Altered resting-state cerebral blood flow and functional connectivity mediate suicidal ideation in major depressive disorder

• Published in: Journal of cerebral blood flow and metabolism Vol. 42; no. 9; pp. 1603 - 1615
• Main Authors: Fan, Dandan, He, Cancan, Liu, Xinyi, Zang, Feifei, Zhu, Yao, Zhang, Haisan, Zhang, Hongxing, Zhang, Zhijun, Xie, Chunming
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2022
• Subjects: Cerebrovascular Circulation; Depressive Disorder, Major - diagnostic imaging; Humans; Magnetic Resonance Imaging - methods; Original; Parietal Lobe; Suicidal Ideation; suicidal ideation; Depression; cerebral blood flow; mediation analysis; functional connectivity; arterial spin labeling
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1177/0271678X221090998

The relationships among cerebral blood flow (CBF), functional connectivity (FC) and suicidal ideation (SI) in major depressive disorder (MDD) patients have remained elusive. In this study, we characterized the changes in CBF and FC among 175 individuals including 47 MDD without SI (MDDNSI), 59 MDD with SI (MDDSI), and 69 healthy control (HC) who underwent arterial spin labeling and resting-state functional MRI scans. Then the voxel-wise CBF, seed-based FC and partial correlation analyses were measured. Mediation analysis was carried out to reveal the effects of FC on the association between CBF and behavioral performances in both subgroups. Results showed that CBF was higher in MDDSI patients in the bilateral precuneus compared to HC and MDDNSI participants. MDDSI patients exhibited enhanced FC in the prefrontal-limbic system and decreased FC in the sensorimotor cortex (SMC) relative to MDDNSI patients. CBF and FC were significantly correlated with clinical variables. More importantly, exploratory mediation analyses identified that abnormal FC can mediate the association between regional CBF and behavioral performances. These results highlight the potential role of precuneus gyrus, prefrontal-limbic system as well as SMC in the process of suicide and provide new insights into the neural mechanism underlying suicide in MDD patients.