目的 探究青少年非自杀性自伤患者大脑结构及自发神经活动的异常,寻找非自杀性自伤潜在的客观生物学指标.方法 根据美国第5版《精神障碍诊断与统计手册》非自杀性自伤的(non-suicidal self-injury,NSSI)标准共纳入23例青少年NSSI患者(NSSI组),匹配20例青少年为健康对照组(healthy control group,HC组).采用汉密尔顿抑郁量表、汉密尔顿焦虑量表、渥太华自我伤害调查表评估受试者抑郁焦虑以及NSSI程度.采用体素形态学分析、低频振幅(amplitude of low-frequency fluctuation,ALFF)、比率低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)、局部一致性(regional homogeneity,ReHo)多模态方法分析两组青少年脑灰质体积和自发神经活动的差异.结果 (1)NSSI组左背外侧额上回、左脑岛皮质体积减小,差异有统计学意义(P＜0.05).(2)NSSI组杏仁核、右前后扣带回的ALFF值降低,辅助运动区的ALFF值增高,右前扣带回的fALFF值降低,右直回ReHo值降低,而背外侧额上回ReHo值增高,差异有统计学意义(P＜0.05).结论 青少年NSSI患者存在额叶-边缘系统脑区结构及广泛的自发神经功能活动改变,可能是NSSI发生的神经生物学机制.
Characteristics of Brain Structure and Spontaneous Neural Activity in Adolescents with Non-suicidal Self-injury
Objective To explore the abnormalities of brain structure and spontaneous neural activity in ado-lescents with non-suicidal self-injury,and to find potential objective biological indicators of non-suicidal self-injury.Methods A total of 23 adolescents with non-suicidal self-injury(NSSI group)were included according to the di-agnostic criteria of NSSI in DSM-5,and 20 adolescents were matched as healthy control group(HC group).Ham-ilton Depression Scale,Hamilton Anxiety Scale and Ottawa self-injury inventory were used to evaluate the severity of depression,anxiety and NSSI.The voxel morphology analysis,low frequency ratio of amplitude,low frequency amplitude,local consistency method of modal analysis two groups of youth cerebral gray matter volume and differences of spontaneous neural activity.Results(1)The volume of left dorsolateral superior frontal gyrus and left insular cor-tex decreased in NSSI group(P＜0.05).(2)In the NSSI group,the ALFF value of the amygdala and the right anterior cingulate gyrus decreased,the ALFF value of the supplementary motor area increased,the fALFF value of the right anterior cingulate gyrus decreased,the ReHo value of the right rectus gyrus decreased,and the ReHo value of the dor-sal-lateral superior frontal gyrus increased(P＜0.05).Conclusion Adolescents with NSSI have structural changes in the frontal limbic system and extensive spontaneous neural activity changes,which may be the neurobiological mecha-nism of NSSI.
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