摘要
目的 抑郁症是影响青少年成长的严重心理健康问题，其患病率在过去十年急剧上升，而自杀是青少年抑郁症最严重的后果，青少年抑郁症自杀问题引起了社会日益广泛的关注。然而目前对于青少年抑郁症自杀的神经生物学特征仍知之甚少，因此准确识别和预防青少年抑郁症自杀的发生仍然面临挑战。方法 采用病例-对照研究，我们纳入了19例伴有自杀未遂的青少年抑郁症患者（SAD组）、11例不伴有自杀行为的青少年抑郁症患者（MDD组）以及20名健康对照者（HC组），采集睁眼静息态脑电信号，进行微状态聚类与参数比较比较三组脑电微状态的差异，以期探索静息态脑电微状态在青少年抑郁症自杀未遂患者中的特异性表现。结果 研究结果显示：与MDD组相比，SAD组微状态B的平均持续时间（P<0.001）和覆盖范围（P<0.001）显著升高；与HC组相比，SAD组的微状态B的平均持续时间（P<0.001）、出现频次（P<0.001）以及覆盖范围显著升高（P<0.001），微状态C的平均持续时间（P<0.001）、出现频次（P<0.001）和覆盖范围显著降低（P=0.002）；MDD组微状态B的出现频次（P<0.001）和覆盖范围（P<0.001）较HC组升高，而微状态C的出现频次较HC组显著降低（P<0.001）。结论 本研究表明静息态脑电微状态特征可作为识别青少年抑郁症患者自杀行为的潜在生物标记物。但仍需进一步深入探索，未来有望为青少年抑郁症自杀的精准防控提供参考。
关键词： 青少年；抑郁症；自杀未遂；静息态；脑电微状态
Abstract
Objective Depression is a serious mental health problem that affects adolescent development, and its prevalence has risen sharply over the past decade. Suicide is the most severe consequence of depression in youth, drawing increasing societal attention. However, the neurobiological characteristics underlying suicidal behavior in adolescents with depression remain poorly understood, making accurate identification and prevention of suicide in this population a continuing challenge. Methods Using a case–control design, we enrolled 19 adolescents diagnosed with major depressive disorder and a history of suicide attempt (SAD group), 11 adolescents with depression but no suicidal behavior (MDD group), and 20 healthy controls (HC group). Eyes-open resting-state EEG was recorded, microstate clustering was performed, and the resulting parameters were compared across the three groups to identify resting-state EEG microstate features specific to depressed adolescents with suicide attempt. Results The results showed that, compared with the MDD group, the SAD group exhibited significantly longer mean duration (P < 0.001) and greater coverage (P < 0.001) of microstate B. Relative to the HC group, the SAD group displayed increased mean duration (P < 0.001), occurrence frequency (P < 0.001), and coverage (P < 0.001) of microstate B, along with decreased mean duration (P < 0.001), occurrence frequency (P < 0.001), and coverage (P = 0.002) of microstate C. The MDD group, in turn, showed higher occurrence frequency (P < 0.001) and coverage (P < 0.001) of microstate B and lower occurrence frequency of microstate C (P < 0.001) than the HC group. Conclusion These findings suggest that resting-state EEG microstate characteristics could serve as potential biomarkers for identifying suicidal behavior in adolescents with depression. Further investigation is warranted, with the prospect of informing precision prevention and intervention strategies for youth depression-related suicide.
Key words： Adolescents; Depression; Suicide attempts; Resting-state; EEG microstates
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