Neural circuit for non-suicidal self-injury and causal clinical validation

Abstract

Background: Non-suicidal self-injury (NSSI) refers to the intentional damage inflicted on one's body tissues without the intent to die. This behavior significantly affects individuals' psychological health and social functioning. Given the unclear neural mechanisms of NSSI, this study aimed to explore the neural circuits involved in NSSI to improve and provide alternative treatment options.

Methods: This study combined Activation Likelihood Estimation (ALE) with network mapping theory through a systematic literature search, selection, and meta-analysis to define the NSSI circuit. Additionally, a clinical trial of transcranial magnetic stimulation (TMS) treatment guided by neuronavigation was conducted to verify the accuracy of the defined NSSI circuit.

Results: The ALE meta-analysis identified a significant difference in the left parahippocampal gyrus (PHG). The NSSI circuit included bilateral PHG and cingulate gyrus, bilateral middle frontal gyrus, middle temporal gyrus, inferior temporal gyrus, parietal lobes, and portions of the cerebellum, occipital lobe, and brainstem. A clinical trial of TMS targeting the NSSI circuit significantly improved NSSI symptoms. Moreover, significant changes were observed in the activity levels of specific brain regions of the NSSI circuit, and were significantly correlated with the improvement of NSSI symptoms.

Conclusions: This study successfully explored and validated the NSSI circuit using a targeted treatment. TMS targeting the NSSI circuit significantly improved NSSI symptoms and changed the activity levels of specific brain regions of the NSSI circuit. These findings offer a new perspective for a deeper understanding of the neural mechanisms underlying NSSI and provide a scientific basis for developing new treatment methods.

Keywords: Activation likelihood estimation; Functional magnetic resonance imaging; Non-suicidal self-injury; Transcranial magnetic stimulation.