Preliminary evidence of an association between increased cortical inhibition and reduced suicidal ideation in adolescents treated for major depression

Charles P. Lewis, Deniz Doruk Camsari, A. Irem Sonmez, Aiswarya Lakshmi Nandakumar, Marjorie A. Gresbrink, Zafiris J. Daskalakis, Paul E. Croarkin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Suicide is a leading cause of death among youth. Prior research using transcranial magnetic stimulation (TMS) has implicated deficits in GABAergic cortical inhibition in adolescent suicidal behavior, yet no studies have assessed whether cortical inhibition varies over time in conjunction with changes in suicidal ideation (SI). This study examined dynamic changes in long-interval intracortical inhibition (LICI), a TMS measure of GABA B -mediated inhibition, and their relationship with changes in SI in a small sample of adolescents undergoing pharmacologic treatment for depression. Methods: Ten depressed adolescents (aged 13–17) underwent clinical assessment and TMS testing at baseline and again at follow-up. All were treated with antidepressant medication in the interim. SI was measured with the Columbia Suicide Severity Rating Scale (C-SSRS) Intensity of Ideation subscale. LICI was measured at interstimulus intervals of 100 and 150 ms. Results: There was a significant partial correlation, controlling for change in depression severity, between ΔLICI-100 and change in SI as measured by ΔC-SSRS (ρ =.746, df = 7, p =.021), which remained after also controlling for time to follow-up assessment (ρ =.752, df = 6, p =.032). No significant correlation was observed between ΔLICI-150 and change in SI. Limitations: Sample size; variable follow-up interval; inability to control for age, sex, and potential treatment effects. Conclusions: These data offer preliminary signal of an association between increases in GABA B -mediated cortical inhibition and reduction in SI over time in adolescents treated for depression. Further studies are warranted to explore the role of cortical inhibition in adolescent suicidal ideation and behavior.

Original languageEnglish (US)
Pages (from-to)21-24
Number of pages4
JournalJournal of Affective Disorders
Volume244
DOIs
StatePublished - Feb 1 2019
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by a National Institute of Mental Health ( NIMH ) grant, R01MH113700 “Glutamatergic and GABAergic Biomarkers in TMS for Adolescent Depression” (Dr. Croarkin).

Funding Information:
CPL receives research support from the Mayo Clinic Foundation Departmental Small Grant Program and is a site investigator for multicenter studies funded by Neuronetics, Inc. and NeoSync, Inc . DDC receives research support from the Mayo Clinic Foundation Departmental Small Grant Program. ZJD has received research and equipment in-kind support for investigator-initiated studies from Brainsway Ltd. and MagVenture, Inc.; he also has served on the advisory board for F. Hoffmann-La Roche Ltd. and Merck & Co., Inc. and has received speaker support from Eli Lilly and Co. PEC has received research grant support from Pfizer, Inc., NIMH, the Brain and Behavior Research Foundation, and the Mayo Clinic Foundation. He has served as a site subprincipal or principal investigator (without additional compensation) for Eli Lilly and Co. , Forest Laboratories, Inc., Merck & Co., Inc. , and Pfizer, Inc.; has received equipment support from Neuronetics, Inc.; and receives supplies and genotyping services from Assurex Health, Inc. for an investigator-initiated study. He is the primary investigator for a multicenter study funded by Neuronetics, Inc. and primary site investigator for a multicenter study funded by NeoSync, Inc. AIS, ALN, and MAG have no financial disclosures.

Funding Information:
CPL receives research support from the Mayo Clinic Foundation Departmental Small Grant Program and is a site investigator for multicenter studies funded by Neuronetics, Inc. and NeoSync, Inc. DDC receives research support from the Mayo Clinic Foundation Departmental Small Grant Program. ZJD has received research and equipment in-kind support for investigator-initiated studies from Brainsway Ltd. and MagVenture, Inc.; he also has served on the advisory board for F. Hoffmann-La Roche Ltd. and Merck & Co., Inc. and has received speaker support from Eli Lilly and Co. PEC has received research grant support from Pfizer, Inc., NIMH, the Brain and Behavior Research Foundation, and the Mayo Clinic Foundation. He has served as a site subprincipal or principal investigator (without additional compensation) for Eli Lilly and Co., Forest Laboratories, Inc., Merck & Co., Inc., and Pfizer, Inc.; has received equipment support from Neuronetics, Inc.; and receives supplies and genotyping services from Assurex Health, Inc. for an investigator-initiated study. He is the primary investigator for a multicenter study funded by Neuronetics, Inc. and primary site investigator for a multicenter study funded by NeoSync, Inc. AIS, ALN, and MAG have no financial disclosures.

Keywords

  • Adolescent
  • Cortical inhibition
  • Depression
  • Suicidal ideation
  • Transcranial magnetic stimulation

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