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Войти в исследования NeuroImage. Clinical · 2026
Differentiating suicide risk in treatment-resistant depression: clinical and functional imaging correlates of suicidal ideation and attempt.
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Burhunduli Patricia, Fang Zhuo, Vandeloo Katie L, Sharmin Fariba, Blier Pierre, Phillips Jennifer L
Аннотация
BACKGROUND: Treatment-resistant depression (TRD) is associated with elevated suicide risk. While many individuals with TRD experience suicidal ideation (SI), only a subset progress to suicide attempts (SA). This study identifies resting-state functional connectivity (FC) differences between individuals with TRD who experience SI only and those with SA history, and examines how these neural differences relate to clinical and trait-level suicide risk factors.
METHODS: Resting-state functional MRI data were acquired from 41 individuals with TRD and lifetime SI, including 21 with no SA history (SI group) and 20 with a lifetime SA (SA group), alongside 47 age- and sex-matched healthy controls. FC was measured using the CONN FC toolbox. Associations between clinical features and connectivity markers explored the clinical relevance of neural differences.
RESULTS: Group-level network-based statistics analyses identified FC differences among 11 ROIs and 9 connections (pFDR < 0.05). The SA group exhibited lower FC than the SI group between the right anterior insula and bilateral anterior parahippocampal gyri (right: pFDR = 0.02; left: pFDR = 0.04), the left anterior middle temporal gyrus (pFDR = 0.04), and between the right anterior parahippocampal gyrus and the left amygdala (pFDR = 0.01). Within the SA group, SI severity (p = 0.005), anxiety severity (p < 0.001), and childhood sexual abuse scores (p < 0.001) were independent predictors of FC between the left amygdala and right anterior parahippocampal gyrus.
CONCLUSION: This study highlights distinct neural signatures associated with SI and SA in individuals with TRD in regions implicated in emotional memory and self-referential processing. These neural markers meaningfully relate to clinical features and may differentiate SI and SA in TRD, advancing our understanding of suicide risk.
METHODS: Resting-state functional MRI data were acquired from 41 individuals with TRD and lifetime SI, including 21 with no SA history (SI group) and 20 with a lifetime SA (SA group), alongside 47 age- and sex-matched healthy controls. FC was measured using the CONN FC toolbox. Associations between clinical features and connectivity markers explored the clinical relevance of neural differences.
RESULTS: Group-level network-based statistics analyses identified FC differences among 11 ROIs and 9 connections (pFDR < 0.05). The SA group exhibited lower FC than the SI group between the right anterior insula and bilateral anterior parahippocampal gyri (right: pFDR = 0.02; left: pFDR = 0.04), the left anterior middle temporal gyrus (pFDR = 0.04), and between the right anterior parahippocampal gyrus and the left amygdala (pFDR = 0.01). Within the SA group, SI severity (p = 0.005), anxiety severity (p < 0.001), and childhood sexual abuse scores (p < 0.001) were independent predictors of FC between the left amygdala and right anterior parahippocampal gyrus.
CONCLUSION: This study highlights distinct neural signatures associated with SI and SA in individuals with TRD in regions implicated in emotional memory and self-referential processing. These neural markers meaningfully relate to clinical features and may differentiate SI and SA in TRD, advancing our understanding of suicide risk.