Abnormal brain activity in nonsuicidal self-injury: a coordinate-based activation likelihood meta-analysis of functional neuroimaging studies

Mingfeng Lai; Ping Jiang; Jiajun Xu; Dan Luo; Xiaoting Hao; Jing Li

doi:10.1093/psyrad/kkab020

Abnormal brain activity in nonsuicidal self-injury: a coordinate-based activation likelihood meta-analysis of functional neuroimaging studies

Psychoradiology. 2021 Dec 27;1(4):249-256. doi: 10.1093/psyrad/kkab020. eCollection 2021 Dec.

Authors

Mingfeng Lai¹, Ping Jiang^{2

3

4}, Jiajun Xu¹, Dan Luo¹, Xiaoting Hao⁵, Jing Li¹

Affiliations

¹ Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China.
² Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
³ Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China.
⁴ Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu 610041, Sichuan, China.
⁵ Department of Neurology, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China.

Abstract

Background: The high prevalence of nonsuicidal self-injury (NSSI) in youths demonstrates a substantial population-level burden on society. NSSI is often associated with emotional and social skill deficits. To date, several studies have aimed to identify the underlying neural mechanism of those deficits in NSSI by using functional magnetic resonance imaging (fMRI). However, their conclusions display poor consistency.

Objective: We aimed to conduct a meta-analysis using activation likelihood estimation (ALE) for fMRI data based on emotional and cognitive tasks to clarify the underlying neural processing deficits of NSSI.

Methods: We searched for MRI studies of NSSI in the PubMed, Cochrane, and Embase databases. We identified significant foci for the included studies and conducted two ALE meta-analyses as follows: (i) activation for the NSSI contrast healthy control group and (ii) deactivation for the NSSI contrast healthy controls. Considering the diverse sex composition of study participants and possible bias from one large sample study, we conducted sensitivity analyses for the meta-analysis.

Results: Nine studies comprising 359 participants were included, and the results demonstrated substantial activation in NSSI patients compared with healthy controls in two clusters located in the right medial frontal gyrus extending to the rostral anterior cingulate and the left inferior frontal gyrus extending to the insula.

Conclusions: The results suggest that individuals with NSSI show brain activity alterations that underpin their core symptoms, including poor emotional regulation and reward processing deficits. Our findings provide new insights into the neural mechanism of NSSI, which may serve as functional biomarkers for developing effective diagnosis and therapeutic interventions for these patients.

Keywords: functional magnetic resonance imaging; meta-analysis; neural activation; nonsuicidal self-injury.