores significantly correlated increased occurrence of microstate D, occurrence of microstate E, and coverage of microstate E. A key limitation is the cross-sectional design, which restricts the capacity to establish whether microstate dynamics can serve as predictors of future suicidal behavior. The present results imply that the microstate dynamics of SA survivors are distinct from those of individuals with SI. These results indicate that microstate dynamics could potentially act as neurobiomarkers for distinguishing suicidal behavior and SI.