Reduced left precentral regional responses in patients with major depressive disorder and history of suicide attempts

Abstract

Previous neuroimaging studies have revealed frontal and temporal functional abnormalities in patients with major depressive disorder (MDD) and a history of suicidal behavior. However, it is unknown whether multi-channel near-infrared spectroscopy (NIRS) signal changes among individuals with MDD are associated with a history of suicide attempts and a diathesis for suicidal behavior (impulsivity, hopelessness, and aggression). Therefore, we aimed to explore frontotemporal hemodynamic responses in depressed patients with a history of suicide attempts using 52-channel NIRS. We recruited 30 patients with MDD and a history of suicidal behavior (suicide attempters; SAs), 38 patient controls without suicidal behavior (non-attempters; NAs), and 40 healthy controls (HCs) matched by age, gender ratio, and estimated IQ. Regional hemodynamic responses during a verbal fluency task (VFT) were monitored using NIRS. Our results showed that severities of depression, impulsivity, aggression, and hopelessness were similar between SAs and NAs. Both patient groups had significantly reduced activation compared with HCs in the bilateral frontotemporal regions. Post hoc analyses revealed that SAs exhibited a smaller hemodynamic response in the left precentral gyrus than NAs and HCs. Furthermore, the reduced response in the left inferior frontal gyrus was negatively correlated with impulsivity level and hemodynamic responses in the right middle frontal gyrus were negatively associated with hopelessness and aggression in SAs but not in NAs and HCs. Our findings suggest that MDD patients with a history of suicide attempts demonstrate patterns of VFT-induced NIRS signal changes different from those demonstrated by individuals without a history of suicidal behaviors, even in cases where clinical symptoms are similar. NIRS has a relatively high time resolution, which may help visually differentiate SAs from NAs.

Neural substrates of suicide and suicidal behaviour: from a neuroimaging perspective

“…They speculated that blunted increase in Near-infrared spectroscopy with verbal fluency task: regional cerebral oxy-hemoglobin measurement Smaller hemodynamic changes during the task in the left precentral gyrus in the attempters prefrontal blood perfusion during the task may indicate a possible biological reason for reduced drive and loss of initiative in suicide attempters [107]. Two other studies replicated this one using nearinfrared spectroscopy and found smaller hemodynamic changes in the right dorsolateral PFC, the OFC, the frontopolar cortex, and the left precentral gyrus in MDD patients with suicidality [108,109]. Infralimbic dysfunction, and hypometabolism in the right middle frontal gyri and the right inferior parietal lobe were also implicated in the aetiopathogenesis of the suicidal ideation [110,111].…”

Prefrontal Asymmetry during Cognitive Tasks and Its Relationship with Suicide Ideation in Major Depressive Disorder: An fNIRS Study

“…While these findings suggest that prefrontal asymmetry contributes to suicidality, the role of prefrontal asymmetry in linking depression to suicide ideation is expected to help identify depressed individuals with suicide risk. Also, the results of the previous studies need to be replicated owing to the limited number of studies and conflicting reports from others [32,33].…”

Application of functional near-infrared spectroscopy in the healthcare industry: A review

“…131 MDD patients who attempted suicide showed a smaller HbO response in the left precentral gyrus compared to those who did not attempt suicide and to healthy persons, and the HbO response was negatively correlated with impulsivity, hopelessness, and aggression levels. 132 The dorsolateral PFC in BD patients showed higher activation than in SZ patients, demonstrating the less severe verbal memory impairment associated with BD compared to SZ. 133 The HbO response in the right dorsolateral PFC in BD patients with psychotic symptoms was negatively associated with the extent of disease and was lower compared to 134 The depressive patients with the mandatory symptoms showed signi¯cantly lower activation in the left dorsolateral PFC compared to depressive patients without mandatory symptoms, which illustrated that a higher level of impairment in the left dorsolateral PFC is associated with mandatory symptoms.…”

“…Patients are usually classi¯ed based on the impaired hemodynamic responses caused due to some disease. [128][129][130][131][132][133] The localization of an impairment in the brain is a vital step to evaluate the intensity and type of the disease. Therefore, the placement of fNIRS sources, detectors, or optodes on a patient's head based on the task involved is important as most tasks are associated with known brain regions.…”