Neuroinflammatory Marker Linked to Suicidal Thoughts in Depressed Patients
Elevated translocator protein (TSPO) binding, a marker of neuroinflammatory processes, was associated with more pronounced daily suicidal ideation and negative affect during real-world stress in patients with major depressive disorder (MDD), according to study findings published in JAMA Psychiatry.
“The findings suggest that elevated brain TSPO binding in individuals with depression may be an indicator of vulnerability to acute stress-related increases in suicidal ideation and negative affect, thereby raising risk of suicide,” wrote first author Sarah Herzog, PhD, of the New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, New York, and study coauthors.
The cross-sectional study included 53 adults with MDD recruited through clinical referrals, online ads, and the Columbia University research subject web portal. Participants underwent 11C-ER176 positron emission tomography imaging of TSPO binding and arterial blood sampling. The primary outcome measure was 11C-ER176 total distribution volume across 11 brain regions.
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Researchers measured suicidal ideation using the clinician-rated Beck Scale for Suicidal Ideation. In addition, 21 participants completed ecological momentary assessment of suicidal ideation, negative affect, and stressors over 7 days.
The total distribution volume of 11C-ER176 was associated at trend levels with clinician-rated severity of suicidal ideation in the overall sample, according to the study, and did not differ by history of suicide attempt.
The presence of suicidal ideation on the Beck Scale for Suicidal Ideation or ecological momentary assessment, meanwhile, was linked with higher TSPO binding in exploratory analyses.
In the subset of participants who completed ecological momentary assessment, elevated TSPO binding was associated with greater suicidal ideation and negative affect during stressful periods compared with nonstressful periods, the study found.
“Continued study is needed to determine the causal direction of TSPO binding and stress-related suicidal ideation or negative affect,” researchers wrote, “and whether targeting neuroinflammation may improve resilience to life stress in patients with depression.”
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