Association between abnormal default mode network activity and suicidality in depressed adolescents.
BACKGROUND
Suicide is the second leading cause of death among 15- to 29-year-olds in China, and 60 % of suicidal patients have a history of depression. Previous brain imaging studies have shown that depression and suicide may be associated with abnormal activity in default mode network (DMN) regions. However, no study has specifically investigated the relationship between DMN functional activity and suicidal behavior in depressed individuals. Therefore, in the present study, we directly investigated features of DMN brain activity in adolescent patients with histories of depression and attempted suicide.


METHODS
A total of 35 sex- and age-matched suicidal depressed patients were compared with 18 non-suicidal depressed patients and 47 healthy controls. We explored functional activity changes in DMN regions that could be associated with suicidal behavior by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals using independent component analysis (ICA). Scores on six clinical scales that measure depression severity (Hamilton Depression Scale (HDRS) and Beck Depression Inventory (BDI)) and suicidal traits (Barratt Impulsiveness Scale (BIS-11), Suicide Attitude Questionnaire (SAQ), Beck Hopelessness Scale (BHS), and Scale for Suicide Ideation (SSI)) were compared in the three groups.


RESULTS
Compared with the healthy controls, all of the evaluated depressed patients showed increased functional connectivity in select DMN regions. The suicidal patients showed increased connectivity in the left cerebellum and decreased connectivity in the right posterior cingulate cortex (PCC), whereas the non-suicidal depressed patients showed increased connectivity in the left superior frontal gyrus, left lingual gyrus and right precuneus and decreased connectivity in the left cerebellum. Compared to the non-suicidal patients, the suicidal patients showed increased connectivity in the left cerebellum and the left lingual gyrus and decreased connectivity in the right precuneus. No differences in the scores of any clinical scales were found between the suicidal and non-suicidal depressed patients.


CONCLUSIONS
Collectively, our results highlight the importance of the DMN in the pathophysiology of depression and suggest that suicidal behavior in depressed adolescents may be related to abnormal functional connectivity in the DMN. In particular, abnormal connectivity in the PCC/precuneus and left cerebellum might be a predictor of suicidal behavior in depressed adolescent patients.
Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China.
Shuang
S
Zhang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Jian-Mei
JM
Chen
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. kuangli0308@163.com.
Li
http://orcid.org/0000-0001-6468-5553
L
Kuang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Jun
J
Cao
Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou, 310015, China.
Han
H
Zhang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Ming
M
Ai
Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China.
Wo
W
Wang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Shu-Dong
SD
Zhang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Su-Ya
SY
Wang
Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Shi-Jing
SJ
Liu
Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Wei-Dong
WD
Fang
Adolescents; Attempted suicide; Default mode network; Depression; rs-fMRI
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