Mürner-Lavanchy Ines, Josi Johannes, Koenig Julian, Reichl Corinna, Brunner Romuald, Kaess Michael
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland.
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
J Affect Disord. 2023 Apr 14;327:79-86. doi: 10.1016/j.jad.2023.01.117. Epub 2023 Feb 3.
Non-suicidal self-injury (NSSI) is highly prevalent among adolescents and predicts future psychopathology including suicide. To improve therapeutic decisions and clinical outcome of patients engaging in NSSI, it seems beneficial to determine neurobiological markers associated with treatment response. The present study investigated whether resting-state functional brain connectivity (RSFC) served to predict clinical improvements following treatment in adolescents engaging in NSSI.
N = 27 female adolescents with NSSI took part in a baseline MRI exam and clinical outcome was assessed at follow-ups one, two and three years after baseline. During the follow-up period, patients received in- and/or outpatient treatment. Mixed-effects linear regression models were calculated to examine whether RSFC was associated with clinical improvement.
Patients' clinical outcome improved across time. Lower baseline RSFC between left paracentral gyrus and right anterior cingulate gyrus was associated with clinical improvement from baseline to one-year and from two-year to three-year follow-up. Lower and higher baseline RSFC in several inter- and intrahemispheric cortico-cortical and cortico-subcortical connections of interest were associated with clinical symptomatology and its severity, independent from time.
A relatively small sample size constrains the generalizability of our findings. Further, no control group not receiving treatment was recruited, therefore clinical changes across time cannot solely be attributed to treatment.
While there was some evidence that RSFC was associated with clinical improvement following treatment, our findings suggest that functional connectivity is more predictive of severity of psychopathology and global functioning independent of time and treatment. We thereby add to the limited research on neurobiological markers as predictors of clinical outcome after treatment.
非自杀性自伤行为（NSSI）在青少年中极为普遍，并预示着未来包括自杀在内的精神病理学问题。为改善参与NSSI患者的治疗决策和临床结局，确定与治疗反应相关的神经生物学标志物似乎有益。本研究调查静息态功能脑连接（RSFC）是否有助于预测参与NSSI的青少年治疗后的临床改善情况。
27名有NSSI行为的女性青少年参加了基线MRI检查，并在基线后1年、2年和3年的随访中评估临床结局。在随访期间，患者接受了住院和/或门诊治疗。计算混合效应线性回归模型，以检查RSFC是否与临床改善相关。
患者的临床结局随时间改善。左侧中央旁回与右侧前扣带回之间较低的基线RSFC与从基线到1年以及从2年到3年随访的临床改善相关。在几个感兴趣的半球间和半球内皮质-皮质及皮质-皮质下连接中，较低和较高的基线RSFC与临床症状及其严重程度相关，与时间无关。
相对较小的样本量限制了我们研究结果的普遍性。此外，未招募未接受治疗的对照组，因此随时间的临床变化不能仅归因于治疗。
虽然有一些证据表明RSFC与治疗后的临床改善相关，但我们的研究结果表明，功能连接更能预测精神病理学严重程度和整体功能，与时间和治疗无关。我们从而为作为治疗后临床结局预测指标的神经生物学标志物的有限研究增添了内容。
