Suicidal ideation is associated with reduced prefrontal activation during a verbal fluency task in patients with major depressive disorder
Suicidal ideation is associated with reduced prefrontal activation during a verbal fluency task in patients with major depressive disorder
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DOI：
10.1016/j.jad.2015.04.010
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发表时间：
2015-08-01
影响因子：
6.6
通讯作者：
Kaneko, Koichi
中科院分区：
文献类型：
--
作者：
Pu, Shenghong;Nakagome, Kazuyuki;Kaneko, Koichi
背景资料：尽管在重性抑郁症发作期间前额叶功能与自杀倾向增加之间的关系是已知的，但在重性抑郁症（MDD）中前额叶功能与自杀倾向之间的联系仍不清楚。自杀意念通常先于自杀企图。如果前额叶皮层（PFC）活动是抑郁症自杀意念的生物标志物，那么监测它可能有助于预防自杀。因此，在这项研究中，我们评估了前额叶功能和自杀意念之间的关联在MDD。方法：前额叶功能在67例MDD患者（31自杀意念和36没有）和67年龄，性别和智力匹配的健康对照组（HC）进行了评估，使用近红外光谱（NIRS）在言语流畅性任务（VFT）。结果：MDD患者的脑血流动力学改变明显小于前额叶和颞叶HC患者。有自杀意念的MDD患者右背外侧PFC（DLPFC）、眶额皮质（OFC）和右额极皮质（FPC）区域的血流动力学变化显著小于无自杀意念的MDD患者。此外，在MDD患者中，血流动力学变化与DLPFC、OFC和FPC中自杀意念的严重程度呈负相关。局限性：需要进一步的研究，更大的样本量来验证我们的findings.Conclusions：这些结果表明，DLPFC，OFC，和FPC的自杀意念在抑郁状态下的MDD患者的大脑基板，近红外光谱数据可以作为一个临床上有用的生物标志物，用于评估自杀风险。(C)2015 Elsevier B.V.版权所有。
Background: Despite the known relationship between prefrontal function and increased suicidality during major depressive episodes, the links between prefrontal function and suicidality remain unclear in major depressive disorder (MDD). Suicidal ideation usually precedes a suicide attempt. If prefrontal cortex (PFC) activity is a biomarker for suicidal ideation in depression, monitoring it could be useful for suicide prevention. Therefore, in this study, we assessed the association between prefrontal function and suicidal ideation in MDD.Methods: Prefrontal function in 67 patients with MDD (31 with suicidal ideation and 36 without) and 67 age-, gender-, and intelligence quotient-matched healthy controls (HCs) was evaluated using near-infrared spectroscopy (NIRS) during a verbal fluency task (VFT). Suicidal ideation was assessed using item 3 of the Hamilton Depression Rating Scale (HAMD).Results: Regional hemodynamic changes were significantly smaller in patients with MDD than in HCs in prefrontal and temporal regions. Hemodynamic changes in the right dorsolateral PFC (DLPFC), orbitofrontal cortex (OFC), and right frontopolar cortex (FPC) regions in patients with MDD with suicidal ideation were significantly smaller than in those without suicidal ideation. In addition, hemodynamic changes correlated negatively with the severity of suicidal ideation in the DLPFC, OFC, and FPC in patients with MDD. Limitations: Further studies with a larger sample size are required to verify our findings.Conclusions: These results suggest that the DLPFC, OFC, and FPC are brain substrates of suicidal ideation in depressive states in patients with MDD, and that NIRS data can be employed as a clinically useful biomarker for the assessment of suicide risk. (C) 2015 Elsevier B.V. All rights reserved.