Depression
Conditions
Keywords
Psychiatry, Suicidal behaviour, Cerebral metabolites, MRI, Inflammatory markers
Brief summary
Suicidal behaviors (SB) are a major health problem in France : 10 000 suicides and 220 000 suicide attempts every year. SB management is therefore a major public health issue. Evidence associated dysregulation of the serotonergic system and the hypothalamic-pituitary-adrenal axis to vulnerability to SB. Recent data point to linke these abnormalities with neuroinflammatory clues, glutamatergic function and neuronal plasticity. There is a need to better understand the physiopathology and develop diagnostic and therapeutic tools in SB. The investigators hypothesize that increased peripheral biomarkers of inflammation would correlate to a disturbance of the cerebral metabolites, such as glutamate and NAA, especially in suicidal patients. Our aim is to compare rates of cerebral metabolites, in particular the complex glutamine/glutamate, in cerebral areas involved in suicidal vulnerability (the anterior cingulate cortex and the orbito-frontal cortex) between person with unipolar disorder with and without suicidal attempt.
Detailed description
69 patients : 23 with suicidal thoughts and attempt, 23 with suicidal thoughts without attempt and 23 healthy volunteers. 2 visits : * Inclusion visit (V0) : (Day 1) o Clinical interview : self and hetero assessment questionnaire * Visit V1 (as soon as possible, day 1 if available) : * MRI (spectroscopy)
Interventions
OTHERMagnetic Resonance Imaging (MRI) and biological samples
Participants will have to do a MRI and biological samples.
Sponsors
University Hospital, Montpellier
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
Non-specific inclusion criteria: * Having signed informed consent * Able to understand nature, aims and methodology of the study Specific inclusion criteria : * Suicidal patient with suicide attempt : * Persistent depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders - V (DSM-V) criteria, and evaluated by the Mini International Neuropsychiatric Interview (MINI) * Hamilton Depression Scale \> 7 * Suicide attempt \< 1 week * Suicidal patient without suicide attempt : * Persistent depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders - V (DSM-V) criteria, and evaluated by the Mini International Neuropsychiatric Interview (MINI) * Hamilton Depression Scale \> 7 * No history of suicide attempt * Healthy volunteers : * No psychiatric history * No history of suicide attempt
Exclusion criteria
* Actual somatic, neurological or inflammatory pathology (C-Reactive Protein \> 10mg/L) * Traumatic brain injury with loss of consciousness * Antibiotic treatment or anti-inflammatory treatment * Actual toxic abuse according to DSM-V (except tobacco and alcohol) * Actual or passed history of psychotic disorder * Patient on protective measures (guardianship or trusteeship) * Deprived of liberty subject (judicial or administrative decision) * Pregnant women or breastfeeding * Contraindications to MRI scan
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Glutamine (Glu) and Glutamate (Glx) levels | At V1 (the day of the MRI) | Levels of Glu/Glx in the anterior cingulate cortex and the orbitofrontal cortex between the depressed patients with and without suicide attempt |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of N-Acetyl-Aspartate (NAA) | At V1 (the day of the MRI) | Comparison of levels of NAA in the anterior cingulate cortex and the orbito-frontal cortex between the 3 groups |
| Level of Choline (Cho) | At V1 (the day of the MRI) | Comparison of levels of Cho in the anterior cingulate cortex and the orbito-frontal cortex between the 3 groups |
| Level of Myo-inositol (Myo) | At V1 (the day of the MRI) | Comparison of levels of Myo in the anterior cingulate cortex and the orbito-frontal cortex between the 3 groups |
| Level of Creatinine (Cr) | At V1 (the day of the MRI) | Comparison of levels of Creatinine (Cr) in the anterior cingulate cortex and the orbito-frontal cortex between the 3 groups |
| Link between level of suicidal intentionality assessed by the Columbia Suicide Severity Rating Scale (CSS-RS) and metabolites levels | At V1 (the day of the MRI) | Relationship between level of suicidal intentionality and Glu/Glx levels between the 3 groups |
| Link between level of depression assessed by the clinician with the Hamilton Rating Scale (HAMD) and metabolite levels | At V1 (the day of the MRI) | Relationship between level of depression and Glu/Glx levels between the 3 groups |
| Link between rate of Interleukin 1, 2, 4, 5, 6, 7, 9, 10, 13 and suicide attempt | At V1 (the day of the MRI) | Comparison of Interleukin 1, 2, 4, 5, 6, 7, 9, 10, 13 between the 3 groups |
| Link between rate of Tumor necrosis factor alpha (TNF α) and suicide attempt | At V1 (the day of the MRI) | Comparison of biomarkers inflammation (TNF α) between the 3 groups |
| Link between rate of Tumor necrosis factor beta (TNFβ) and suicide attempt | At V1 (the day of the MRI) | Comparison of biomarkers inflammation (TNFβ) between the 3 groups |
| Link between rate of Interferon gamma (IFNγ) and suicide attempt | At V1 (the day of the MRI) | Comparison of biomarkers inflammation (IFNγ) between the 3 groups |
| Link between rate of C-Reactive Protein (CRP) and suicide attempt | At V1 (the day of the MRI) | Comparison of biomarkers inflammation (CRP) between the 3 groups |
| Link between rate of Interferon Gamma Inducing Factors (IGIF)and suicide attempt | At V1 (the day of the MRI) | Comparison of biomarkers inflammation (IGIF) between the 3 groups |
| Link between level of depression self assessed with the Beck Scale and metabolites levels | At V1 (the day of the MRI) | Relationship between level of depression and Glu/Glx levels between the 3 groups |
Countries
France
Outcome results
None listed