Citation

Yang J, Palaniyappan L, Xi C, Cheng Y, Fan Z, Chen C, Zhang M, Pan Y, Tao H, Ouyang X, Yang J, Liu Z. J. Psychiatr. Res. 2022; 148: 277-285.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpsychires.2022.02.003

PMID

35180634

Abstract

BACKGROUND: Suicidal ideation is a common symptom of major depressive disorder (MDD) that reflects a cognitive alteration in the background of intense emotional dysregulation. Amygdala is a critical emotion processing center that facilitates moving from emotional appraisal to action. However, whether MDD patients with suicidal ideation show dysconnectivity of the amygdala within a large-scale neurocognitive circuitry remains unknown.
METHODS: Participants were 22 MDD patients without suicidal ideation (MDD-NSI), 59 MDD patients with suicidal ideation (MDD-SI), and 60 healthy controls (HCs). We compared the amygdala-based resting-state functional connectivity of four amygdala subregions across the three groups. We selected brain regions with significant between-group differences in amygdalar conectivity as the regions of interest (ROI) and performed ROI-to-ROI and graph-theoretical analyses to explore dysconnectivity patterns at various granularity levels.
RESULTS: Brain regions showing omnibus differences across the three groups were distributed across a cortico-limbic-striatal circuitry. MDD-SI had unique dysconnectivity of the lateral amygdala with caudate, middle temporal gyrus, and postcentral gyrus compared with the other two groups. MDD-SI and MDD-NSI had shared dysconnectivity of the medial amygdala with medial superior frontal gyrus and middle temporal gyrus. Within the derived cortico-limbic-striatal circuitry, MDD-SI exhibited lower global connectivity, reduced sigma (small-worldness), but increased lambda (path-length) than HCs. Reduced sigma correlated with increased severity of suicidal ideation. We achieved high classification accuracy (84.09%, with AUC 0.82) in distinguishing MDD-SI from MDD-NSI.
CONCLUSIONS: Aberrant integrity of the cortico-limbic-striatal circuit centered on the amygdala provides a promising neural substrate for suicidal ideation that requires further investigation in MDD.

Language: en

Keywords

Humans; Magnetic Resonance Imaging; Suicidal Ideation; Suicidal ideation; Major depressive disorder; Amygdala; Depressive Disorder, Major; Corpus Striatum; Machine learning; Resting-state functional connectivity; Cortico-limbic-striatal circuit