Temporal dynamic brain-heart interaction alterations associated with suicidal ideation in major depressive disorder

BACKGROUND: Previous studies have indicated abnormal brain activation or heart rate variability in patients with major depressive disorder (MDD). Suicidal ideation, as one of the main concerns of MDD, is a serious public health problem. However, the interactions between brain and heart of MDD patients with and without suicidal ideation remain largely unknown. METHODS: In this study, resting-state EEG and ECG data were simultaneously collected from 42 healthy controls (HCs), 69 MDD patients with suicidal ideation (MDDSI), and 39 MDD patients without suicidal ideation (MDDNSI). We proposed a novel methodology for analyzing temporal dynamic brain-heart interactions (TD-BHI). Then, we calculated the correlations between abnormalities of TD-BHI and cognitive performance, as well as sleep quality. Finally, we assessed the ability of TD-BHI to distinguish MDDSI patients. RESULTS: We found that the TD-BHI values in the MDDSI group significantly increased in the parietal lobes and decreased in the right parietal lobes, compared with those in the HCs group. Additionally, the attention/vigilance score of the MATRICS consensus cognitive battery (MCCB) and the Pittsburgh sleep quality index scores were significantly correlated with the TD-BHI values in the MDDSI group. The ensemble learning model based on TD-BHI achieved an AUC of 0.825 in distinguishing MDDSI from MDDNSI patients. CONCLUSION: Distinct abnormalities of TD-BHI may mediate suicidal ideation in MDD patients and can serve as a reliable biomarker for the diagnosis of MDDSI patients.