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Suicidal Attempts and Brain Functional Network Abnormalities in Major Depressive Disorder

Poster No:

562 

Submission Type:

Late-Breaking Abstract Submission 

Authors:

Kyu-Man Han1, Minjee Jung1

Institutions:

1Korea University College of Medicine, Seoul, Korea, Republic of

First Author:

Kyu-Man Han  
Korea University College of Medicine
Seoul, Korea, Republic of

Co-Author:

Minjee Jung  
Korea University College of Medicine
Seoul, Korea, Republic of
E-Poster

Introduction:

Dysfunctional brain networks play a crucial role in the pathophysiology of suicidality in major depressive disorder (MDD). A history of previous suicide attempts is one of the strongest predictors of future suicidal risk in patients with MDD. Therefore, we aimed to compare resting-state functional connectivity (FC) among MDD patients with a history of suicide attempts, MDD patients without such a history, and healthy controls (HCs) using FC-multivariate pattern analysis (FC-MVPA). FC-MVPA is a data-driven approach that analyzes brain-wide connectome at the individual voxel-level. We also sought to explore correlations between the identified FC changes, suicidality severity, and childhood trauma exposure.

Methods:

We enrolled 204 adult participants (19–59 years old) at the outpatient psychiatric clinic of Korea University Anam Hospital in Seoul, Republic of Korea, between March 2015 and December 2021. These included 61 MDD patients who had attempted suicide at least once in their lifetime (SD group), 62 MDD patients without a suicide attempt history (NSD group), and 81 HCs (HC group). Resting-state functional MRI and T1-weighted images were acquired using a 3.0-Tesla Trio™ whole-body imaging system (Siemens Healthcare GmbH, Erlangen, Germany) at the Korea University MRI Center. Resting-state FC analyses were performed using the CONN toolbox (ver. 22.0a). We conducted FC-MVPA for the three groups (SD vs. NSD vs. HC), setting the number of eigenpatterns to 10 (a 20:1 ratio of the total sample size). Seed-to-voxel analyses at the whole-brain level were then performed for significant regions of interest (ROIs) identified by FC-MVPA to examine group differences. Cluster-wise correction using a family-wise error (FWE)-corrected threshold of p < 0.05 with a voxel-wise height of p < 0.001 (uncorrected) was applied to determine significant clusters, with age, sex, and years of education included as covariates.

Results:

FC-MVPA revealed eight significant clusters differing among the three groups, located in the right frontal pole, bilateral posterior cingulate cortex (PCC), right lateral occipital cortex (LOC), left cuneus, and left angular gyrus. Seed-to-voxel analysis of these ROIs identified 58 significant FC measures showing differences among the three groups. Of the extracted FC values (z-scores), 29 displayed significant differences between the SD and NSD groups after False Discovery Rate (FDR) correction (all FDR-corrected p [pcorr] < 0.05). In the combined MDD sample (SD + NSD), FC between the left cuneus and bilateral medial orbitofrontal cortex-which was significantly lower in the SD group compared to the NSD group (pcorr = 6.42 × 10-6)-showed a significant negative correlation with suicidality severity, as measured by the Beck's Scale for Suicide Ideation (r = -0.331, pcorr = 0.012). In the SD group, FC between the right LOC and right supramarginal gyrus-which was significantly higher compared to the NSD group (pcorr = 0.025)-showed a positive correlation with both the total score (r = 0.431, pcorr = 0.038) and physical neglect subscale score (r = 0.478, pcorr = 0.006) of the 28-item Childhood Trauma Questionnaire.

Conclusions:

We observed that alterations in FC between regions in the visual and default mode networks were associated with a history of suicidal attempts in patients with MDD. Recent studies have similarly reported that resting-state FC abnormalities in the visual network may be linked to suicidality in individuals with MDD or anxiety disorders. Our findings suggest that FC abnormalities in the visual network could serve as a potential biomarker for assessing suicidality risk in patients with MDD.

Disorders of the Nervous System:

Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1

Modeling and Analysis Methods:

Connectivity (eg. functional, effective, structural) 2
fMRI Connectivity and Network Modeling

Keywords:

Affective Disorders
DISORDERS
FUNCTIONAL MRI
Psychiatric
Psychiatric Disorders
Trauma

1|2Indicates the priority used for review

Abstract Information

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Please indicate below if your study was a "resting state" or "task-activation” study.

Resting state

Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

Patients

Was this research conducted in the United States?

No

Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.

Yes

Were any animal research approved by the relevant IACUC or other animal research panel? NOTE: Any animal studies without IACUC approval will be automatically rejected.

Not applicable

Please indicate which methods were used in your research:

Functional MRI

For human MRI, what field strength scanner do you use?

3.0T

Which processing packages did you use for your study?

Other, Please list  -   Conn functional connectivity toolbox

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not applicable

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