Department of Human Neuroscience, Sapienza University, Rome, Italy.
Department of Methods and Models for Economics, Territory and Finance, Sapienza University, Rome, Italy.
Eur J Pain. 2021 Sep;25(8):1815-1828. doi: 10.1002/ejp.1793. Epub 2021 May 31.
Although non-suicidal self-injury (NSSI) disorder is highly prevalent in adolescents, its relationship with pain system function and suicidality is still controversial. The present study was designed to assess the function of the nociceptive afferent pathways and the endogenous pain modulation in adolescent patients with NSSI and to longitudinally register any suicide attempt, describe its frequency and find a possible association between suicide, neurophysiological measures and psychological measures.
We enrolled 30 adolescents suffering from NSSI and 20 age- and gender-matched healthy controls. Patients underwent a comprehensive psychological evaluation. Each participant underwent thermal pain thresholds of the quantitative sensory testing, laser-evoked potential recording to study the ascending nociceptive pathway and the conditioned pain modulation testing to test the endogenous pain modulation.
We found that patients with NSSI had a reduced amplitude of the N2 component of laser-evoked potentials and an abnormal conditioned pain modulation. The amplitude of the N2 was associated with suicidal risk.
The deficit of the endogenous pain modulation likely depends on a saturation due to continuous pain solicitation. The strong association of a reduced amplitude of the N2 component with suicide suggests that it may serve as a possible biomarker in self-harming adolescents.
The present study identifies the N2 component of laser-evoked potentials as a possible neurophysiological biomarker of suicidal risk in patients with non-suicidal self-injury, therefore, raising the possibility for a non-invasive test to identify subjects at higher risk of suicide among self-harming patients.
尽管非自杀性自伤（NSSI）在青少年中非常普遍，但它与疼痛系统功能和自杀的关系仍存在争议。本研究旨在评估青少年 NSSI 患者的伤害感受传入通路和内源性疼痛调节功能，并对任何自杀企图进行纵向登记，描述其频率，并找到自杀与神经生理测量和心理测量之间的可能关联。
我们招募了 30 名患有 NSSI 的青少年和 20 名年龄和性别匹配的健康对照者。患者接受了全面的心理评估。每位参与者均接受了定量感觉测试的热痛阈值、激光诱发电位记录以研究上行伤害感受通路以及条件性疼痛调制测试以测试内源性疼痛调制。
我们发现，NSSI 患者的激光诱发电位 N2 成分幅度降低，且条件性疼痛调制异常。N2 的幅度与自杀风险相关。
内源性疼痛调制的缺陷可能是由于持续的疼痛刺激而导致的饱和。N2 成分幅度降低与自杀强烈相关，这表明它可能作为自伤青少年的一个可能的生物标志物。
本研究确定了激光诱发电位的 N2 成分作为非自杀性自伤患者自杀风险的可能神经生理生物标志物，因此，有可能进行非侵入性测试来识别自伤患者中自杀风险较高的个体。
