Westlund Schreiner Melinda, Mueller Bryon A, Klimes-Dougan Bonnie, Begnel Erin D, Fiecas Mark, Hill Dawson, Lim Kelvin O, Cullen Kathryn R
Department of Psychiatry, University of Utah, School of Medicine, Salt Lake City, UT, United States.
Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States.
Front Psychiatry. 2020 Jan 24;10:1019. doi: 10.3389/fpsyt.2019.01019. eCollection 2019.
Non-suicidal self-injury (NSSI) is a growing public health concern that commonly begins in adolescence, and can persist into young adulthood. A promising approach for advancing our understanding of NSSI in youth is to examine white matter microstructure using diffusion magnetic resonance imaging (dMRI).
The present study examined whole-brain group differences in structural connectivity (as measured by generalized fractional anisotropy [GFA]) between 28 female adolescents and young adults ages 13-21 years with NSSI and 22 age-matched healthy controls (HC). We also explored the association between clinical characteristics including NSSI severity and duration, impulsivity, emotion regulation and personality traits within the NSSI group and GFA of the uncinate fasciculus and cingulum.
Compared to the HC group, participants with NSSI had lower GFA in several white matter tracts, including the uncinate fasciculus, cingulum, bilateral superior and inferior longitudinal fasciculi, anterior thalamic radiation, callosal body, and corticospinal tract. When controlling for depressive symptoms, the NSSI group showed an association between NSSI duration (time since initiating NSSI behavior) and lower GFA in the left cingulum. Higher levels of attentional impulsivity were related to lower GFA in the left uncinate fasciculus within the NSSI group.
We found evidence suggesting widespread white matter microstructure deficits in adolescents and young adults with NSSI versus HC. We also report inverse associations between white matter integrity and clinical characteristics (duration of NSSI and attentional impulsivity). These white matter microstructural deficits may represent a possible neurobiologically-based vulnerability to developing maladaptive coping mechanisms, such as NSSI. Additionally, results suggest that this white matter disorganization may either worsen with prolonged engagement in NSSI or predict persistent NSSI; thereby highlighting the importance of early intervention targeting this behavior.
非自杀性自伤（NSSI）是一个日益受到关注的公共卫生问题，通常始于青春期，并可能持续到青年期。增进我们对青少年NSSI理解的一种有前景的方法是使用扩散磁共振成像（dMRI）检查白质微观结构。
本研究检查了28名年龄在13 - 21岁有NSSI的女性青少年和青年与22名年龄匹配的健康对照（HC）之间全脑结构连通性的组间差异（通过广义分数各向异性[GFA]测量）。我们还探讨了NSSI组内临床特征（包括NSSI严重程度和持续时间、冲动性、情绪调节和人格特质）与钩束和扣带束的GFA之间的关联。
与HC组相比，有NSSI的参与者在几个白质束中GFA较低，包括钩束、扣带束、双侧上纵束和下纵束、丘脑前辐射、胼胝体和皮质脊髓束。在控制抑郁症状后，NSSI组显示NSSI持续时间（自开始NSSI行为以来的时间）与左侧扣带束较低的GFA之间存在关联。较高水平的注意力冲动性与NSSI组左侧钩束较低的GFA相关。
我们发现有证据表明，与HC相比，有NSSI的青少年和青年存在广泛的白质微观结构缺陷。我们还报告了白质完整性与临床特征（NSSI持续时间和注意力冲动性）之间的负相关。这些白质微观结构缺陷可能代表了发展适应不良应对机制（如NSSI）的一种可能的基于神经生物学的易感性。此外，结果表明这种白质紊乱可能随着NSSI持续时间的延长而恶化或预测持续性NSSI；从而突出了针对这种行为进行早期干预的重要性。
