A Study Of Resting FMRI Based On Low Frequency Aamplitude In First-episode Adolescent Depression With Suicidal Ideation

BackgroundDepression is a crippling disease characterized by depression,cognitive impairment and social dysfunction.It is also the most common mental disease related to suicide.Adolescence is a high-risk period for suicide.According to the survey,17.7%of American high school students reported that they had seriously considered suicide in the past year.Suicidal ideation is regarded as the first step of suicide pathway,not only the symptom of depression,but also driven by neurobio logical process.Resting state fMIRI technology has been widely used in the study of depression.Low frequency oscillation amplitude can reflect the spontaneous neural activity of the whole brain area,and can provide direct information about the damaged area.It is an important method to study resting state brain function changes.Although there are a lot of researches on adult depression,the findings of adult neurobiology may not be directly applicable to adolescents,but there are few researches on neuroimaging directly related to adolescent depression with suicidal ideation,and the results are not consistent.Therefore,it is necessary to explore the relationship between the changes of brain function and depression and suicidal ideation in adolescent depression patients with suicidal ideation,so as to clarify the potential neuropsychological and neurobiological mechanisms of suicidal ideation in depression,and provide the basis for the assessment of suicidal risk.Objective1.To analyze the difference of brain spontaneous function activity in adolescent depression patients with suicidal ideation in resting state,and to explore its potential role in suicidal ideation.2.To explore the correlation between the abnormal activity of the local brain area and the clinical characteristics of adolescent depression with suicidal ideation.MethodsThirty three first-episode adolescent depression patients with suicidal ideation(SI Group),28 first-episode adolescent depression patients without suicidal ideation(NSI group)and 29 healthy adolescents(HC group)matched by sex,age and education years were scanned with resting-state fMRI and the general data were collected,and 24 items of Hamilton Depression Scale(HAMD-24)and Beck Suicide Ideation Scale(BSI-CV)were assessed.The REST software was used to preprocess the imaging data,and the low-frequency amplitude(ALFF)analysis method was used to compare the differences of brain function activities among the three groups of subjects.In order to eliminate individual differences and improve specificity,the standardized mean value of ALFF(that is,the value of mALFF)in the whole brain was used for analysis.The SPM 12 software was used to test the mALFF value of three groups of subjects by one-way ANOVA,and the correlation between the mALFF value of different brain areas and the severity of depression and the intensity of suicidal ideation was analyzed by Pearson.Results1.There was no significant difference in gender(P=0.066),age(P=0.122)and years of Education(P=0.086)between SI group,NSI group and HC group.The scores of HAMD-24(P=0.045)and suicide ideation intensity factor(P<0.001)in SI group were significantly higher than those in NSI group.2.There were statistically significant differences in mALFF values among SI Group,NSI group and HC group in Cingulum_Mid_L,Thalamus_L,Occipital_Sup_L/Calcarine_L,Temporal_Inf_R/Temporal_Sup_R,Frontal_Inf_Oper_R,Calcarine_R,Frontal_Mid_R(aal)(P<0.05 with FEW correction).The results of post-hoc analysis showed that the mALFF value of SI group was significantly higher than that of NSI group and HC group(P<0.05 with Bonferroni correction).There was no significant difference between NSI group and HC group(P>0.05).3.The mALFF values of the Thalamus_L(r=-0.448,P=0.017),Temporal_Inf_R/Temporal_Sup_R(r=-0.349,P=0.047),Frontal_Inf_Oper_R(r=-0.374,P=0.032),Frontal_Mid_R(r=-0.381,P=0.029)in SI group were negatively correlated with the HAMD-24 scores,and the mALFF values of Thalamus_L(aal)in NSI group were negatively correlated with the HAMD-24 scores(r=-0.383,P=0.028).There was no correlation between the value of mALFF and the score of suicidal ideation intensity factor(P>0.05).Conclusions1.Many brain regions of adolescents with suicidal ideation depression have abnormal local nerve function,mainly involving cingulate gyrus,thalamus,occipital lobe,temporal lobe and frontal lobe,which may be the neuropathological basis and biological marker of suicidal ideation in depression patients.2.The abnormal activities in some brain areas of adolescents with suicide ideation depression are related to the severity of the disease,which is of great significance to the evaluation of the disease,and may be involved in the pathophysiological mechanism of adolescents with suicide ideation depression.