| Background and objective To explore the differences in brain structure and inflammation levels in patients with early-onset depressive disorder with and without suicidal ideation in my country and their relationship with the severity of depression and suicide.Early-onset depression refers to depression that develops during adolescence(childhood and adolescence).It has the characteristics of high prevalence rate,high recurrence rate,high disability rate and high mortality rate,and is often accompanied by severe cognitive impairment and the risk of suicide.A large number of previous studies have shown that patients with adult depressive disorder associated with suicidal activity often have abnormal brain structure and immune inflammation levels,while there are currently few relevant studies on patients with early-onset depressive disorder in my country.Therefore,this study intends to use VBM technology and MSD electrochemiluminescence multi-factor detection technology to study patients with early-onset depressive disorder and their associated suicidal ideation,to explore possible neurobiomarkers,with a view to early recognition and intervention of suicidal ideation and suicidal behavior in patients with early-onset depression disorder in the future.Methods Adolescent patients who meet the DSM-5 diagnostic criteria for depression are collected by two trained psychiatric graduate students for demographic and clinical data and asked all subjects to complete MRI scans and blood sampling.The Hamilton Depression Scale(HAMD-17)and the Beck Scale for Suicide Ideation-Chinese Version(BSSI-CV)were used to evaluate the clinical symptoms of all subjects.According to the Baker suicidal ideation score,the subjects were divided into a group of patients with early-onset depressive disorder with suicidal ideation and a group of patients with early-onset depressive disorder without suicidal ideation.The SPSS24.0 statistical software package was used for statistical analysis.Measurement data are expressed as mean ± standard deviation.Measurement data such as age,years of education,and HAMD-17 scores between the two groups are measured by a two-sample t test,and count data(gender)is measured by Chi-square test.Pearson correlation analysis was used to test the correlation between magnetic resonance and serum inflammatory factor level data and neurocognitive function and neuropsychology,and the difference was statistically significant with p<0.05.Use voxel-based morphometry(VBM)technology to analyze the magnetic resonance images of the two groups of subjects.For the images obtained by VBM statistical analysis,use SPM8 software to implement the between-group t test.The different brain regions of the two groups of subjects were taken as the region of interest(ROI),and the gray matter volume of all subjects in the region of interest(ROI)was extracted and averaged.Pearson correlation analysis was performed between the average gray matter volume of all subjects in the region of interest(ROI)and the scores of the Hamilton Depression Scale-17(HAMD-17).The statistical level was p<0.05 as a significant difference.MSD electrochemiluminescence multi-factor detection technology was used to detect serum inflammatory factor levels.The serum inflammatory factor levels of the two groups of subjects were compared and their correlation with clinical symptoms was analyzed.Results After removing the effects of differences in gender,age,and years of education on the study in the form of covariates,there are differences in brain regions between the two groups with and without suicidal ideation.Compared with the group without suicide ideation,the volume of gray matter in the right middle frontal gyrus and left angular gyrus of the suicide idea group increased(FWE correction for mass level,p<0.05).There was no significant correlation between the difference in gray matter volume of the brain area between the two groups of subjects and the HAMD-17 score(P>0.05).The level of serum TNF-α(1.40±0.35 pg/ml)in the group with suicidal ideation was higher than the level of serum TNF-α(1.24±0.19 pg/ml)in the group without suicide ideation,and the difference was statistically significant(P<0.05)).There was no significant correlation between the serum TNF-α levels of the two groups of subjects and the HAMD-17 score(p>0.05).Conclusion Patients with early-onset depression with suicidal ideation and patients with early-onset depression without suicidal ideation have differences in the structure of brain regions.The difference brain regions are the right middle frontal gyrus and left angular gyrus.However,this study did not find a correlation between the different brain areas and the severity of depression in patients.The level of serum TNF-α in the suicidal ideation group was higher than that in the suicide ideation group.The occurrence of suicidal ideation may be related to the increase in serum TNF-α level. |
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