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Chen Z, Xu T, Li Q, Shu Y, Zhou X, Guo T, Liang F. Grey matter abnormalities in major depressive disorder patients with suicide attempts: A systematic review of age-specific differences. Heliyon 2024; 10:e24894. [PMID: 38317985 PMCID: PMC10839985 DOI: 10.1016/j.heliyon.2024.e24894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
Background Previous studies have reported alterations in brain structure in major depressive disorder (MDD) patients with suicide attempts. However, age-related changes in suicidal MDD patients remain unclear. Methods We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, PubMed, and Web of Science were searched to identify relevant studies from inception to January 2023. All voxel-based and surface-based morphometry studies comparing suicidal MDD patients to MDD or healthy controls were included. Studies were then grouped by age range (old, middle-age, adolescent) and the commonalities and age-related structural brain alterations were summarized. The included studies were evaluated using the Newcastle-Ottawa Scale (NOS). Results A total of 17 studies met the inclusion criteria, including 3 of late-life depression (LLD) patients, 11 of middle-aged depression (MAD) patients, and 3 of adolescent depression (AOD) patients. The majority of studies had moderate to high NOS scores, indicating good quality. Patients in all three age groups exhibited extensive alterations in the lateral, medial, and orbital regions of the frontal lobes. Furthermore, suicidal MAD patients showed a specific decrease in the gray matter volume of the dorsolateral prefrontal cortex compared to suicidal LLD patients. Cortical thickness and left angular gyrus volume were decreased in suicidal MAD and suicidal LLD patients, but increased in suicidal AOD patients. Conclusion This systematic review summarizes structural brain changes in suicidal MDD patients at three age groups: elderly, middle-aged, and adolescent. These findings help elucidate the common circuitry of MDD related to suicide over the lifespan and highlight unique circuitry associated with different ages. These findings may help predict the risk of suicide in MDD patients at different ages.
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Affiliation(s)
- Ziwen Chen
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Xu
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qifu Li
- Department of Acupuncture and Moxibustion Rehabilitation, Yunnan University of Chinese Medicine, Kunming, China
| | - Yunjie Shu
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xueli Zhou
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Taipin Guo
- Department of Acupuncture and Moxibustion Rehabilitation, Yunnan University of Chinese Medicine, Kunming, China
| | - Fanrong Liang
- Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Vieira R, Faria AR, Ribeiro D, Picó-Pérez M, Bessa JM. Structural and functional brain correlates of suicidal ideation and behaviors in depression: A scoping review of MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110799. [PMID: 37207727 DOI: 10.1016/j.pnpbp.2023.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Identifying and integrating the neural correlates of suicidal ideation and behaviors is crucial to expand the knowledge and develop targeted strategies to prevent suicide. This review aimed to describe the neural correlates of suicidal ideation, behavior and the transition between them, using different magnetic resonance imaging (MRI) modalities, providing an up-to-date overview of the literature. To be included, the observational, experimental, or quasi-experimental studies must include adult patients currently diagnosed with major depressive disorder and investigate the neural correlates of suicidal ideation, behavior and/or the transition using MRI. The searches were conducted on PubMed, ISI Web of Knowledge and Scopus. Fifty articles were included in this review: 22 on suicidal ideation, 26 on suicide behaviors and two on the transition between them. The qualitative analysis of the included studies suggested alterations in the frontal, limbic and temporal lobes in suicidal ideation associated with deficits in emotional processing and regulation, and in the frontal, limbic, parietal lobes, and basal ganglia in suicide behaviors associated with impairments in decision-making. Gaps in the literature and methodological concerns were identified and might be addressed in future studies.
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Affiliation(s)
- Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | | | - Diogo Ribeiro
- Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - João M Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
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Vandeloo KL, Burhunduli P, Bouix S, Owsia K, Cho KIK, Fang Z, Van Geel A, Pasternak O, Blier P, Phillips JL. Free-Water Diffusion Magnetic Resonance Imaging Differentiates Suicidal Ideation From Suicide Attempt in Treatment-Resistant Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:471-481. [PMID: 36906445 DOI: 10.1016/j.bpsc.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide attempt is highly prevalent in treatment-resistant depression (TRD); however, the neurobiological profile of suicidal ideation versus suicide attempt is unclear. Neuroimaging methods including diffusion magnetic resonance imaging-based free-water imaging may identify neural correlates underlying suicidal ideation and attempts in individuals with TRD. METHODS Diffusion magnetic resonance imaging data were obtained from 64 male and female participants (mean age 44.5 ± 14.2 years), including 39 patients with TRD (n = 21 and lifetime history of suicidal ideation but no attempts [SI group]; n = 18 with lifetime history of suicide attempt [SA group]), and 25 age- and sex-matched healthy control participants. Depression and suicidal ideation severity were examined using clinician-rated and self-report measures. Whole-brain neuroimaging analysis was conducted using tract-based spatial statistics via FSL to identify differences in white matter microstructure in the SI versus SA groups and in patients versus control participants. RESULTS Free-water imaging revealed elevated axial diffusivity and extracellular free water in fronto-thalamo-limbic white matter tracts of the SA group compared with the SI group. In a separate comparison, patients with TRD had widespread reductions in fractional anisotropy and axial diffusivity, as well as elevated radial diffusivity compared with control participants (thresholded p < .05, familywise error corrected). CONCLUSIONS A unique neural signature consisting of elevated axial diffusivity and free water was identified in patients with TRD and suicide attempt history. Findings of reduced fractional anisotropy, axial diffusivity, and elevated radial diffusivity in patients versus control participants are consistent with previously published studies. Multimodal and prospective investigations are recommended to better understand biological correlates of suicide attempt in TRD.
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Affiliation(s)
- Katie L Vandeloo
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Patricia Burhunduli
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kimia Owsia
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zhuo Fang
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Amanda Van Geel
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer L Phillips
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
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Anticipatory cues in emotional processing shift the activation of a combined salience sensorimotor functional network in drug-naïve depressed patients. J Affect Disord 2023; 320:509-516. [PMID: 36206887 DOI: 10.1016/j.jad.2022.09.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Major depressive disorder is characterized by a large-scale brain network dysfunction, contributing to impairments in cognitive and affective functioning. Core regions of default mode, limbic and salience networks are also impaired in emotional processing and anticipation. This study aimed to explore default mode, salience, and limbic networks modulation during the processing of emotional stimuli with and without anticipatory cues in depression, and further investigate how these networks were functionally coupled with the rest of the brain. METHODS Twenty-one drug-naïve depressed patients and 15 matched controls were included in the study. All participants completed a psychological assessment and the affective pictures paradigm during an fMRI acquisition. Group independent component analysis and psychophysiological interactions analyses were performed. RESULTS A significant interaction between Cue, Valence and Group was found for the salience/sensorimotor network. When processing uncued emotional stimuli, patients showed increased activation of this network for negative vs. neutral pictures, whereas when anticipatory cues were displayed previously to the picture presentation, they invert this pattern of activation (hyperactivating the salience/sensorimotor network for positive vs. neutral pictures). Patients showed increased functional connectivity between the salience/sensorimotor network and the left amygdala as well as the right inferior parietal lobule compared to controls when processing uncued negative pictures. LIMITATIONS The sample size was modest, and the salience/sensorimotor network included regions not typically identified as part of salience network. Thus, this study should be replicated to further interpret the results. CONCLUSIONS Anticipatory cues shift the pattern of activation of the salience/sensorimotor network in drug-naïve depressed patients.
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