青少年非自杀性自伤患者静息态功能磁共振研究

Research on rs-f MRI in adolescents with non-suicidal self-injury

目的探讨非自杀性自伤(non-suicidal self-injury,NSSI)青少年静息态功能磁共振成像下脑功能特征。方法采用病例对照研究设计,纳入NSSI青少年患者23例(NSSI组)与健康青少年18名(healthy control,HC组),进行静息态功能MRI扫描,分析NSSI组与HC组低频振幅(amplitude of low frequency fluctuation,ALFF)有差异的脑区,以差异脑区为种子点计算全脑功能连接(functional connectivity,FC),并分析NSSI组差异脑区的ALFF值与青少年非自杀性自伤行为评定问卷及汉密尔顿抑郁量表评分相关性。结果与HC组比较,NSSI组ALFF升高的脑区包括双侧杏仁核(x=-27,y=3,z=-24,t=2.492,P<0.05,FDR校正;x=27,y=3,z=-12,t=2.746,P<0.05,FDR校正)、右侧背外侧额上回(x=15,y=21,z=45,t=4.051,P<0.05,FDR校正)。以双侧杏仁核作为种子点分别计算全脑FC,与HC组比较,NSSI组左侧杏仁核与右侧前扣带回(t=3.352,P<0.05,FDR校正)、左侧前扣带回(t=2.843,P<0.05,FDR校正)、右侧丘脑(t=3.026,P<0.05,FDR校正)、左侧丘脑(t=2.352,P<0.05,FDR校正)FC强度增高,与左侧眶部额上回(t=-2.181,P<0.05,FDR校正)、左侧眶部额中回(t=-3.378,P<0.05,FDR校正)FC强度减低。NSSI组左侧杏仁核ALFF值与汉密尔顿抑郁量表评分呈正相关(r=0.627,P=0.004)。结论NSSI青少年静息态下多个脑区存在神经元异常活动,左侧杏仁核与多个脑区的FC存在异常,这可能是NSSI神经病理发病机制。

Objective This study aimed to explore the brain function characteristics of adolescents with nonsuicidal self-injury(NSSI)of resting-state functional magnetic resonance imaging(rs-fMRI).Methods Case-control study design was used to enroll 23 adolescents with NSSI(NSSI group)and 18 healthy adolescents(healthy control group,HC group)for rs-MRI scanning.The brain regions with significant differences in amplitude of low frequency fluctuation(ALFF)between the NSSI group and the HC group were analyzed.Differential brain areas were taken as the seed points to analyze functional connectivity(FC)of the whole brain.Pearson correlation analysis were carried out for the differential brain areas and adolescent non-suicidal self-injury behavior assessment questionnaire and 24-item Hamilton Depression Scale(HAMD24)in ALFF analysis.Results Compared with the HC group,ALFF values were increased in the brain areas in the NSSI group included bilateral amygdala(x=-27,y=3,z=-24,t=2.492,P<0.05,FDR corrected;x=27,y=3,z=-12,t=2.746,P<0.05,FDR corrected)and right dorsolateral superior frontal gyrus(x=15,y=21,z=45,t=4.051,P<0.05,FDR corrected).The bilateral amygdala was used as the seed point for the whole brain functional connection analysis.Compared with the HC group,FC intensity of left amygdala and right anterior cingulate cortex(t=3.352,P<0.05,FDR corrected),left anterior cingulate cortex(t=2.843,P<0.05,FDR corrected),right thalamus(t=3.026,P<0.05,FDR corrected),left thalamus(t=2.352,P<0.05,FDR corrected)in the NSSI group increased,and the FC intensity of left amygdala and left orbital superior frontal gyrus(t=-2.181,P<0.05,FDR corrected),left orbital middle frontal gyrus(t=-3.378,P<0.05,FDR corrected)decreased in the NSSI group.The ALFF value of the left amygdala in NSSI group was positively correlated with HAMD24 score(r=0.627,P=0.004).Conclusion There are abnormal neuronal activity in many brain regions of NSSI adolescents under resting state and the abnormal FC between left amygdala and multiple brain regions may be the neuropathologic mechanism of NSSI.