Huang Qian, Xiao Muni, Ai Ming, Chen Jianmei, Wang Wo, Hu Lan, Cao Jun, Wang Mengyao, Kuang Li
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2021 Jun 1;12:571532. doi: 10.3389/fpsyt.2021.571532. eCollection 2021.
Non-suicidal self-injury (NSSI), which commonly occurs during adolescence, often co-occurs with major depressive disorder (MDD). However, the underlying neurobiological mechanisms in adolescents with MDD who engage in NSSI remain unclear. The current study examined the aberrant local neural activity in certain areas of the visual regions and the default mode network (DMN) and the resting-state functional connectivity (rs-FC) in changed brain regions in adolescents with MDD who engage in NSSI and adolescents with MDD only. A total of 67 adolescents with MDD were divided into two groups based on their NSSI behavior: the NSSI group ( = 31) and an age-, gender-, and education-matched MDD group ( = 36). The Hamilton Depression Rating Scale (HAMD) was used to assess the severity of MDD. Amplitude of low-frequency fluctuation (ALFF) analysis was used to detect alterations in local neural activity. Brain regions with aberrant neural activity were considered regions of interest (ROI). ALFF-based rs-FC analysis was used to further explore the underlying changes in connectivity between ROI and other areas in the NSSI group. Correlation analyses were performed to examine the relationship between neural changes and clinical characteristics. There was no significant difference in HAMD scores between the two groups. ALFF analysis revealed that, compared to adolescents with MDD only, adolescents with MDD who engaged in NSSI displayed significantly enhanced neural activity in the right fusiform gyrus (FFG. R) and the right median cingulate and paracingulate gyri (DCG. R). Significantly reduced rs-FC of the FFG. R-bilateral medial orbital of the superior frontal gyrus (ORBsupmed. L/R)/bilateral medial superior frontal gyrus (SFGmed. L/R), FFG. R-bilateral posterior cingulate gyrus (PCG. L/R), DCG. R-left pallidum (PAL. L), DCG. R-right superior temporal gyrus (STG. R), and DCG. R-right postcentral gyrus (PoCG. R)/right inferior parietal lobule (IPL. R) was found in adolescents with MDD who were engaged in NSSI. Additionally, no significant correlations were observed between ALFF or rs-FC values and the HAMD scores between the two groups. Owing to the cross-sectional design, the alterations in ALFF and rs-FC values in the FFG. R and DCG. R could not demonstrate that it was a state or feature in adolescents with MDD who engaged in NSSI. Additionally, the sample size was relatively small. This study highlights changes in regional brain activity and remote connectivity in the FFG. R and DCG. R in adolescents with MDD who engage in NSSI. This could provide a new perspective for further studies on the neurobiological mechanism of NSSI behavior in adolescents with MDD.
非自杀性自伤行为（NSSI）常见于青少年时期，常与重度抑郁症（MDD）并发。然而，伴有NSSI行为的青少年MDD患者潜在的神经生物学机制仍不清楚。本研究检测了伴有NSSI行为的青少年MDD患者及仅患有MDD的青少年在视觉区域特定脑区和默认模式网络（DMN）的异常局部神经活动，以及这些脑区变化后的静息态功能连接（rs-FC）情况。总共67名患有MDD的青少年根据其NSSI行为被分为两组：NSSI组（n = 31）和年龄、性别及教育程度相匹配的MDD组（n = 36）。采用汉密尔顿抑郁量表（HAMD）评估MDD的严重程度。采用低频振幅（ALFF）分析检测局部神经活动的改变。神经活动异常的脑区被视为感兴趣区（ROI）。基于ALFF的rs-FC分析用于进一步探究NSSI组中ROI与其他脑区之间连接性的潜在变化。进行相关性分析以检验神经变化与临床特征之间的关系。两组之间的HAMD评分无显著差异。ALFF分析显示，与仅患有MDD的青少年相比，伴有NSSI行为的青少年MDD患者右侧梭状回（FFG.R）、右侧中央扣带回和旁扣带回（DCG.R）的神经活动显著增强。在伴有NSSI行为的青少年MDD患者中发现，FFG.R与双侧额上回内侧眶部（ORBsupmed.L/R）/双侧额上回内侧（SFGmed.L/R）、FFG.R与双侧后扣带回（PCG.L/R）、DCG.R与左侧苍白球（PAL.L）、DCG.R与右侧颞上回（STG.R）以及DCG.R与右侧中央后回（PoCG.R）/右侧顶下小叶（IPL.R）之间的rs-FC显著降低。此外，两组之间ALFF或rs-FC值与HAMD评分之间未观察到显著相关性。由于采用横断面设计，FFG.R和DCG.R中ALFF和rs-FC值的改变无法证明这是伴有NSSI行为的青少年MDD患者的一种状态或特征。此外，样本量相对较小。本研究强调了伴有NSSI行为的青少年MDD患者FFG.R和DCG.R区域脑活动及远距离连接的变化。这可为进一步研究伴有NSSI行为的青少年MDD患者的神经生物学机制提供新的视角。
