Resting State FMRI In Non-suicidal Adolescents Study On The Value Of NSSI

Objective:Non-suicidal self-injury(NSSI)is the act of intentionally destroying one’s own body tissues without suicidal intent,which is more common among adolescents and is not only closely related to psychiatric disorders such as depression and borderline personality disorder,but is also an important precursor to future suicidal behavior,and therefore has become a serious public health challenge in China and globally.Therefore,it has become a serious public health challenge in China and globally.The neurobiological factors underlying the development of NSSI are still unclear,and the lack of objective neuroimaging markers for diagnosis is a scientific problem that needs to be addressed in clinical research.Resting-state functional MRI imaging(rs-f MRI)is noninvasive,radiation-free,and can provide rich imaging information,and is now widely used in the study of neurological/psychiatric disorders.Therefore,this study provides neuroimaging markers for the clinical diagnosis of NSSI by calculating the imaging indexes based on rs-f MRI and identifying the abnormalities of brain function in adolescent patients with NSSI using comparative analysis and correlation analysis;the efficacy of imaging markers in clinical diagnosis is verified by modeling analysis,which provides methodological reference for the clinical diagnosis of NSSI.This study will contribute to the understanding of the pathogenesis of NSSI,improve the accuracy of clinical diagnosis of NSSI,and provide precise targets for the treatment of NSSI.Materials and methods:Fifteen patients aged 13-18 years who attended the outpatient clinic of the Department of Psychological Medicine of Henan Provincial People’s Hospital from December 2021 to December 2022 and met the diagnostic and statistical manual of mental disorders,5th edition(DSM-5)were collected.Fifteen patients who met the diagnostic criteria of NSSI(NSSI group)and 15 healthy adolescents matched for age,sex,and education(healthy control,HC group)were recruited,and the general information form,Self-rating anxiety scale(SAS),Self-rating depression scale(SDS),and Self-rated depression scale(SDS)were used.The general information and clinical information of all subjects were collected using the general information form,Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS),and the NSSI information of the patients were collected using the Non-Suicidal Self-Injurious Behavior Rating Questionnaire for Adolescents,and the rs-f MRI data were collected for all subjects.Local differences in neural activity were detected using amplitude of low-frequency fluctuations(ALFF),regional homogeneity(Re Ho),fractional amplitude of low-frequency fluctuations(f ALFF),and resting state functional connectivity(rs-FC)were used to assess the differences in correlation with whole brain voxel time series,using differential brain regions as seed points;age,gender,and education were used as covariates,and bias correlation analysis was performed between ALFF,Re Ho,f ALFF,and rs-FC values and clinical symptom scale scores for brain areas with differences,as a way to assess whether there was a correlation between functionally differential brain areas and clinical symptoms.Receiver operating characteristic(ROC)curve analysis was used to assess the effectiveness of the abnormal imaging metrics in differentiating between NSSI patients and healthy adolescents,and the area under the curve(AUC)and corresponding 95%confidence interval(CI)were calculated.Results :1.There was no significant difference between the NSSI and HC groups in terms of gender,age,and education(p>0.05),while the SDS and SAS scores of NSSI group were significantly higher than those of HC group(79.40±2.56 vs.25.53±1.13,t=74.654,p < 0.001;77.93±4.33 vs.25.20±0.41,t=46.914,p <0.001).2.Rs-f MRI analysis revealed that the ALFF values of the left lingual gyrus,left periapical cortex,the left cuneus and the left middle occipital gyrus in NSSI group were significantly higher than those in HC group(t=4.718,p< 0.05;t= 5.780,p< 0.05;t = 4.376,p< 0.05;t = 5.670,p< 0.05,adjusted for GRF).The Re Ho value of the right lingual gyrus in the NSSI group was significantly higher than that in the HC group(t=4.583,p< 0.05,adjusted for GRF),However,the Re Ho value of the right inferior temporal gyrus was significantly lower than that of the HC group(t=-4.511,p<0.05,adjusted for GRF).The f ALFF values of the right lingual gyrus and the left middle occipital gyrus in the NSSI group were significantly higher than those in the HC group(t=5.306,p< 0.05;t= 4.499,p< 0.05,adjusted for GRF),However,the right angular gyrus was significantly lower in the HC group(t=-5.171,p< 0.05,adjusted for GRF).The whole-brain rs-FC analysis based on the differential brain regions as seed points showed that the functional connectivity of the left lingual gyrus with the left precentral gyrus,left medial gyrus and left lateral cingulate gyrus in the NSSI group was significantly higher than that in the HC group(t=8.077,p<0.05;t=6.819,p< 0.05,all GRF corrected),while the functional connectivity between the left lingual gyrus and the right dorsal-lateral superior frontal gyrus was significantly lower than those in the HC group(t=-4.529,p< 0.05,GRF corrected).3.Correlation analysis in the NSSI group found a significant positive correlation between ALFF in the left tongue gyrus of patients and SAS and SDS scores(r=0.716,p=0.009;r=0.697,p=0.012).There was a significant positive correlation between ALFF value of left cuneus and the scores of emotional expression subscale of NSSI(r=0.720,p=0.008),and the correlation still existed after SAS and SDS scores were included as covariates(r= 0.734,p=0.016).4.The ROC curve showed that the ALFF value of the left middle occipital gyrus had a certain ability to distinguish NSSI patients from healthy adolescents(AUC=0.800,p=0.005).Conclusions:1.The presence of altered local neural activity as well as functional connectivity in several brain regions in resting state of NSSI adolescents suggests that these brain regions may regulate adolescent NSSI behavior through emotion regulation and social cognition,and the occurrence of NSSI behavior may be the result of the interaction between low-level visual processing and high-level cognitive processing,emotional processing and cognitive processing in the brain,which helps us understand the occurrence of NSSI behavior This helps us to understand the neurobiological process of NSSI behavior.2.The correlation result analysis suggested that the neural activity of the lingual gyrus was related to the severity of depression and anxiety in self-injured patients,and the cuneate lobe neural activity was related to self-injurious behaviors,suggesting that the brain regions related to visual processing might be potential targets for neuromodulation treatments(eg.deep brain stimulation,transcranial magnetic stimulation treatment).3.The results of ROC curve method analysis suggest that the intensity of neural activity in the middle occipital gyrus has the ability to discriminate between adolescents with NSSI and healthy adolescents,which provides a preliminary basis for exploring imaging markers of NSSI.