Abstract
Background: 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.Methods: A total of 67 adolescents with MDD were divided into two groups based on their NSSI behavior: the NSSI group (n = 31) and an age-, gender-, and education-matched MDD group (n = 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.Results: 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.Limitations: 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.Conclusions: 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.
Highlights
Major depressive disorder (MDD) is the most prevalent mental disorder and is mainly characterized by aberrant emotion and cognitive function [1]
We performed ALFF analysis and ALFF-based whole-brain rsFC analysis to investigate the following hypotheses: [1] the differences in neural activity between adolescents with MDD who engage in non-suicidal self-injury (NSSI) and adolescents with MDD only may be located in certain areas of the visual regions and default mode network (DMN) and [2] the remote resting-state functional connectivity (rs-FC) in the changed regions may be obviously different in adolescents with MDD with and without a history of NSSI
A total of 31 adolescents (8 male and 23 female subjects) with MDD who engage in NSSI with a mean age of 16.13 ± 1.69 years were assessed as the NSSI group
Summary
Major depressive disorder (MDD) is the most prevalent mental disorder and is mainly characterized by aberrant emotion (lack of pleasure) and cognitive function (dysfunctional attention and memory) [1]. NSSI, which refers to directly and deliberately damaging one’s own body tissue without intending to end one’s life [4], often occurs in the context of a diagnosis such as borderline personality disorder [BPD; [5]], MDD [6] or other psychiatric disorders. It can occur independently of a psychiatric diagnosis. Adolescents with MDD who engage in NSSI may have a higher risk of suicidal behavior. 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
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