The Correlations Between Cognitive Dysfunction And Frontal Lobe-basal Ganglia-cerebellum Gamma Neural Oscillation Network In Major Depressive Disorder Patients With Suicidal Ideation

Objective:We used MATRICS Consensus Cognitive Battery(MCCB)and Magnetic Source Image(MSI)to systematically evaluate cognitive functions and precisely explore the frontal lobe-basal ganglia-cerebellum Gamma neural oscillation networks of Major Depressive Disorder(MDD)patients with suicidal ideation(SI),aiming to find out psychology and neuroimaging markers of MDD with SI and provide evidence for thorough understanding of brain pathological mechanisms and early interventions of cognitive dysfunction in MDD patients.Methods:According to diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),clinical interview and Beck Scale for Suicide Ideation-Chinese Version,34 MDD patients with SI(SI group),33 MDD patients with NSI(NSI group)and 32 healthy controls(HC group)were recruited in the study.Then we used MCCB to access 7 cognitive functions,including Speed of Processing,Attention/Vigilance,Working Memory,Verbal Learning,Visual Learning,Reasoning and Problem Solving and Social Cognition,of participants in 3 groups.The MSI was utilized to accurately explore the Gamma neural network oscillation of the frontal lobe-basal ganglia-cerebellum circuits in each group.Differences of cognitive functions and Gamma neural oscillation networks among 3 groups and correlations between cognitive abilities and functional connectivity of the network under Gamma oscillation in the SI group were comprehensively analyzed through data processing.Results:(1)Results of MCCB: there were significant cognitive impairments in Speed of Processing,Attention/Vigilance,Social Cognition of SI group(ES=0.918;ES=0.811;ES=0.845),moderate cognitive impairments in Verbal Learning,Visual Learning,Reasoning and Problem Solving(ES=0.693;ES=0.761;ES=0.560),mild impairment in Working Memory(ES=0.345)of SI group.And there were significant cognitive impairments in Visual Learning and Social Cognition(ES=0.809;ES=0.865),moderate cognitive impairments in Speed of Processing,Working Memory and Verbal Learning(ES=0.740;ES=0.551;ES=0.767),mild impairments in Attention/Vigilance,Reasoning and Problem Solving(ES=0.343;ES=0.337)of NSI group.No significant correlation was observed between cognitive function and clinical symptoms(p>0.05).(2)Results of frontal lobe-basal ganglia-cerebellum Gamma neural oscillation network:there were moderate enhancements of functional connectivity between frontal lobe-basal ganglia,basal ganglia-cerebellum and mild enhancement of functional connectivity between frontal lobe-cerebellum in the SI group(ES=0.51;ES=0.55;ES=0.45).No significant abnormality was observed in the NSI group(p>0.05).(3)Results of correlations between cognitive impairments and Gamma neural network in SI group: Verbal Learning impairment in MDD patients with SI was significantly negatively correlated with abnormal connectivity of the right thalamus-cerebellar vermis4?5 under Gamma oscillation(p=0.026).Reasoning and problem solving dysfunction was significantly negatively correlated with the abnormal connectivity of the right triangular part of inferior frontal gyrus-right thalamus under Gamma oscillation(p=0.005).Conclusion:(1)There are different degrees of cognitive dysfunction in patients with depression,whether it is accompanied with SI,including Processing Speed,Attention/ Vigilance,Verbal Learning,Working Memory,Visual Learning,Reasoning and Problem Solving,Social Cognition.These cognitive disorders may be independent of clinical symptoms.(2)MDD Patients with SI have more severe impairments in Processing Speed,Sttention/ Vigilance,Reasoning and Problem Solving than patients without SI,combining with connectivity abnormalities in frontal lobe-basal ganglia-cerebellum Gamma neural oscillation network,these two objective indexes can be regarded as psychological and radiological predictors to distinguish MDD patients with SI and without SI.(3)Verbal Learning impairment in MDD patients with SI is influenced by the abnormal connectivity of the right thalamus-cerebellar vermis 4,5 under Gamma oscillation.The reasoning and problem solving dysfunction is affected by the abnormal connectivity of the right triangular part of inferior frontal gyrus-right thalamus under Gamma oscillation.Therefore,the abnormal connectivity of right thalamus,cerebellar vermis 4,5 and right triangular part of inferior frontal gyrus can be used as a target for treatment of Verbal Learning,Reasoning and Problem Solving dysfunction in MDD patients with SI.