Suicide attempt-related gray matter volume alterations in major depressive disorder and its associations with childhood trauma

초록

Background: Suicide is a major cause of premature mortality in major depressive disorder (MDD), yet its neurobiological substrates remain unclear. Suicide attempters represent a distinct phenotype characterized by impaired affect regulation and fronto-limbic structural alterations. Early-life adversity may further sensitize stress-responsive circuits. This study examined gray matter volume (GMV) alterations associated with suicide attempts in MDD and their relationships with childhood trauma and suicidal ideation. Methods: T1-weighted magnetic resonance imaging data were obtained from 204 adults (61 suicidal depression [SD], 62 non-suicidal depression [NSD], 81 healthy controls [HC]). Whole-brain voxel-based morphometry (VBM) identified regions differentiating SD from NSD. The cluster showing a significant SD-NSD GMV difference was defined as the region of interest (ROI), and its GMV was correlated with Childhood Trauma Questionnaire (CTQ) and Suicidal Ideation Scale (SSI) scores. Exploratory voxel-wise regression assessed childhood traumarelated GMV patterns across groups. Results: VBM revealed reduced GMV in the septal nucleus, distinguishing SD from NSD. ROI analyses confirmed lower septal GMV in SD than in NSD and HC, and smaller volume correlated with greater suicidal ideation in patients with MDD. Within the SD group, voxel-wise regression showed negative associations between CTQ scores and GMV in the cerebellar vermis. Conclusion: Distinct gray matter alterations emerged in MDD, with septal atrophy appearing as a potential suicide-related feature, while cerebellar vermis reductions showed a tentative association with early adversity that warrants cautious interpretation. These findings suggest that interrelated limbic, cerebellar, and septal regions may contribute to stress regulation and suicidality in depression.

키워드