A Resting-state Functional Connectivity Study In Female,first-episode Major Depressive Disorder With And Without Suicidal Ideation

Objective: Major depressive disorder?MDD?is one of the most common serious mental disorders with high risk of suicide.Sex differences in suicide behavior related to MDD have long been recognized.It has been found that women have higher suicidal ideation or suicide rate than men.However,the mechanism of suicidal ideation in female MDD patients is still unclear.The present study aimed to explore the neural circuits related to suicidal ideation in female MDD patients.By directly comparing amygdala-whole brain resting functional connections between female MDD patients with or without suicidal ideation and healthy controls?HC?,and to explore the correlation between brain functional imaging changes and depression and anxiety symptoms.This study was carried out to provide early detection and treatment of female MDD suicidal ideation from the perspective of neuroimaging.Methods: Seventy-two first-episode female MDD and 74 age-matched female HC aged between 18 and 45 were collected,and the informed consents were obtained before the start of the study.The demographic data,Hamilton Depression Scale-17 items?HAMD-17?,Hamilton Anxiety Scale?HAMA?and Beck Scale for Suicide Ideation?BSS?were collected for all participants.Subsequently,according to the BSI score,the female MDD patients were divided into MDD with suicidal ideation group?30 cases?and MDD without suicidal ideation group?42 cases?.All participants underwent resting-state functional magnetic resonance imaging?rs-f MRI?.Firstly,according to the collected demographic data and clinical data,we use SPSS 22.0 software for analysis of variance,two-sample t test and chi-square test to analyze the differences between groups.Then,based on the platform of MATLAB software,three groups of rs-f MRI data were preprocessed and analyzed by DPABI software package and DPASFA software package.The statistical analysis of magnetic resonance data has three parts:?1?The analysis of covariance?ANCOVA?was performed among the three groups,and age was used as the covariance variable.The significant threshold was set at P < 0.05,and FWE correction was used.Then the brain regions with significant differences among the three groups were extracted,and to carry out the post-hoc analysis.?2?Two sample t-test was performed on the drug-treated and non-drug-treated women in the MDD group with and without suicidal ideation separately;?3?Pearson correlation coefficients of FC value and HAMD₁7 and HAMA total scores in MDD with and without suicidal ideation were calculated respectively.Results: 1.The results of ANCOVA showed that there were significant differences in amygdala-bilateral precuneus FC between the three groups?P<0.05?.2.Post-hoc analysis showed that compared with HC group and MDD without suicidal ideation group,increased FC between amygdala and right precuneus?P<0.05?significantly was observed in MDD with suicidal ideation group.In the FC of amygdala-left precuneus,MDD with or without suicidal ideation increased significantly?P<0.05?,and the FC of MDD with suicidal ideation was higher than those of MDD without suicidal ideation?P<0.05?.3.There was no significant difference between unmedicated and medicated patients in MDD group with or without suicidal ideation respectively?P>0.05?.4.The correlation analysis showed that there was no significant correlation between FC and HAMD₁7 scores or HAMA scores in the amygdala-bilateral precuneus of MDD group with or without suicidal ideation separately?P>0.05?.Conclusion: 1.Increased FC in amygdala-right precuneus maybe related to the mechanism of suicidal ideation;2.Increased FC in amygdala-left precuneus may be involved not only in suicidal ideation mechanism,but also in the pathological mechanism of MDD.The findings of this study provide preliminary evidence for impaired nerve circuits in female suicidal ideation.