Romain Colle1, Marie Chupin2, Claire Cury2, Christophe Vandendrie3, Florence Gressier4, Patrick Hardy4, Bruno Falissard5, Olivier Colliot2, Denis Ducreux3, Emmanuelle Corruble4. 1. INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. Electronic address: romaincolle@hotmail.com. 2. INSERM, U1127, F-75013 Paris, France; CNRS, UMR 7225 ICM, 75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, F-75013 Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Inria, Aramis Team, Centre de Recherche Paris, Rocquencourt, France. 3. CNRS IR4M, UMR 8081, Neuroradiology Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. 4. INSERM UMR 1178, Team "Depression and Antidepressants", Univ Paris Sud, Service de Psychiatrie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, 94275 Le Kremlin Bicêtre, France. 5. INSERM UMR 1178, Département de Biostatistiques, Univ Paris Sud, Hôpital Paul Brousse, Assistance Publique Hôpitaux de Paris, 94400 Villejuif, France.
Abstract
BACKGROUND: Despite known relationship between hippocampal volumes and major depressive episodes (MDE) and the increased suicidality in MDE, the links between hippocampal volumes and suicidality remain unclear in major depressive disorders (MDD). If the hippocampus could be a biomarker of suicide attempts in depression, it could be useful for prevention matters. This study assessed the association between hippocampal volumes and suicide attempts in MDD. METHODS: Hippocampal volumes assessed with automatic segmentation were compared in 63 patients with MDD, with (n = 24) or without (n = 39) suicide attempts. Acute (<one month) and past (>one month) suicide attempts were studied. RESULTS: Although not different in terms of socio-demographic, MDD and MDE clinical features, suicide attempters had lower total hippocampus volumes than non-attempters (4.61 (± 1.15) cm(3) vs 5.22 (± 0.99) cm(3); w = 625.5; p = 0.03), especially for acute suicide attempts (4.19 (± 0.81) cm(3) vs 5.22 (± 0.99) cm(3); w = 334; p = 0.005), even after adjustment on brain volumes, sex, age, Hamilton Depression Rating Scale (HDRS) scores and MDD duration. A ROC analysis showed that a total hippocampal volume threshold of 5.00 cm(3) had a 98.2% negative predictive value for acute suicide attempts. CONCLUSION: Depressed suicide attempters have smaller hippocampus than depressed patients without suicide attempts, independently from socio-demographics and MDD characteristics. This difference is related to acute suicide attempts but neither to past suicide attempts nor to duration since the first suicide attempt, suggesting that hippocampal volume could be a suicidal state marker in MDE. Further studies are required to better understand this association.
BACKGROUND: Despite known relationship between hippocampal volumes and major depressive episodes (MDE) and the increased suicidality in MDE, the links between hippocampal volumes and suicidality remain unclear in major depressive disorders (MDD). If the hippocampus could be a biomarker of suicide attempts in depression, it could be useful for prevention matters. This study assessed the association between hippocampal volumes and suicide attempts in MDD. METHODS: Hippocampal volumes assessed with automatic segmentation were compared in 63 patients with MDD, with (n = 24) or without (n = 39) suicide attempts. Acute (<one month) and past (>one month) suicide attempts were studied. RESULTS: Although not different in terms of socio-demographic, MDD and MDE clinical features, suicide attempters had lower total hippocampus volumes than non-attempters (4.61 (± 1.15) cm(3) vs 5.22 (± 0.99) cm(3); w = 625.5; p = 0.03), especially for acute suicide attempts (4.19 (± 0.81) cm(3) vs 5.22 (± 0.99) cm(3); w = 334; p = 0.005), even after adjustment on brain volumes, sex, age, Hamilton Depression Rating Scale (HDRS) scores and MDD duration. A ROC analysis showed that a total hippocampal volume threshold of 5.00 cm(3) had a 98.2% negative predictive value for acute suicide attempts. CONCLUSION:Depressed suicide attempters have smaller hippocampus than depressedpatients without suicide attempts, independently from socio-demographics and MDD characteristics. This difference is related to acute suicide attempts but neither to past suicide attempts nor to duration since the first suicide attempt, suggesting that hippocampal volume could be a suicidal state marker in MDE. Further studies are required to better understand this association.
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