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

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.