AUTHOR=Shiwei Lin , Xiaojing Zhang , Yingli Zhang , Shengli Chen , Xiaoshan Lin , Ziyun Xu , Gangqiang Hou , Yingwei Qiu TITLE=Cortical hierarchy disorganization in major depressive disorder and its association with suicidality JOURNAL=Frontiers in Psychiatry VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1140915 DOI=10.3389/fpsyt.2023.1140915 ISSN=1664-0640 ABSTRACT=Objectives

To explore the suicide risk-specific disruption of cortical hierarchy in major depressive disorder (MDD) patients with diverse suicide risks.

Methods

Ninety-two MDD patients with diverse suicide risks and 38 matched controls underwent resting-state functional MRI. Connectome gradient analysis and stepwise functional connectivity (SFC) analysis were used to characterize the suicide risk-specific alterations of cortical hierarchy in MDD patients.

Results

Relative to controls, patients with suicide attempts (SA) had a prominent compression from the sensorimotor system; patients with suicide ideations (SI) had a prominent compression from the higher-level systems; non-suicide patients had a compression from both the sensorimotor system and higher-level systems, although it was less prominent relative to SA and SI patients. SFC analysis further validated this depolarization phenomenon.

Conclusion

This study revealed MDD patients had suicide risk-specific disruptions of cortical hierarchy, which advance our understanding of the neuromechanisms of suicidality in MDD patients.