Disruption of Neural Activity and Functional Connectivity in Adolescents With Major Depressive Disorder Who Engage in Non-suicidal Self-Injury: A Resting-State fMRI Study.

Background: Non-suicidal self-injury (NSSI), which commonly occurs during adolescence, often co-occurs with major depressive disorder (MDD). However, the underlying neurobiological mechanisms in adolescents with MDD who engage in NSSI remain unclear. The current study examined the aberrant local neural activity in certain areas of the visual regions and the default mode network (DMN) and the resting-state functional connectivity (rs-FC) in changed brain regions in adolescents with MDD who engage in NSSI and adolescents with MDD only. Methods: A total of 67 adolescents with MDD were divided into two groups based on their NSSI behavior: the NSSI group (n = 31) and an age-, gender-, and education-matched MDD group (n = 36). The Hamilton Depression Rating Scale (HAMD) was used to assess the severity of MDD. Amplitude of low-frequency fluctuation (ALFF) analysis was used to detect alterations in local neural activity. Brain regions with aberrant neural activity were considered regions of interest (ROI). ALFF-based rs-FC analysis was used to further explore the underlying changes in connectivity between ROI and other areas in the NSSI group. Correlation analyses were performed to examine the relationship between neural changes and clinical characteristics. Results: There was no significant difference in HAMD scores between the two groups. ALFF analysis revealed that, compared to adolescents with MDD only, adolescents with MDD who engaged in NSSI displayed significantly enhanced neural activity in the right fusiform gyrus (FFG. R) and the right median cingulate and paracingulate gyri (DCG. R). Significantly reduced rs-FC of the FFG. R-bilateral medial orbital of the superior frontal gyrus (ORBsupmed. L/R)/bilateral medial superior frontal gyrus (SFGmed. L/R), FFG. R-bilateral posterior cingulate gyrus (PCG. L/R), DCG. R-left pallidum (PAL. L), DCG. R-right superior temporal gyrus (STG. R), and DCG. R-right postcentral gyrus (PoCG. R)/right inferior parietal lobule (IPL. R) was found in adolescents with MDD who were engaged in NSSI. Additionally, no significant correlations were observed between ALFF or rs-FC values and the HAMD scores between the two groups. Limitations: Owing to the cross-sectional design, the alterations in ALFF and rs-FC values in the FFG. R and DCG. R could not demonstrate that it was a state or feature in adolescents with MDD who engaged in NSSI. Additionally, the sample size was relatively small. Conclusions: This study highlights changes in regional brain activity and remote connectivity in the FFG. R and DCG. R in adolescents with MDD who engage in NSSI. This could provide a new perspective for further studies on the neurobiological mechanism of NSSI behavior in adolescents with MDD.

The Association Between Insular Subdivisions Functional Connectivity and Suicide Attempt in Adolescents and Young Adults with Major Depressive Disorder.

Previous studies demonstrated the possible involvement of insula in suicide owing to depression. However, the function of insula in young depressed patients with suicide attempt (SA) remains to be revealed. This study aimed to explore the association between resting-state functional connectivity (FC) of insula and SA in young depressed patients. Fifty-eight adolescents and young adults with major depressive disorder, including 22 with a history of at least one SA (SA group) and 36 without a history of SA (NSA group) were scanned with a 3.0T functional magnetic resonance imaging system, and the resting-state functional magnetic resonance imaging data was extracted. Whole brain resting-state FC of insular subdivisions were compared between the two groups. Significantly increased FC of the left posterior insula with the orbital part of left inferior frontal gyrus, the right supplementary motor area and the bilateral paracentral lobule extending to the bilateral middle cingulate cortex was observed in the SA group compared with the NSA group. In addition, the orbital part of left superior frontal gyrus in the SA group exhibited significantly increased FC with the right posterior insula compared with the NSA group. However, no significant correlation was found between the insular subdivisions FC and different clinical variables in two groups. The present study highlighted the disruptions of the resting-state FC of the posterior insula with the orbitofrontal cortex and a series of motor cortices, and added incremental value to the knowledge of the neural mechanism underlying SA in young depressed patients.

Abnormal brain activity in adolescents with Internet addiction who attempt suicide: an assessment using functional magnetic resonance imaging.

Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents. However, whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown. This observational cross-sectional study enrolled 41 young Internet addicts, aged from 15 to 20 years, from the Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, China from January to May 2018. The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history. Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner. The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group. In the resting state, the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities, which may provide a new basis for studying suicide pathogenesis in Internet addicts. The study was authorized by the Ethics Committee of Chongqing Medical University, China (approval No. 2017 Scientific Research Ethics (2017-157)) on December 11, 2017.

Disruption of resting-state functional connectivity of right posterior insula in adolescents and young adults with major depressive disorder.

BACKGROUND: The neural basis of Major Depressive Disorder (MDD) which is a clinical syndrome characterized by emotional and cognitive impairments is poorly understood. Accumulating evidence has suggested that the insula is an important substrate underlying the mechanism of MDD. This study aimed to examine the disrupted resting-state brain regional function in insula and to further investigate the associated resting-state functional connectivity (rs-FC) of insula underlie the MDD in adolescents and young adults. METHODS: We employed 3.0T resting-state functional magnetic resonance imaging (rs-fMRI) to acquire data from 76 adolescents and young adults with MDD and 44 age and sex matched healthy control subjects. We employed a regional Amplitude of Low-Frequency Fluctuation (ALFF) analysis to explore local intrinsic neural oscillation alterations in insula and an ALFF-based functional connectivity (FC) approach to detect the potential changes in remote connectivity with insula in adolescents and young adults with MDD. RESULTS: By applying ALFF analysis, significantly decreased activities were detected in bilateral insula, and in particular in right anterior insular gyrus (MNI; ROI1: 42, 24, -3), right posterior insular gyrus (Montreal Neurological Institute, MNI; ROI2: 36, -9, 15) and left anterior insular gyrus (MNI; ROI3: -36, 12, 9) in patients with MDD compared to the healthy controls (p < 0.05, 1000 permutations, TFCE corrected). With ROI2 as the seed in the subsequent ALFF-based rs-FC analysis, patients with MDD were observed to have significantly reduced FC with bilateral middle occipital gyrus, lingual gyrus, calcarine, postcentral gyrus, precentral gyrus, supramarginal area, superior temporal gyrus and middle cingulate gyrus as compared to the healthy controls (p < 0.05, 1000 permutations, TFCE corrected). No significant differences of FC were detected between the patients and healthy controls when using ROI1 and ROI3 as the seeds. We found no correlations between ALFF or rs-FC values and the severity of depression as estimated by Hamilton Depression Rating Scale (HAM-D). LIMITATIONS: Clinical information were limited and no significant correlations were found between imaging variables and HAM-D scores, which reduces the power to interpret the present findings. A cross-sectional design was employed in this study so that it is not possible to know whether the abnormal ALFF or altered brain FC of insula reflects a state or trait effect in young people with MDD. CONCLUSIONS: This study highlights the regional/network interaction abnormalities of insula in adolescents and young adults with MDD, and could provide further insight into understanding the neural pathomechanism of MDD in young patients.