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• Clinical Article •
The study on CBF and CBF connectivity differences in adolescent patients with major depressive disorder accompanied by non-suicidal self-injury
MA Xiaojin  MA Laiyang  WANG Danyang  MA Xiaoyang  FAN Fengxian  ZHANG Jing 

DOI:10.12015/issn.1674-8034.2025.11.009.


[Abstract] Objective To explore cerebral blood flow (CBF) and CBF connectivity characteristics between healthy control (HC) and major depressive disorder (MDD) in adolescents accompanied by non-suicidal self-injury (NSSI).Materials and Methods We enrolled 35 adolescent patients with MDD accompanied by NSSI, along with 30 gender-and-age-matched healthy controls (HC). All participants underwent comprehensive emotional and cognitive assessments, including: Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Snaith-Hamilton Pleasure Scale (SHAPS), 24-item Hamilton Depression Scale (HAMD-24), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Ottawa Self-Injury Inventory. All subjects underwent 3.0 Tesla MRI scanning, including 3D T1-weighted imaging (T1WI) and arterial spin labeling (ASL) sequences. We compared cerebral blood flow (CBF) differences and CBF connectivity patterns between the two groups, and analyzed correlations between CBF alterations in specific brain regions and clinical symptom severity.Results Compared with HCs, the MDD with NSSI group exhibited significantly higher anxiety and depression scores, along with reduced cognitive performance (P < 0.001). In the MDD with NSSI group, cerebral blood flow (CBF) values showed negative correlations with depression, anxiety, and anhedonia scores, but positive correlation with MMSE scores. Relative to HCs, MDD with NSSI patients demonstrated decreased CBF in the right putamen and right insula (P < 0.05, FWE-corrected, t = 4.9). Using the right putamen (the primary region showing CBF differences) as a seed region for whole-brain CBF connectivity analysis in the MDD with NSSI group revealed distinct connectivity patterns. Specifically, we found positive CBF connectivity between the right putamen and right insula, right frontal operculumand right inferior frontal gyrus (pars opercularis) (P < 0.05, FWE-corrected, t = 12.4). No brain regions showed negative CBF connectivity with the right putamen in MDD with NSSI patients.Conclusions This study provides novel insights to explore the underlying neural mechanisms of MDD with NSSI behavior, demonstrating that CBF analysis serves as an effective approach for investigating MDD with NSSI, which offers new neuroimaging evidence of prevention strategies and therapeutic interventions for self-injurious behaviors.
[Keywords] non-suicidal self-injury；major depressive disorder；magnetic resonance imaging；cerebral blood flow；adolescent

MA Xiaojin1, 2, 3   MA Laiyang1, 2, 3   WANG Danyang1, 2, 3   MA Xiaoyang1, 2, 3   FAN Fengxian1, 2, 3   ZHANG Jing1, 2, 3*  

1 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Gansu Functional and Molecular Imaging Clinical Medical Research Center, Lanzhou 730030, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2025-07-23
Accepted  2025-10-29
DOI: 10.12015/issn.1674-8034.2025.11.009
DOI:10.12015/issn.1674-8034.2025.11.009.

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