Temporal dynamic brain-heart interaction alterations associated with suicidal ideation in major depressive disorder

Previous studies have indicated abnormal brain activation or heart rate variability in patients with major depressive disorder (MDD). Suicidal ideation, as one of the main concerns of MDD, is a serious public health problem. However, the interactions between brain and heart of MDD patients with and without suicidal ideation remain largely unknown.

In this study, resting-state EEG and ECG data were simultaneously collected from 42 healthy controls (HCs), 69 MDD patients with suicidal ideation (MDDSI), and 39 MDD patients without suicidal ideation (MDDNSI). We proposed a novel methodology for analyzing temporal dynamic brain-heart interactions (TD-BHI). Then, we calculated the correlations between abnormalities of TD-BHI and cognitive performance, as well as sleep quality. Finally, we assessed the ability of TD-BHI to distinguish MDDSI patients.

We found that the TD-BHI values in the MDDSI group significantly increased in the parietal lobes and decreased in the right parietal lobes, compared with those in the HCs group. Additionally, the attention/vigilance score of the MATRICS consensus cognitive battery (MCCB) and the Pittsburgh sleep quality index scores were significantly correlated with the TD-BHI values in the MDDSI group. The ensemble learning model based on TD-BHI achieved an AUC of 0.825 in distinguishing MDDSI from MDDNSI patients.

Distinct abnormalities of TD-BHI may mediate suicidal ideation in MDD patients and can serve as a reliable biomarker for the diagnosis of MDDSI patients.