Inflammatory Biomarkers and Brain Metabolites, a Study Based on Magnetic Resonance Spectroscopy

University Hospital, Montpellier69 enrolled

Overview

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.

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)

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Depression

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 YearsHealthy volunteers:

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Glutamine (Glu) and Glutamate (Glx) levels

Levels of Glu/Glx in the anterior cingulate cortex and the orbitofrontal cortex between the depressed patients with and without suicide attempt