The neurobiology of self-face recognition in depressed adolescents with low or high suicidality.

Abstract

This study sought to test whether the neurobiology of self-processing differentiated depressed adolescents with high suicidality from those with low suicidality and healthy controls (N=119, MAGE= 14.79, SD=1.64, Min=11.3, Max = 17.8). Participants completed a visual self-recognition task in the scanner during which they identified their own or an unfamiliar adolescent face across three emotional expressions (happy, neutral or sad). A 3 Group (HS, LS, HC) by two within subject factors [2 Self conditions (self, other) and 3 Emotions (happy, neutral, sad)] GLM yielded: 1) a main effect of Self condition with all participants showing higher activity in the right occipital, precuneus and fusiform during the self-versus other-face conditions; 2) a main effect of Group where all depressed youth showed higher dorsolateral prefrontal cortex activity than HC across all conditions, and with HS showing higher cuneus and occipital activity versus both LS and HC; and 3) a Group by Self by Emotion interaction with HS showing lower activity in both mid parietal, limbic and prefrontal areas in the Happy self versus other-face condition relative to the LS group, who in turn had less activity compared to HC youth. Covarying for depression severity replicated all results except the third finding; in this subsequent analysis, a Group by Self interaction showed that although HC had similar midline cortical structure (MCS) activity for all faces, LS showed higher MCS activity for the self vs. other faces while HS showed the opposite pattern. Results suggest that the neurophysiology of emotionally charged self-referential information can distinguish depressed, suicidal youth versus non-suicidal depressed and healthy adolescents. Neurophysiological differences and implications for the prediction of suicidality in youth are discussed. General Scientific Summary: Depressed adolescents with high suicidality show less activity in brain areas that support emotional experiences and self-awareness when identifying their own face, suggesting that abnormal self-processing may be associated with greater suicide risk.

Neural Correlates of Suicidality in Adolescents with Major Depression: Resting‐State Functional Connectivity of the Precuneus and Posterior Cingulate Cortex

“…Further, a meta‐analysis of rumination in MDD, a construct related to negative self‐referential processing, found that rumination in MDD is positively associated with RSFC between the DMN (particularly the PCC) and subgenual PFC (Hamilton, Farmer, Fogelman, & Gotlib, ). As noted previously, the PCC showed aberrant activation, and both the PCC and precuneus showed reduced connectivity in adolescents with MDD and high suicidality or suicide attempts (Quevedo et al., ; Zhang, Chen, et al., 2016; Zhang, Tang, et al., 2016). However, these studies are limited in that they did not examine long‐range FC with the PCC and precuneus.…”

“…In regard to both affective experience and self‐referential processing in adolescent suicidality, one study examined brain activation during the viewing of self‐ and other emotional faces. Adolescents with MDD and high suicidality, defined by scores on a semistructured interview and clinical assessment, showed lower activation in the medial prefrontal cortex (PFC), ACC, posterior cingulate cortex (PCC), hippocampus, and amygdala compared to adolescents with MDD and low suicidality and healthy controls (Quevedo et al., ).…”

Untitled

“…Most importantly, our top findings revealed that frequent self-referencing like 'I', 'me ', and myself' (ranked 1, 2, 5, 7, 19) and negated self-referencing (ranked 35) posed an elevated risk as illustrated in literatures. (Burke et al, 2017;Quevedo et al, 2016) On the other hand, LDA topic modeling, sentiment analysis, and social determinants of health did not play critical roles for classification in our experiments. We attributed its low impact due to the variety of subreddits in the cohort, which possibly makes it challenge to effectively group certain topics for classifying suicide risk levels.…”

Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies

“…Lower PCC gray matter volume was found in adult SAs with MDD [145]. Decreased PCC activation was observed during cognitive control in adult SAs with psychotic mood disorders [51] and during self-referential processing in adolescent ideators with MDD [146], although adult SAs with depressive disorders, compared with HCs, showed increased PCC response when viewing knives [135].…”

“…A small percentage of studies (13.8%) included sex as a variable to assess potential interactions with STBs. Five studies (3.8%) reported sex-related findings, though no relationship with STBs [36,146,[193][194][195][196] and one study (0.8%) reported more females than males studied were SAs but reported no neuroimaging-related findings [197]. Chase et al [198], in a study that controlled for sex, noted that one participant identified as transmale.…”