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[Preprint]. 2024 Nov 7:2024.11.07.24316876.
doi: 10.1101/2024.11.07.24316876.

Transdiagnostic alterations in white matter microstructure associated with suicidal thoughts and behaviours in the ENIGMA Suicidal Thoughts and Behaviours consortium

Laura S van Velzen  1   2 Lejla Colic  3   4   5 Zuriel Ceja  6   7 Maria R Dauvermann  8   9 Luca M Villa  3 Hannah S Savage  2   10 Yara J Toenders  1   2   11 Niousha Dehestani  10   12 Alyssa H Zhu  13 Adrian I Campos  14 Lauren E Salminen  13 Ingrid Agartz  15   16   17 Nina Alexander  18   19 Rosa Ayesa-Arriola  20 Elizabeth D Ballard  21 Nerisa Banaj  22 Carlotta Barkhau  23 Zeynep Başgöze  24 Jochen Bauer  25 Francesco Benedetti  26 Klaus Berger  27 Bianca Besteher  4   5 Katharina Brosch  18   19   28 Manuel Canal-Rivero  29   30 Simon Cervenka  17   31 Romain Colle  32 Colm G Connolly  33 Emmanuelle Corruble  32 Philippe Courtet  34   35 Baptiste Couvy-Duchesne  36   37 Benedicto Crespo-Facorro  29   30   38 Kathryn R Cullen  24 Udo Dannlowski  23 Jeremy Deverdun  39   40 Ana M Diaz-Zuluaga  41   42 Lorielle M F Dietze  43 Jennifer W Evans  21 Negar Fani  44 Kira Flinkenflügel  23 Naomi P Friedman  45 Ian H Gotlib  46 Nynke A Groenewold  47 Dominik Grotegerd  23 Tomas Hajek  43 Alexander S Hatoum  48 Marco Hermesdorf  27 Ian B Hickie  49 Yoshiyuki Hirano  50   51 Tiffany C Ho  52   53 Yuki Ikemizu  50   54 Frank Iorfino  49 Jonathan C Ipser  47 Yuko Isobe  50   51 Andrea P Jackowski  55   56 Fabrice Jollant  57   58   59   32 Tilo Kircher  18   19 Melissa Klug  23 Sheri-Michelle Koopowitz  47 Anna Kraus  23 Axel Krug  18   60 Emmanuelle Le Bars  39   40 Elisabeth J Leehr  23 Meng Li  4   5 Elizabeth T C Lippard  61   62 Carlos Lopez-Jaramillo  42 Ivan I Maximov  15   63 Andrew M McIntosh  64 Katie A McLaughlin  65   66 Sean R McWhinney  43 Susanne Meinert  23   67 Elisa Melloni  26 Philip B Mitchell  68 Benson Mwangi  69   70 Igor Nenadić  18   19 Stener Nerland  15   16 Emilie Olie  34   35 Victor Ortiz-García de la Foz  20 Pedro M Pan  56 Fabricio Pereira  71   72 Fabrizio Piras  22 Federica Piras  22 Sara Poletti  26 Andrew E Reineberg  73 Gloria Roberts  68 Rafael Romero-García  9   29 Matthew D Sacchet  74 Giovanni A Salum  75   76 Anca-Larisa Sandu  77 Carl M Sellgren  17   78 Eiji Shimizu  50   51   54 Harry R Smolker  79 Jair C Soares  69   70 Gianfranco Spalletta  22   80 J Douglas Steele  81 Frederike Stein  18   19 Dan J Stein  82 Benjamin Straube  18   19 Lea Teutenberg  18   19 Florian Thomas-Odenthal  18   19 Paula Usemann  18   19 Romain Valabregue  83   84 Johanna Valencia-Echeverry  42 Gerd Wagner  4   85 Gordon Waiter  77 Martin Walter  4   5   86   87 Heather C Whalley  64   88 Mon-Ju Wu  69   70 Tony T Yang  89 Carlos A Zarate  21 Andre Zugman  90 Giovana B Zunta-Soares  69   70 Kees van Heeringen  91 Sanne J H van Rooij  44 Nic van der Wee  92   93 Steven van der Werff  92   93 Paul M Thompson  13 Hilary P Blumberg  3   94   95 Anne-Laura van Harmelen  9   96 Miguel E Rentería  6   7 Neda Jahanshad  13 ENIGMA Suicidal Thoughts and Behaviours ConsortiumLianne Schmaal  1   2
Affiliations

Transdiagnostic alterations in white matter microstructure associated with suicidal thoughts and behaviours in the ENIGMA Suicidal Thoughts and Behaviours consortium

Laura S van Velzen et al. medRxiv. .

Abstract

Previous studies have suggested that alterations in white matter (WM) microstructure are implicated in suicidal thoughts and behaviours (STBs). However, findings of diffusion tensor imaging (DTI) studies have been inconsistent. In this large-scale mega-analysis conducted by the ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium, we examined WM alterations associated with STBs. Data processing was standardised across sites, and resulting WM microstructure measures (fractional anisotropy, axial diffusivity, mean diffusivity and radial diffusivity) for 25 WM tracts were pooled across 40 cohorts. We compared these measures among individuals with a psychiatric diagnosis and lifetime history of suicide attempt (n=652; mean age=35.4±14.7; female=71.8%), individuals with a psychiatric diagnosis but no STB (i.e., clinical controls; n=1871; mean age=34±14.8; female=59.8%), and individuals with no mental disorder diagnosis and no STB (i.e., healthy controls; n=642; mean age=29.6±13.1; female=62.9%). We also compared these measures among individuals with recent suicidal ideation (n=714; mean age=36.3±15.3; female=66.1%), clinical controls (n=1184; mean age=36.8±15.6; female=63.1%), and healthy controls (n=1240; mean age= 31.6±15.5; female=61.0%). We found subtle but statistically significant effects, such as lower fractional anisotropy associated with a history of suicide attempt, over and above the effect of psychiatric diagnoses. These effects were strongest in the corona radiata, thalamic radiation, fornix/stria terminalis, corpus callosum and superior longitudinal fasciculus. Effect sizes were small (Cohen's d < 0.25). Recent suicidal ideation was not associated with alterations in WM microstructure. This large-scale coordinated mega-analysis revealed subtle regional and global alterations in WM microstructure in individuals with a history of suicide attempt. Longitudinal studies are needed to confirm whether these alterations are a risk factor for suicidal behaviour.

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Conflict of interest statement

Conflicts of interest ALvH receives consultancy fees from the Augeo foundation. CAZ is a full-time US government employee. He is listed as a co-inventor on a patent for the use of ketamine and its metabolites in major depression and suicidal ideation. Dr. Zarate has assigned his patent rights to the U.S. government but will share a percentage of any royalties that may be received by the government. HPB has consulted to the Milken Institute. MW is a member of the following advisory boards and gave presentations to the following companies: Bayer AG, Germany; Boehringer Ingelheim, Germany; and Biologische Heilmittel Heel GmbH, Germany. MW has further conducted studies with institutional research support from HEEL and Janssen Pharmaceutical Research for a clinical trial (IIT) on ketamine in patients with MDD, unrelated to this investigation. MW did not receive any financial compensation from the companies mentioned above. IA received speakers honorarium from Lundbeck. IBH is the Co-Director, Health and Policy at the Brain and Mind Centre (BMC) University of Sydney. The BMC operates an early-intervention youth services at Camperdown under contract to headspace. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd which aims to transform mental health services through the use of innovative technologies. AC reports being currently an employee of the Regeneron Genetics Center, and may own Regeneron stock or stock options. JCS acknowledge to be related with the next companies ALKERMES (Advisory Board), BOEHRINGER Ingelheim (Consultant), COMPASS Pathways (Research Grant), JOHNSON & JOHNSON (Consultant), LIVANOVA (Consultant), RELMADA (Research Grant), SUNOVION (Research Grant),Mind Med (Research Grant). PMP received payment or honoraria for lectures and presentations in educational events for Sandoz, Daiichi Sankyo, Eurofarma, Abbot, Libbs, Instituto Israelita de Pesquisa e Ensino Albert Einstein, Instituto D’Or de Pesquisa e Ensino. All other authors report no biomedical financial interests, disclosures or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Cohen’s d map represents significant ROIs without the global covariate and threshold of pFDR < 0.05. From left to right, middle slices of sagittal, axial, and coronal views were used, except for C, where only the sagittal view was used. The figure includes three sections: A) FA and RD for individuals with a lifetime history of suicide attempt versus HC, B) FA for individuals with a lifetime history of suicide attempt versus CLC and C) FA and RD for individuals with recent suicidal ideation versus HC. Abbreviations: CLC= clinical control group ; FA= fractional anisotropy; HC= healthy control group; pFDRR= p value corrected using Benjamini Hochberg correction; RD= radial diffusivity; ROI= region of interest; SA= individuals with a lifetime history of suicide attempt; SI= individuals with recent suicidal ideation.

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