初发无自杀意图的青少年非自杀性自伤患者存在难治性前额叶和边缘白质网络破坏。

Intractable prefrontal and limbic white matter network disruption in adolescents with drug-naïve nonsuicidal self-injury.

作者信息

Chen Yuwei, Yang Xiongxiong, Liao Kaike, Yu Rui, Chen Xinyue, Zhang Wenjing, Liu Nian

机构信息

Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan South Road, Nanchong, 637000, China.

Department of Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.

出版信息

BMC Psychiatry. 2025 Jul 1;25(1):662. doi: 10.1186/s12888-025-07106-6.

DOI:10.1186/s12888-025-07106-6

PMID:40597916

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12219605/

Abstract

BACKGROUND

The white matter network changes that accompany nonsuicidal self-injury (NSSI) among adolescents are not well understood. This study thus sought to investigate the structural connectivity and network features of adolescents with drug-naïve NSSI, while also evaluating the alterations in these parameters following treatment.

METHOD

The diffusion tensor imaging and clinical scales were used to evaluate 43 adolescents with drug-naïve NSSI, 20 of them after treatment (post-treatment NSSI group), and 43 healthy controls (HC). Graph theory analyses were used to construct a white matter network consisting of 90 regions for these participants. Network-based statistic (NBS) correction methods were used to assess structural connectivity within this network, and a generalized linear model was used to compare network metrics between NSSI and HCs, whereas paired t-tests were used to compare the same patients pre- and post-treatment. Correlations between clinical symptoms and both structural connectivity and network metrics were assessed.

RESULTS

Greater structural connectivity was observed between the right caudate nucleus and right olfactory cortex, right superior frontal gyrus (medial orbital), and right amygdala in adolescents with drug-naïve NSSI relative to HCs. Adolescents with drug-naïve NSSI was also found with increased characteristic path length and normalized characteristic path length values in network metrics, and reduced global efficiency and nodal network metrics for the right orbital middle frontal gyrus, which were also negatively correlated with anxiety and self-injury symptoms. After treatment, post-treatment NSSI group exhibited network alterations that were most pronounced in the prefrontal lobes, left parahippocampal gyrus, and left middle occipital gyrus.

CONCLUSIONS

These results offer new insight into the abnormal structural connectivity and network metrics that arise in the prefrontal gyrus and limbic system of adolescents with drug-naïve NSSI, potentially providing guidance for the interpretation of NSSI-related imaging changes in the white matter network.

摘要

背景

青少年非自杀性自伤（NSSI）所伴随的白质网络变化尚未得到充分理解。因此，本研究旨在调查初涉毒品的NSSI青少年的结构连通性和网络特征，同时评估治疗后这些参数的变化。

方法

采用扩散张量成像和临床量表对43名初涉毒品的NSSI青少年、其中20名治疗后的青少年（治疗后NSSI组）以及43名健康对照者（HC）进行评估。使用图论分析为这些参与者构建一个由90个区域组成的白质网络。基于网络的统计（NBS）校正方法用于评估该网络内的结构连通性，使用广义线性模型比较NSSI组和HC组之间的网络指标，而配对t检验用于比较同一患者治疗前后的情况。评估临床症状与结构连通性和网络指标之间的相关性。

结果

相对于HC组，初涉毒品的NSSI青少年右侧尾状核与右侧嗅觉皮质、右侧额上回（眶内侧）和右侧杏仁核之间观察到更强的结构连通性。还发现初涉毒品的NSSI青少年在网络指标中特征路径长度和标准化特征路径长度值增加，右侧眶额中回的全局效率和节点网络指标降低，这些指标也与焦虑和自伤症状呈负相关。治疗后，治疗后NSSI组表现出的网络改变在额叶、左侧海马旁回和左侧枕中回最为明显。