학술논문
Subcortical brain structure and suicidal behaviour in major depressive disorder: a meta-analysis from the ENIGMA-MDD working group.
Document Type
article
Author
Rentería, ME; Schmaal, L; Hibar, DP; Couvy-Duchesne, B; Strike, LT; Mills, NT; de Zubicaray, GI; McMahon, KL; Medland, SE; Gillespie, NA; Hatton, SN; Lagopoulos, J; Veltman, DJ; van der Wee, N; van Erp, TGM; Wittfeld, K; Grabe, HJ; Block, A; Hegenscheid, K; Völzke, H; Veer, IM; Walter, H; Schnell, K; Schramm, E; Normann, C; Schoepf, D; Konrad, C; Zurowski, B; Godlewska, BR; Cowen, PJ; Penninx, BWJH; Jahanshad, N; Thompson, PM; Wright, MJ; Martin, NG; Christensen, H; Hickie, IB
Source
Translational psychiatry. 7(5)
Subject
Language
Abstract
The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands of individuals collected by research groups from around the world. Here we present analyses in a subset sample (n=3097) for whom suicidality data were available. Prevalence of suicidal symptoms among major depressive disorder (MDD) cases ranged between 29 and 69% across cohorts. We compared mean subcortical grey matter volumes, lateral ventricle volumes and total intracranial volume (ICV) in MDD patients with suicidal symptoms (N=451) vs healthy controls (N=1996) or MDD patients with no suicidal symptoms (N=650). MDD patients reporting suicidal plans or attempts showed a smaller ICV (P=4.12 × 10-3) or a 2.87% smaller volume compared with controls (Cohen's d=-0.284). In addition, we observed a nonsignificant trend in which MDD cases with suicidal symptoms had smaller subcortical volumes and larger ventricular volumes compared with controls. Finally, no significant differences (P=0.28-0.97) were found between MDD patients with and those without suicidal symptoms for any of the brain volume measures. This is by far the largest neuroimaging meta-analysis of suicidal behaviour in MDD to date. Our results did not replicate previous reports of association between subcortical brain structure and suicidality and highlight the need for collecting better-powered imaging samples and using improved suicidality assessment instruments.