Disrupted fronto-parietal network and default-mode network gamma interactions distinguishing suicidal ideation and suicide attempt in depression

Background: Precise suicide risk evaluation struggled in Major depressive disorder (MDD), especially for patients with only suicidal-ideation (SI) but without suicide attempt (SA). MDD patients have deficits in negative emotion processing, which is associated with the generation of SI and SA. Given the critical role of gamma oscillations in negative emotion processing, we hypothesize that the transition from SI to SA in MDD could be characterized by abnormal gamma interactions.

Methods: We recruited 162 participants containing 106 MDD patients and 56 healthy controls (HCs). Participants performed facial recognition tasks while magnetoencephalography data were recorded. Time-frequency-representation (TFR) analysis was conducted to identify the dominant spectra differences between MDD and HCs, and then source analysis was applied to localize the region of interests. Furthermore, frequency-specific functional connectivity network were constructed and a semi-supervised clustering algorithm was utilized to predict potential suicide risk.

Results: Gamma (50-70 Hz) power was found significantly increased in MDD, mainly residing in regions from fronto-parietal-control-network (FPN), visual-network (VN), default-mode-network (DMN) and salience-network (SN). Based on impaired gamma functional connectivity network between well-established SA group and non-SI group, semi-supervised algorithm clustered patients with only SI into two groups with different suicide risks. Moreover, Inter-network gamma connectivity between FPN and DMN significantly negatively correlated with suicide risk and not confounded by depression severity.

Conclusion: Inter-network gamma connectivity with FPN and DMN might be the key neuropathological interactions underling the progression from SI to SA. By applying semi-supervised clustering to electrophysiological data, it is possible to predict individual suicide risk.