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. 2025 Jul 1;25(1):662.
doi: 10.1186/s12888-025-07106-6.

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

Yuwei Chen #  1   2 , Xiongxiong Yang #  3 , Kaike Liao  1 , Rui Yu  1 , Xinyue Chen  1 , Wenjing Zhang  4 , Nian Liu  5   6
Affiliations

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

Yuwei Chen et al. BMC Psychiatry. .

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.

Keywords: Adolescent; Diffusion tensor imaging; Emotional regulation; Nonsuicidal self-injury; Structural connectivity; White matter.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: This study complied with the content and requirements of the Helsinki Declaration and was reviewed and approved by the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (2022ER406-1), with all participants and legal guardians having provided written informed consent before participating. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of image processing
Fig. 2
Fig. 2
The differences in structural connectivity between the NSSI group and the HC group. Blue represented the nodal network metric in the NSSI group, red represented the structural connectivity in the NSSI group was increased than that of the HC group. Abbreviations: NSSI: nonsuicidal self-injury, HC: healthy control, CAU.R: right caudate nucleus, OLF.R: right olfactory cortex, ORBsupmed.R: right superior frontal gyrus (medial orbital), AMYG.R: right amygdala, L: left, R: right
Fig. 3
Fig. 3
The differences in nodal degree centrality and nodal efficiency(a) and nodal shortest path length(b) between the NSSI group and the HC group. Blue represents the nodal metric value in the NSSI group is lower than that of the HC group; red represents the nodal metric value in the NSSI group is higher than that of the HC group. Abbreviations: ORBmid.R: right orbital middle frontal gyrus, NSSI: nonsuicidal self-injury, HC: healthy control, L: left, R: right
Fig. 4
Fig. 4
The differences in nodal efficiency(a) nodal degree centrality(b) and nodal shortest path length(c) between the NSSI pre-treatment group and the NSSI post-treatment group. Blue represents the nodal metric value in the NSSI post-treatment group is lower than that of the pre-treatment group; red represents the nodal metric value in the NSSI post-treatment group is higher than that of the pre-treatment group. Abbreviations: ORBmid.R: right orbital middle frontal gyrus, ORBsup.R: right superior orbital frontal gyrus, ROL.R: right rolandic operculum, ORBsupmed.L: left superior medial orbital frontal gyrus, ANG.L: left angular gyrus, MOG.L: left middle occipital gyrus, PHG.L: left parahippocampal gyrus, PrCG.L: left precentral, NSSI: nonsuicidal self-injury, L: left, R: right
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