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Alterations of insular dynamic functional connectivity and psychological characteristics in unmedicated bipolar depression patients with a recent suicide attempt

Published online by Cambridge University Press:  08 March 2022

Lai Shunkai Open the ORCID record for Lai Shunkai [Opens in a new window] ,
Pan Chen ,
Shuming Zhong ,
Guanmao Chen ,
Yiliang Zhang ,
Hui Zhao ,
Jiali He ,
Ting Su ,
Shuya Yan  and
Yange Luo
...Show all authors
Lai Shunkai*
Affiliation:
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Pan Chen
Affiliation:
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
Shuming Zhong
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Guanmao Chen
Affiliation:
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
Yiliang Zhang
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Hui Zhao
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Jiali He
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Ting Su
Affiliation:
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
Shuya Yan
Affiliation:
School of Management, Jinan University, Guangzhou, China
Yange Luo
Affiliation:
School of Management, Jinan University, Guangzhou, China
Hanglin Ran
Affiliation:
School of Management, Jinan University, Guangzhou, China
Yanbin Jia
Affiliation:
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
Ying Wang
Affiliation:
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
*
Authors for correspondence: Yanbin Jia, E-mail: yanbinjia2006@163.com; Ying Wang, E-mail: johneil@vip.sina.com
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Abstract

Background

Mounting evidence showed that insula contributed to the neurobiological mechanism of suicidal behaviors in bipolar disorder (BD). However, no studies have analyzed the dynamic functional connectivity (dFC) of insular Mubregions and its association with personality traits in BD with suicidal behaviors. Therefore, we investigated the alterations of dFC variability in insular subregions and personality characteristics in BD patients with a recent suicide attempt (SA).

Methods

Thirty unmedicated BD patients with SA, 38 patients without SA (NSA) and 35 demographically matched healthy controls (HCs) were included. The sliding-window analysis was used to evaluate whole-brain dFC for each insular subregion seed. We assessed between-group differences of psychological characteristics on the Minnesota Multiphasic Personality Inventory-2. Finally, a multivariate regression model was adopted to predict the severity of suicidality.

Results

Compared to NSA and HCs, the SA group exhibited decreased dFC variability values between the left dorsal anterior insula and the left anterior cerebellum. These dFC variability values could also be utilized to predict the severity of suicidality (r = 0.456, p = 0.031), while static functional connectivity values were not appropriate for this prediction. Besides, the SA group scored significantly higher on the schizophrenia clinical scales (p < 0.001) compared with the NSA group.

Conclusions

Our findings indicated that the dysfunction of insula–cerebellum connectivity may underlie the neural basis of SA in BD patients, and highlighted the dFC variability values could be considered a neuromarker for predictive models of the severity of suicidality. Moreover, the psychiatric features may increase the vulnerability of suicidal behavior.

Keywords

Bipolar disordercerebellumdynamic functional connectivityinsula subregionspersonality traitssuicidal attempters
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 9 , July 2023 , pp. 3837 - 3848
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

Lai Shunkai, Pan Chen and Shuming Zhong contributed equally to this work, and are the first co-authors.

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