Cortical hierarchy disorganization in major depressive disorder and its association with suicidality

Lin Shiwei; Zhang Xiaojing; Zhang Yingli; Chen Shengli; Lin Xiaoshan; Xu Ziyun; Hou Gangqiang; Qiu Yingwei

doi:10.3389/fpsyt.2023.1140915

Cortical hierarchy disorganization in major depressive disorder and its association with suicidality

Front Psychiatry. 2023 Apr 24:14:1140915. doi: 10.3389/fpsyt.2023.1140915. eCollection 2023.

Authors

Lin Shiwei¹, Zhang Xiaojing², Zhang Yingli³, Chen Shengli¹, Lin Xiaoshan¹, Xu Ziyun⁴, Hou Gangqiang⁴, Qiu Yingwei¹

Affiliations

¹ Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China.
² Guangdong Provincial Key Laboratory of Genome Stability and Disease Prevention and Regional Immunity and Diseases, Department of Pathology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.
³ Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
⁴ Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China.

Abstract

Objectives: To explore the suicide risk-specific disruption of cortical hierarchy in major depressive disorder (MDD) patients with diverse suicide risks.

Methods: Ninety-two MDD patients with diverse suicide risks and 38 matched controls underwent resting-state functional MRI. Connectome gradient analysis and stepwise functional connectivity (SFC) analysis were used to characterize the suicide risk-specific alterations of cortical hierarchy in MDD patients.

Results: Relative to controls, patients with suicide attempts (SA) had a prominent compression from the sensorimotor system; patients with suicide ideations (SI) had a prominent compression from the higher-level systems; non-suicide patients had a compression from both the sensorimotor system and higher-level systems, although it was less prominent relative to SA and SI patients. SFC analysis further validated this depolarization phenomenon.

Conclusion: This study revealed MDD patients had suicide risk-specific disruptions of cortical hierarchy, which advance our understanding of the neuromechanisms of suicidality in MDD patients.

Keywords: connectome gradient; major depressive disorder; resting-state fMRI; stepwise connectivity; suicide.