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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Structural network communication differences in drug-naive depressed adolescents with non-suicidal self-injury and suicide attempts
Shuai Wang, Jiao-Long Qin, Lian-Lian Yang, Ying-Ying Ji, Hai-Xia Huang, Xiao-Shan Gao, Zi-Mo Zhou, Zhen-Ru Guo, Ye Wu, Lin Tian, Huang-Jing Ni, Zhen-He Zhou
Shuai Wang, Xiao-Shan Gao, Zhen-He Zhou, School of Wuxi Medicine, Nanjing Medical University, Wuxi 214000, Jiangsu Province, China
Shuai Wang, Department of Clinical Psychology, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi 214000, Jiangsu Province, China
Jiao-Long Qin, Key Lab of Intelligent Perception and Systems for High-Dimensional Information of Ministry of Education, School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210000, Jiangsu Province, China
Lian-Lian Yang, Zi-Mo Zhou, Zhen-Ru Guo, School of Medicine, Jiangnan University, Wuxi 214000, Jiangsu Province, China
Ying-Ying Ji, Department of Rehabilitation Medicine, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi 214000, Jiangsu Province, China
Hai-Xia Huang, Department of Medical Imaging, Huadong Sanatorium, Wuxi 214000, Jiangsu Province, China
Ye Wu, School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210000, Jiangsu Province, China
Lin Tian, Zhen-He Zhou, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi 214000, Jiangsu Province, China
Huang-Jing Ni, School of Computer Science and Engineering, Nanjing University of Posts and Telecommunications, Nanjing 210000, Jiangsu Province, China
Co-first authors: Shuai Wang and Jiao-Long Qin.
Author contributions: Wang S and Qin JL drafted the manuscript, contributed equally to this article, and are the co-first authors of this manuscript; Wang S, Qin JL, Yang LL, Ji YY, Huang HX, Gao XS, Zhou ZM, Guo ZR, Wu Y, and Ni HJ analyzed data; Zhou ZH and Tian L designed the study; and all the authors contributed to the interpretation of the results, manuscript revision, and approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81871081 and No. 62201265; the Fundamental Research Funds for the Central Universities, No. NJ2024029-14; and the Talent Support Programs of Wuxi Health Commission, No. BJ2023085, No. FZXK2021012, and No. M202358.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Wuxi Mental Health Center, approval No. WXMHCIRB2021 LLky126.
Informed consent statement: All study participants or their legal guardian provided informed written consent regarding personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhen-He Zhou, MD, PhD, Professor, School of Wuxi Medicine, Nanjing Medical University, No. 156 Qianhu Road, Binhu District, Wuxi 214000, Jiangsu Province, China.
zhouzh@njmu.edu.cn
Received: October 28, 2024
Revised: January 26, 2025
Accepted: February 14, 2025
Published online: May 19, 2025
Processing time: 185 Days and 23.2 Hours
BACKGROUND
Depression, non-suicidal self-injury (NSSI), and suicide attempts (SA) often co-occur during adolescence and are associated with long-term adverse health outcomes. Unfortunately, neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.
AIM
To investigate structural network communication within large-scale brain networks in adolescents with depression.
METHODS
We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression. Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents, including 17 depressed adolescents without SA or NSSI (major depressive disorder group), 27 depressed adolescents with NSSI but no SA (NSSI group), and 41 depressed adolescents with SA and NSSI (NSSI + SA group).
RESULTS
Significant differences in structural network communication were observed across the four groups, involving spatially widespread brain regions, particularly encompassing cortico-cortical connections (e.g., dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus; connections based on precentral gyrus) and cortico-subcortical circuits (e.g., the nucleus accumbens-frontal circuit). In addition, we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents. We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.
CONCLUSION
This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA, highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms. These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.
Core Tip: This study investigates structural network communication differences in depressed adolescents, highlighting impaired brain network efficiency in those with non-suicidal self-injury and suicide attempts. Using diffusion magnetic resonance imaging, the research identifies disrupted cortico-cortical and cortico-subcortical circuits, particularly in regions such as the posterior cingulate gyrus and nucleus accumbens. The findings suggest that compromised neural communication is linked to clinical symptoms, offering new insights into the neurobiological mechanisms behind the comorbidity of non-suicidal self-injury and suicide attempts in depression.
