Amygdala Functional Connectivity During Self-Face Processing in Depressed Adolescents With Recent Suicide Attempt

Objective: Suicide is the second leading cause of death among adolescents; however, objective biomarkers of suicide risk are lacking. Aberrant self-face amygdala activity is associated with suicide ideation, and its connectivity with neural regions that enable self-processing (eg medial prefrontal cortex) may be a suicide risk factor. Method: Adolescents (aged 11−17 years; N = 120) were sorted into four groups: healthy controls (HC), depressed individuals with low suicide ideation (LS), depressed individuals with high suicide ideation (HS), and depressed suicide attempters (SA). Youth completed an emotional (Happy, Sad, Neutral) self-face recognition task in the scanner. Bilateral amygdala task-dependent functional connectivity was determined with psychophysiological interaction analysis. Connectivity was compared across groups and within Self versus Other faces across emotions and hemispheres. Voxelwise results were thresholded (p <.005, uncorrected) and corrected for multiple comparisons (p <.05, familywise error). Results: Both HS and SA displayed greater amygdala connectivity with the dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and precuneus, compared to LS, who, in turn, showed greater connectivity than HC. Greater left amygdala−rostral anterior cingulate cortex (rACC) connectivity was observed in SA compared to all other groups, whereas right amygdala−rACC connectivity was greater in HS versus LS and HC. Conclusion: Greater connectivity between amygdala and other regions implicated in self-face processing differentiated suicide ideation and suicide attempt groups. A dose-dependent response showed that greater rACC−left amygdala connectivity during self-face processing was associated with a recent suicide attempt, but that a greater rACC−right amygdala connectivity was associated with suicide ideation.