The amplitude of low-frequency fluctuation (ALFF) is a measure of spontaneous brain activity derived from resting-state functional magnetic resonance imaging (rs-fMRI). Previous research has suggested that abnormal ALFF values may be associated with major depressive disorder (MDD) and suicide attempts in adolescents. In this study, our aim was to investigate the differences in ALFF values between adolescent MDD patients with and without a history of suicide attempts, and to explore the potential utility of ALFF as a neuroimaging biomarker for aiding in the diagnosis and prediction of suicide attempts in this population.The study included 34 adolescent depression patients with suicide attempts (SU group), 43 depression patients without suicide attempts (NSU group), and 36 healthy controls (HC group). Depression was diagnosed using a threshold score greater than 17 on the Hamilton Depression Rating Scale (HDRS). The rs-fMRI was employed to calculate zALFF values and compare differences among the groups. Associations between zALFF values in specific brain regions and clinical variables such as emotion regulation difficulties were explored using Pearson partial correlation analysis. Receiver-Operating Characteristics (ROC) analysis assessed the ability of mean zALFF values to differentiate between SU and NSU groups.Significant differences in zALFF values were observed in the left and right inferior temporal gyrus (l-ITG, r-ITG) and right fusiform gyrus (r-FG) among the three groups (GRF corrected). Both SU and NSU groups exhibited increased zALFF values in the inferior temporal gyrus compared to the HC group. Furthermore, the SU group showed significantly higher zALFF values in the l-ITG and r-FG compared to both the NSU group and the HC group. Partial correlation analysis revealed a negative correlation between zALFF values in the left superior and middle frontal gyrus (l-SFG, l-MFG) and the degree of emotional dysregulation in the SU group (R = -0.496, p = 0.003; R = -0.484, p = 0.005). Combining zALFF values from the l-ITG and r-FG achieved successful discrimination between depressed adolescents with and without suicide attempts (AUC = 0.855) with high sensitivity (86%) and specificity (71%).Depressed adolescents with suicidal behavior exhibit unique neural activity patterns in the inferior temporal gyrus and fusiform gyrus. These findings highlight the potential utility of these specific brain regions as biomarkers for identifying suicide risk in depressed adolescents. Furthermore, associations between emotion dysregulation and activity in their frontal gyrus regions were observed. These findings provide preliminary yet pertinent insights into the pathophysiology of suicide in depressed adolescents. 

The amplitude of low-frequency fluctuation characteristics in depressed adolescents with suicide attempts: a resting-state fMRI study

BACKGROUND
 Adolescent major depressive disorder (MDD) is a significant mental health concern that often leads to recurrent depression in adulthood. Resting-state functional magnetic resonance imaging (rs-fMRI) offers unique insights into the neural mechanisms underlying this condition. However, despite previous research, the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.
 AIM
 To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation (ALE) meta-analysis.
 METHODS
 We performed a comprehensive literature search through July 12, 2023, for studies investigating brain functional changes in adolescent MDD patients. We utilized regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) analyses. We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls (HCs) using ALE.
 RESULTS
 Ten studies (369 adolescent MDD patients and 313 HCs) were included. Combining the ReHo and ALFF/fALFF data, the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs (voxel size: 648 mm3, P < 0.05), and no brain region exhibited increased activity. Based on the ALFF data, we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients (voxel size: 736 mm3, P < 0.05), with no regions exhibiting increased activity.
 CONCLUSION
 Through ALE meta-analysis, we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients, increasing our understanding of the neuropathology of affected adolescents.

Vulnerable brain regions in adolescent major depressive disorder: A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

BACKGROUND Research has found that the amygdala plays a significant role in underlying pathology of major depressive disorder (MDD). However, few studies have explored machine learning-assisted diagnostic biomarkers based on amygdala functional connectivity (FC). AIM To investigate the analysis of neuroimaging biomarkers as a streamlined approach for the diagnosis of MDD in adolescents. METHODS Forty-four adolescents diagnosed with MDD and 43 healthy controls were enrolled in the study. Using resting-state functional magnetic resonance imaging, the FC was compared between the adolescents with MDD and the healthy controls, with the bilateral amygdala serving as the seed point, followed by statistical analysis of the results. The support vector machine (SVM) method was then applied to classify functional connections in various brain regions and to evaluate the neurophysiological characteristics associated with MDD. RESULTS Compared to the controls and using the bilateral amygdala as the region of interest, patients with MDD showed significantly lower FC values in the left inferior temporal gyrus, bilateral calcarine, right lingual gyrus, and left superior occipital gyrus. However, there was an increase in the FC value in Vermis-10. The SVM analysis revealed that the reduction in the FC value in the right lingual gyrus could effectively differentiate patients with MDD from healthy controls, achieving a diagnostic accuracy of 83.91%, sensitivity of 79.55%, specificity of 88.37%, and an area under the curve of 67.65%. CONCLUSION The results showed that an abnormal FC value in the right lingual gyrus was effective as a neuroimaging biomarker to distinguish patients with MDD from healthy controls. 

Resting-state functional magnetic resonance imaging and support vector machines for the diagnosis of major depressive disorder in adolescents

Emotional disorders inflict an enormous burden on society. Research on brain abnormalities implicated in emotional disorders has witnessed great progress over the past decades. Using cross-sectional and longitudinal designs, resting state functional magnetic resonance imaging (rs-fMRI) and its analytic approaches have been applied to characterize the local properties of patients with emotional disorders. Additionally, brain activity alterations of emotional disorders have shown frequency-specific. Despite the gains in understanding the roles of brain abnormalities in emotional disorders, the limitation of the small sample size needs to be highlighted. Lastly, we proposed that evidence from the positive psychology research stream presents it as a viable discipline, whose suggestions could be developed in future emotional disorders research. Such interdisciplinary research may produce novel treatments and intervention options. This article is categorized under: Psychology > Brain Function and Dysfunction.

Local brain abnormalities in emotional disorders: Evidence from resting state fMRI studies.

Background Non-Suicidal Self-Injury (NSSI) is a primary risk factor for suicide, but objective biomarkers to assess this risk are urgently needed. The “prefrontal-limbic dysregulation” model provides a neurobiological framework for self-injurious behaviors. This study aimed to identify resting-state neural markers of suicidal ideation severity in adolescents with NSSI and to build a predictive model for individualized risk assessment. Methods We recruited 64 adolescent psychiatric inpatients with NSSI. Suicidal ideation was measured using the Beck Scale for Suicide Ideation (BSI). Resting-state functional MRI (rs-fMRI) was used to measure spontaneous brain activity via the amplitude of low-frequency fluctuation (ALFF). We performed a whole-brain correlation analysis between ALFF and BSI scores. A support vector regression (SVR) model was then developed using the identified neural feature to predict individual BSI scores. Results A significant negative correlation was found between BSI scores and ALFF values in the left Middle Frontal Gyrus (MFG). Lower spontaneous activity in this region was associated with more severe suicidal ideation. The SVR model, based on the left MFG ALFF values, successfully predicted individual BSI scores with significant accuracy (r = 0.492, p &amp;lt; 0.001), a finding confirmed by permutation testing. Conclusion Diminished resting-state activity in the left MFG is a key neural correlate of suicidal ideation severity in adolescents with NSSI. The functional activity of the left MFG is a promising biomarker for suicide risk assessment and may serve as a potential target for novel neuromodulatory therapies in this high-risk population. 

pdf/resting-state-spontaneous-brain-activity-as-a-neural-marker-so0qxfal3326.pdf

Resting-state spontaneous brain activity as a neural marker for suicidal ideation in adolescents with non-suicidal self-injury: a voxel-wise and machine learning study

Objective Major depressive disorder (MDD) is associated with suicidal attempts (SAs) among adolescents, with suicide being the most common cause of mortality in this age group. This study explored the predictive utility of support vector machine (SVM)-based analyses of amplitude of low-frequency fluctuation (ALFF) results as a neuroimaging biomarker for aiding the diagnosis of MDD with SA in adolescents. Methods Resting-state functional magnetic resonance imaging (rs-fMRI) analyses of 71 first-episode, drug-naive adolescent MDD patients with SA and 54 healthy control individuals were conducted. ALFF and SVM methods were used to analyze the imaging data. Results Relative to healthy control individuals, adolescent MDD patients with a history of SAs showed reduced ALFF values in the bilateral medial superior frontal gyrus (mSFG) and bilateral precuneus. These lower ALFF values were also negatively correlated with child depression inventory (CDI) scores while reduced bilateral precuneus ALFF values were negatively correlated with Suicidal Ideation Questionnaire Junior (SIQ-JR) scores. SVM analyses showed that reduced ALFF values in the bilateral mSFG and bilateral precuneus had diagnostic accuracy levels of 76.8% (96/125) and 82.4% (103/125), respectively. Conclusion Adolescent MDD patients with a history of SA exhibited abnormal ALFF. The identified abnormalities in specific brain regions may be involved in the pathogenesis of this condition and may help identify at-risk adolescents. Specifically, reductions in the ALFF in the bilateral mSFG and bilateral precuneus may be indicative of MDD and SA in adolescent patients.

/pdf/abnormal-amplitude-of-low-frequency-fluctuation-values-as-a-1r66dtoo.pdf

Abnormal amplitude of low-frequency fluctuation values as a neuroimaging biomarker for major depressive disorder with suicidal attempts in adolescents: A resting-state fMRI and support vector machine analysis

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Abnormal amplitude of low-frequency fluctuation values as a neuroimaging biomarker for major depressive disorder with suicidal attempts in adolescents: A resting-state fMRI and support vector machine analysis