Cortical morphological alterations in adolescents with major depression and non-suicidal self-injury.

BACKGROUND

Non-suicidal self-injury (NSSI) involves repetitive self-harm without suicidal intent and is common among adolescents, often linked to major depressive disorder (MDD). NSSI can lead to physical harm, cognitive impairments, interpersonal issues, violent behavior, and increased risks of psychological disorders and suicide attempts later in life.

METHODS

Voxel-based morphometry (VBM) and surface-based morphometry (SBM) were performed on 44 NSSI patients and 44 healthy controls (HCs). Differences in GMV, CT, and cortical complexity were compared using the two-sample t-tests and correlated with neuropsychological scales.

RESULTS

NSSI patients exhibited significant GMV atrophy in multiple regions, including the left insula, left anterior cingulate cortex, left putamen, left middle frontal gyrus, and right superior frontal gyrus showing increased GMV in the cerebellum posterior lobe. NSSI patients had increased CT in multiple left hemisphere regions and decreased CT in the right middle frontal gyrus. Additionally, they exhibited reduced cortical complexity, including decreased SD in the right frontal gyrus, and lower GI in the left insula. There were no significant differences between the two groups in terms of fractal dimension (FD). NSSI patients showed negative correlation between the CT of the right middle frontal gyrus and the anger dimension of the BPAQ, as well as the SD of the right superior frontal gyrus and the hostility dimension of the BPAQ.

CONCLUSION

NSSI patients have significant structural changes in the insular cortex, prefrontal cortex, precentral and postcentral gyrus, temporal lobe, putamen, and anterior cingulate cortex, offering a morphological perspective on the pathophysiology of NSSI in MDD.