Abnormal amplitude of low-frequency fluctuation values as a neuroimaging biomarker for major depressive disorder with suicidal attempts in adolescents: A resting-state fMRI and support vector machine analysis

Abstract

ObjectiveMajor depressive disorder (MDD) is associated with suicidal attempts (SAs) among adolescents, with suicide being the most common cause of mortality in this age group. This study explored the predictive utility of support vector machine (SVM)-based analyses of amplitude of low-frequency fluctuation (ALFF) results as a neuroimaging biomarker for aiding the diagnosis of MDD with SA in adolescents.MethodsResting-state functional magnetic resonance imaging (rs-fMRI) analyses of 71 first-episode, drug-naive adolescent MDD patients with SA and 54 healthy control individuals were conducted. ALFF and SVM methods were used to analyze the imaging data.ResultsRelative to healthy control individuals, adolescent MDD patients with a history of SAs showed reduced ALFF values in the bilateral medial superior frontal gyrus (mSFG) and bilateral precuneus. These lower ALFF values were also negatively correlated with child depression inventory (CDI) scores while reduced bilateral precuneus ALFF values were negatively correlated with Suicidal Ideation Questionnaire Junior (SIQ-JR) scores. SVM analyses showed that reduced ALFF values in the bilateral mSFG and bilateral precuneus had diagnostic accuracy levels of 76.8% (96/125) and 82.4% (103/125), respectively.ConclusionAdolescent MDD patients with a history of SA exhibited abnormal ALFF. The identified abnormalities in specific brain regions may be involved in the pathogenesis of this condition and may help identify at-risk adolescents. Specifically, reductions in the ALFF in the bilateral mSFG and bilateral precuneus may be indicative of MDD and SA in adolescent patients.

Differences in resting‐state brain activity in first‐episode drug‐naïve major depressive disorder patients with and without suicidal ideation

“…MDD patients with suicide attempts showed an increase of ReHo values in the cingulum gyrus, and these changes were associated with the level of suicide attempts (Yang et al, 2022). In addition, MDD patients with a history of suicide attempts exhibited abnormal brain activation in the medial superior frontal gyrus and precuneus, which might be helpful for identifying at‐risk individuals (Zhou et al, 2023). The precuneus is considered as the core hub of DMN, which plays a crucial role in a diverse array of highly integrated functions including self‐referential processing, episodic memory retrieval and emotion regulation (Cunningham et al, 2017; Utevsky et al, 2014).…”

Vulnerable brain regions in adolescent major depressive disorder: A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

“…FC is not a suitable candidate for meta-analysis unless all studies are the same kind of network study[ 7 ]. To our knowledge, although many previous studies have used ReHo, ALFF, and fALFF methods and rs-fMRI to explore the changes in spontaneous brain activity in adolescent depression patients[ 8 - 17 ], the results of these studies are inconsistent and are still controversial.…”

The amplitude of low-frequency fluctuation characteristics in depressed adolescents with suicide attempts: a resting-state fMRI study

“…Several studies have reported abnormal ALFF values in various brain regions of depressed adolescents with suicide attempts compared to healthy controls or depressed adolescents without suicide attempts. These regions include the medial superior frontal gyrus (mSFG), the precuneus, the middle and inferior frontal gyri, the middle and superior temporal gyri, the occipital cortex, the anterior cingulate cortex (ACC), the medial prefrontal cortex (mPFC), the hippocampus, and the thalamus (7,8). The abnormal ALFF values in these regions may reflect impaired functions such as emotion regulation, self-referential processing, cognitive control, memory, and salience detection (9).…”