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Suicide, driven by Major Depressive Disorder (MDD), is one of the leading causes of death among adolescents. Comorbid conditions in adolescents with Suicide Ideation/Suicide Attempt (SI/SA) are common but often challenging to assess, particularly when overlapping with disorders such as bipolar disorder and sleep disturbances. Diffusion Tensor Imaging (DTI) offers a more advanced method for analyzing white matter integrity and brain connectivity. This study uses DTI to identify specific brain connectivity patterns that differentiate comorbidities in SI/SA adolescents with MDD while also exploring how demographic factors may contribute to variations in these patterns. Participants from the baseline data of the Adolescent Brain Cognitive Development Study (n = 11,868; age range: 9–10 years; 44% female) were assessed for white matter integrity using DTI, which allows for the precise measurement of white matter microstructure and the integrity of neural pathways (tracts). Statistical analyses included t-tests and Analysis of Variance to identify significant tracts. Two regression models were used: the first controlled for demographic variables (age, sex, race, parent marital status, household income, and education), and the second included an interaction term between sex and group classification while also controlling for the same demographic variables. In this way, we investigate the overall effects of the demographic variables and possible sex differences in DTI signatures. Decreased fractional anisotropy (FA) in the left fornix and increased mean diffusivity (MD) in the corpus callosum and right hemisphere were statistically significant in SI/SA MDD individuals with both sleep disturbances and no bipolar disorder compared to those with sleep disturbances & bipolar disorder. In individuals with both sleep disturbances and bipolar disorder, significant increases in MD were observed in the parahippocampal cingulum and inferior longitudinal fasciculus compared to those with neither sleep disturbances nor bipolar disorder. The sex interactions model revealed MD differences in the left cingulate cingulum and parietal superior longitudinal fasciculus. This study highlights significant alterations in tracts like the left fornix, uncinate fasciculus, and parahippocampal cingulum in individuals with SI/SA and MDD with sleep problems and/or bipolar disorder.

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White Matter Integrity in Youth with Suicide Ideation/Suicide Attempt, Major Depressive Disorder, and Comorbidities: A Diffusion Tensor Imaging Study

  • 会议论文

  • 发表日期：

    2025年

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  • Yixuan Wang,
  • Yue Wang,
  • Yuan Meng,
  • Yunyu Xiao,
  • Xiaofu He

摘要

Suicide, driven by Major Depressive Disorder (MDD), is one of the leading causes of death among adolescents. Comorbid conditions in adolescents with Suicide Ideation/Suicide Attempt (SI/SA) are common but often challenging to assess, particularly when overlapping with disorders such as bipolar disorder and sleep disturbances. Diffusion Tensor Imaging (DTI) offers a more advanced method for analyzing white matter integrity and brain connectivity. This study uses DTI to identify specific brain connectivity patterns that differentiate comorbidities in SI/SA adolescents with MDD while also exploring how demographic factors may contribute to variations in these patterns. Participants from the baseline data of the Adolescent Brain Cognitive Development Study (n = 11,868; age range: 9–10 years; 44% female) were assessed for white matter integrity using DTI, which allows for the precise measurement of white matter microstructure and the integrity of neural pathways (tracts). Statistical analyses included t-tests and Analysis of Variance to identify significant tracts. Two regression models were used: the first controlled for demographic variables (age, sex, race, parent marital status, household income, and education), and the second included an interaction term between sex and group classification while also controlling for the same demographic variables. In this way, we investigate the overall effects of the demographic variables and possible sex differences in DTI signatures. Decreased fractional anisotropy (FA) in the left fornix and increased mean diffusivity (MD) in the corpus callosum and right hemisphere were statistically significant in SI/SA MDD individuals with both sleep disturbances and no bipolar disorder compared to those with sleep disturbances & bipolar disorder. In individuals with both sleep disturbances and bipolar disorder, significant increases in MD were observed in the parahippocampal cingulum and inferior longitudinal fasciculus compared to those with neither sleep disturbances nor bipolar disorder. The sex interactions model revealed MD differences in the left cingulate cingulum and parietal superior longitudinal fasciculus. This study highlights significant alterations in tracts like the left fornix, uncinate fasciculus, and parahippocampal cingulum in individuals with SI/SA and MDD with sleep problems and/or bipolar disorder.