Aberrant integrity of the cortico-limbic-striatal circuit in major depressive disorder with suicidal ideation. (April 2022)

• Record Type: Journal Article
• Authors: Yang, Jun; Palaniyappan, Lena; Xi, Chang; Cheng, Yixin; Fan, Zebin; Chen, Chujun; Zhang, Manqi; Pan, Yunzhi; Tao, Haojuan; Ouyang, Xuan; Yang, Jie; Liu, Zhening
• Is Part Of: Journal of psychiatric research. Volume 148(2022)
• Page Start: 277
• Page End: 285
• Publication Date: 2022-04
• Subjects: Major depressive disorder -- Suicidal ideation -- Amygdala -- Cortico-limbic-striatal circuit -- Resting-state functional connectivity -- Machine learning; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2022.02.003
• Languages: English
• ISSNs: 0022-3956

Abstract

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.