Caudothalamic dysfunction in drug-free suicidally depressed patients: an MEG study
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Major depressive disorder (MDD), characterized by low mood or anhedonia, is commonly associated with a greater suicidal susceptibility. There are numerous suicide-related findings pertaining to the dorsolateral prefrontal cortex (DLPFC), caudate nucleus and thalamus, which form a cortico-striato-thalamo-cortical (CSTC) circuit responsible for executive function and working memory. An aberrant CSTC circuitry is hypothesized to be implicated in depressed patients with a high suicidal risk. 27 MDD patients were assessed with the Nurses Global Assessment of Suicide Risk (NGASR), following which 14 patients were classified into a high suicide risk group (NGASR ≥ 12) and 13 patients were assigned to a low suicide risk group (NGASR < 6). All 27 patients were enrolled with 25 healthy controls for resting-state magnetoencephalography (MEG). Cross-frequency coupling (CFC) measured the phase of alpha-band (8–13 Hz) as it modulated to cortical gamma-band (30–48 Hz). There was a significantly lower alpha-to-gamma phase-amplitude coupling (PAC) between the right caudate and left thalamus in high-risk suicide group compared to both the low-risk suicide group and healthy controls. The presence of a weaker coupling between the right caudate and left thalamus is indicative of a caudothalamic abnormality in suicidally depressed patients. This implies that a disruption of CSTC loop could result in executive dysfunction and working memory impairment, leading to an increased suicidal risk in MDD patients. In the future, this preliminary study has the possibility of being replicated on a larger scale, and hence validates caudothalamic dysfunction as a reliable neuroimaging biomarker for suicide in depression.
KeywordsCortico-striato-thalamo-cortical (CSTC) circuit Cross-frequency coupling (CFC) Magnetoencephalography (MEG) Major depressive disorder (MDD) Nurses global assessment of suicide risk (NGASR)
We would like to express our sincere gratitude to the Department of Psychiatry and the Department of Radiology at Nanjing Brain Hospital for helping patients during the neuroimaging procedures. We are also thankful to our healthy controls, patients and patient’s family for their generous support, cooperation and participation.
This work was supported by the National Natural Science Foundation of China (81571639, 61372032, and 81871066); Jiangsu Provincial Medical Innovation Team of the Project of Invigorating Health Care through Science, Technology and Education (CXTDC2016004) and Jiangsu Provincial Key Research and Development Program (BE2018609).
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
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