Neural Correlates of Adolescent Depression and Suicide: an fNIRS Study
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1
School of Biomedical Engineering, Science and Health Systems, Drexel University, United States
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2
College of Nursing and Health Professions, Drexel University, United States
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3
University of Pennsylvania, Department of Family and Community Health, United States
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4
Children's Hospital of Philadelphia, Division of General Pediatrics, United States
Suicide is a major public health problem in not only the United States but around the world as well (Nock et al., 2008). Reports from the Centers for Disease Control (CDC) state that suicide is the second leading cause of death among those ages 15-34 (Prevention, 2015). Seventeen percent of students report seriously considering suicide, 13.6% report making a plan for how they would kill themselves, and 8% report having made a suicide attempt (CDC, 2015). In 2013, there were 41,149 completed suicides - approximately 1 every 13 minutes (CDC, 2015). Over 3,000 of these were adolescents. Consequently, youth suicide prevention has become a major area of concern for schools, health care systems, funding agencies, and policy makers. Unfortunately, we still lack basic knowledge about the underlying mechanisms that place youth at risk for suicide and how best to measure them.
The purpose of this study is to demonstrate the feasibility of using noninvasive brain recordings to enhance our knowledge of the underlying mechanisms of suicide. The prevention of teen suicide is of great importance in the interest of public health. However, identifying and measuring the underlying biological mechanisms that place youth at risk for suicide is an area that is currently poorly understood. This study proposes to demonstrate the feasibility and acceptability of recruiting and evaluating adolescents (psychiatric and non-clinical) for a study using non-invasive fNIRS neuroimaging sensors (Ayaz et al., 2013). We seek to demonstrate the hemodynamic differences in the brains of both adolescents with psychiatric distress compared to normal controls and psychiatric adolescents with and without a recent (and history of) suicide attempt.
Eleven participants (8 females, ages 14-17) volunteered for this study thus far. The two participants in the clinical group were recruited from a local psychiatric hospital and had a history of depression. Each participant gave informed consent via a form approved by the Drexel University Institutional Review Board prior to study participation. Participants completed two cognitive tasks, a go/no go task and a verbal fluency task (VFT). In the Go/No-go test, subjects were instructed to press the enter button anytime a green circle appeared on the screen. They were instructed to press nothing when a rare red circle appeared on the screen. Participants completed three go trials, where only green circles would appear and two no-go trials where red circles would appear infrequently. The second task performed was the VFT (Pu et al., 2015). Subjects were given three different trials involving the presentation of either a letter (e.g. A or S), a category (e.g. Colors, Food), or a sound (e.g. la). Subjects were asked to list as many nouns that they could that either started with that letter or fit into the category. For the sound trial, subjects simply had to repeat the sound out loud. Participants were given thirty seconds to complete each trial. Nouns will be explained as a person, a place, or a thing, and subjects will be informed that proper nouns like someone’s name or a city’s name will not be accepted, nor will repeats of words. Participants wore a portable, wireless fNIRS device (fNIR Devices Model 1100W) during the tasks to measure their brain activation.
Preliminary analysis of the behavioral results shows that for the go/no go task the clinical group had a slower response time in both the go and no-go blocks of the task (table 1). The clinical group had a lower accuracy during the no-go blocks than the healthy group as expected. During the VFT, both the clinical and healthy groups were able to list a similar number of words during the letter and category blocks (table 2).
The brain activation results (figure 1) shows that for the go/no go task there was an overall significant effect for the task (F1,13.9 = 4.85, p =0.045). There was also a significant difference between the healthy group and the clinical group in the two different trials of the task (F1,13.9 = 6.01, p =0.028). For the VFT, brain activation results shows that again there was an overall significant effect for the task (F2,33.9 = 4.93, p =0.013). There was also a significant difference between the healthy group and the clinical group in the different trials of the task (F2,33.9 = 9.92, p =0.001).
These results demonstrate that fNIRS is a viable tool to detect a significant difference in brain activation between healthy controls and clinical groups with depression. More participants will be recruited, and further analysis will be performed. Future studies are needed to validate and eventually incorporate these as a tool to assist in diagnostics and interventions.
Figure 1. Oxygenated hemoglobin changes during the go/no-go task.
Table 1. Behavioral results of the go/no go task.
Table 2. Behavioral results of the VFT. Average number of words per trial.
Acknowledgements
Authors would like to thank Clinical & Translational Research Institute for the pilot study funding. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsor.
References
Ayaz, H., Onaral, B., Izzetoglu, K., Shewokis, P. A., McKendrick, R., & Parasuraman, R. (2013). Continuous monitoring of brain dynamics with functional near infrared spectroscopy as a tool for neuroergonomic research: empirical examples and a technological development. Front Hum Neurosci, 7, 871. doi:10.3389/fnhum.2013.00871
Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiol Rev, 30, 133-154. doi:10.1093/epirev/mxn002
CDC (2015). Suicide: Facts at a Glance. Retrieved from http://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf
Pu, S., Nakagome, K., Yamada, T., Yokoyama, K., Matsumura, H., Yamada, S., . . . Kaneko, K. (2015). Suicidal ideation is associated with reduced prefrontal activation during a verbal fluency task in patients with major depressive disorder. J Affect Disord, 181, 9-17. doi:10.1016/j.jad.2015.04.010
Keywords:
Depression,
Adolescent,
suicide prevention,
prefrontal cortex (PFC),
functional near infrared spectrosopy (fNIRS),
response inhibition,
Verbal fluency task (VFT)
Conference:
2nd International Neuroergonomics Conference, Philadelphia, PA, United States, 27 Jun - 29 Jun, 2018.
Presentation Type:
Poster Presentation
Topic:
Neuroergonomics
Citation:
Sargent
A,
Fedorowich
C,
Diamond
G and
Ayaz
H
(2019). Neural Correlates of Adolescent Depression and Suicide: an fNIRS Study.
Conference Abstract:
2nd International Neuroergonomics Conference.
doi: 10.3389/conf.fnhum.2018.227.00078
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Received:
29 Mar 2018;
Published Online:
27 Sep 2019.
*
Correspondence:
Dr. Hasan Ayaz, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, 19104, United States, hasan.ayaz@drexel.edu