Longitudinal decreases in suicidal ideation are associated with increases in salience network coherence in depressed adolescents

Abstract

Background: Suicidal ideation (SI) is an important predictor of suicide attempt, yet SI is difficult to predict. Given that SI begins in adolescence when brain networks are maturing, it is important to understand associations between network functioning and changes in severity of SI. Methods: Thirty-three depressed adolescents were administered the Columbia-Suicide Severity Rating Scale to assess SI and completed resting-state fMRI at baseline (T1) and 6 months later (T2). We computed coherence in the executive control (ECN), default mode (DMN), salience (SN), and non-relevant noise networks and then examined the association between changes in brain network coherence and changes in SI severity from T1 to T2. Results: A greater reduction in severity of SI was associated with a stronger increase in SN coherence from T1 to T2. There were no associations between the other networks and SI. Limitations: We cannot generalize our findings to more psychiatrically diverse samples. More time-points are necessary to understand the trajectory of SI and SN coherence change. Conclusions: Our finding that reductions in SI are associated with increases in SN coherence extends previous cross-sectional results documenting a negative association between SI severity and SN coherence. The SN is involved in coordinating activation of ECN and DMN in response to salient information. Given this regulatory role of the SN, the association between SN coherence and SI suggests that adolescents with reduced SN coherence might more easily engage in harmful

Multimodal neuroimaging and suicidality in a US population-based sample of school-aged children

“…In terms of neuroimaging correlates, at uncorrected level, we found several regions associated with suicidality not consistently reported in the literature 18 ; and those regions that we found that have been reported (e.g. aberrant thickness in medial orbitofrontal gyrus, aberrant connectivity in the default mode and salience networks, or aberrant task-elicited activations in temporal lobe and insula) differed in directionality or specific regions involved 18,38,39,[54][55][56][57] . Moreover, after FDRcorrection, we only found a thinner left bank of the superior temporal sulcus in the caregiverreported suicidality analysis.…”

Default Mode and Salience Network Alterations in Suicidal and Non-Suicidal Self-Injurious Thoughts and Behaviors in Adolescents with Depression

“…In depressed adolescents, greater severity of SI has been associated with both greater connectivity between one node of the DMN (precuneus) with sensorimotor regions, as well as lower connectivity between another node of the DMN (PCC) with visual attention regions (23). In another sample of depressed adolescents, researchers documented lower network coherence (i.e., within-network connectivity) of the anterior node of the DMN (medial PFC), SN (centered on the dACC) and left CEN (24) in relation to participants' most severe intensity of SI in the lifetime; further, longitudinal increases in network coherence of the SN (centered on the dACC) in this same sample were also associated with decreases in severity of SI (25). Compared to healthy controls, transdiagnostic samples of young adults (who were primarily diagnosed with depression) with history of SI were found to exhibit lower connectivity between the SN (dACC) and DMN (specifically, dorsal PCC relative to ventral PCC; 26).…”

“…Contrary to our hypotheses, which were guided by previously published literature, we did not find group differences with respect to SI history in network coherence or between-network connectivity of the CEN or SN-ACC. Previous work from our group using similar analytical approaches (i.e., group ICA combined with dual regression) in an independent sample of depressed adolescents (24,25) found that lower CEN, DMN-A, and SN-ACC coherence levels were associated with greater intensity of the most severe experience of SI in the lifetime (24), and that longitudinal changes in SN-ACC coherence were associated with changes in SI severity (25). Another study also reported that compared to healthy controls, young adults (who were primarily diagnosed with depression) with SI had lower dorsal ACC low frequency BOLD activity and relative connectivity (with dorsal versus ventral PCC; Chase et al, 2017).…”

“…method used to characterize spatiotemporal properties of functional MRI data(52,53) that accounts for multiple voxel-voxel relations in order to define a spatial network of voxels based on the correlations of their timeseries. As in previous work(24,25,48), we identified a set of 25 probabilistic ICA components from the whole sample in order to compute individual-level metrics of network coherence from a comparable spatial set of components for further statistical analysis (see Network Coherence, below, for more details). Based on our hypotheses, we focused on the subdivisions of the CEN, SN, and DMN.…”

Prospective Investigation of the Interaction Between Social Problems and Neuropsychological Characteristics on the Development of Suicide Ideation

“…For adolescents, cognitive flexibility, or the ability to alter thinking and shift attention away from incorrect responses following negative feedback, has been shown to prospectively predict suicidality (Miranda et al, ). Additionally, cognitive abilities have demonstrated the ability to differentially predict young‐adult depressive symptoms, SI, and suicide attempts in a longitudinal studies with adolescents (Crandall, Allsop, & Hanson, ; Schwartz, Ordaz, Ho, & Gotlib, ). Taken together, the literature on neuropsychological correlates of SI for adolescents and adults suggests a need to investigate how these neuropsychological deficits interact with other known risk factors to impact suicidality in adolescence prior to the initial emergence of ideation.…”