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Subcortical brain structure and suicidal behaviour in major depressive disorder: a meta-analysis from the ENIGMA-MDD working group.

  • Author(s): Rentería, ME
  • Schmaal, L
  • Hibar, DP
  • Couvy-Duchesne, B
  • Strike, LT
  • Mills, NT
  • de Zubicaray, GI
  • McMahon, KL
  • Medland, SE
  • Gillespie, NA
  • Hatton, SN
  • Lagopoulos, J
  • Veltman, DJ
  • van der Wee, N
  • van Erp, TGM
  • Wittfeld, K
  • Grabe, HJ
  • Block, A
  • Hegenscheid, K
  • Völzke, H
  • Veer, IM
  • Walter, H
  • Schnell, K
  • Schramm, E
  • Normann, C
  • Schoepf, D
  • Konrad, C
  • Zurowski, B
  • Godlewska, BR
  • Cowen, PJ
  • Penninx, BWJH
  • Jahanshad, N
  • Thompson, PM
  • Wright, MJ
  • Martin, NG
  • Christensen, H
  • Hickie, IB
  • et al.
Abstract

The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands of individuals collected by research groups from around the world. Here we present analyses in a subset sample (n=3097) for whom suicidality data were available. Prevalence of suicidal symptoms among major depressive disorder (MDD) cases ranged between 29 and 69% across cohorts. We compared mean subcortical grey matter volumes, lateral ventricle volumes and total intracranial volume (ICV) in MDD patients with suicidal symptoms (N=451) vs healthy controls (N=1996) or MDD patients with no suicidal symptoms (N=650). MDD patients reporting suicidal plans or attempts showed a smaller ICV (P=4.12 × 10-3) or a 2.87% smaller volume compared with controls (Cohen's d=-0.284). In addition, we observed a nonsignificant trend in which MDD cases with suicidal symptoms had smaller subcortical volumes and larger ventricular volumes compared with controls. Finally, no significant differences (P=0.28-0.97) were found between MDD patients with and those without suicidal symptoms for any of the brain volume measures. This is by far the largest neuroimaging meta-analysis of suicidal behaviour in MDD to date. Our results did not replicate previous reports of association between subcortical brain structure and suicidality and highlight the need for collecting better-powered imaging samples and using improved suicidality assessment instruments.

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