Exploring the Neural Circuitry of Deliberate Self Harm in Adolescents

描述（由申请方提供）：本脑成像研究的目的是检查非自杀性自伤（NSSI）少女的脑连接。迄今为止，人们对NSSI的神经生物学基础知之甚少。这种行为发生在广泛的条件下，包括重度抑郁症（MDD），边缘型人格障碍（BPD），焦虑症，物质滥用障碍，适应障碍和进食障碍。相反，许多患有NSSI的青少年不符合任何精神疾病的标准。因此，该领域已开始考虑NSSI不是作为一个特定的疾病的症状，而是作为一个实体本身的权利。我们的实验室一直在开发使用扩散张量成像（DTI）和功能性磁共振成像（fMRI）检查大脑网络内连接（连接性）的方法。这些工具允许应用基于系统的方法来检查精神病理学的神经基础，这是该领域最近的优先事项。因此，最近的研究重点不是检查特定的大脑区域，而是描述神经回路内的连接。对大脑连接的检查特别相关， 研究在青春期出现的问题，因为在这段时间内，相关大脑系统的连接正在不断成熟。本研究的假设是，异常的神经回路是青少年参与NSSI倾向的基础。当我们研究这组人的大脑连接时，我们将探索关键的心理维度，如情绪调节（和其他），这些维度可以介导电路异常和NSSI之间的联系。为了与NIH的RDoC倡议保持一致，我们不关注诊断，而是关注特定的行为（即，NSSI）;为了增加NSSI组的同质性，我们将包括几个限制因素：未接受过药物治疗、仅女孩、年龄和青春期发育范围窄、无SA病史。该项目可能代表了第一项研究，以检查神经回路的NSSI在 因此，这将是揭示NSSI背后的神经生物学机制的一个重要步骤。阐明NSSI的神经相关性在青春期尤为重要;在神经可塑性增加的时期进行早期干预可以防止异常行为的巩固并促进健康的神经发育。该项目将为未来的纵向研究提供基础，这些研究将检查（a）精神病理学过程和治疗反应的预测因素，以及（2）治疗对NSSI青少年异常连接模式的影响（即，成功的治疗方法）。 公共卫生相关性：故意自我伤害（DSH）经常发生在青少年中，并构成相当大的公共卫生风险。改进的识别和治疗策略的开发取决于提高当前对潜在疾病机制的了解。从拟议的研究结果将产生新的信息，阐明在青春期DSH的病理生理。这些结果将为未来研究DSH青少年异常机制治疗的影响提供重要指导。

DESCRIPTION (provided by applicant): The goal of this brain imaging study is to examine brain connectivity in adolescent girls with non-suicidal self- injury (NSSI). To date, little is knwn about the neurobiological underpinnings of NSSI. This behavior occurs in a wide range of conditions including major depressive disorder (MDD), borderline personality disorder (BPD), anxiety disorders, substance abuse disorders, adjustment disorders and eating disorders. Conversely, many adolescents with NSSI do not meet criteria for any psychiatric disorders. Thus, the field has begun to consider NSSI not as a symptom of a specific disorder, but as an entity in its own right. Our laboratory has been developing methods to examine the connections within brain networks (connectivity) using diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI). These tools allow for the application of systems-based approaches to examining the neural underpinnings of psychopathology, a recent priority in the field. Thus, instead of examining specific brain regions, recent research has been focused on characterizing connectivity within neural circuitry. Examination of brain connectivity is particularly relevant to studying problems that emerge in adolescence given the ongoing maturation of connections within relevant brain systems during this time period. The hypothesis of the current study is that aberrant neural circuitry underlies the tendency to engage in NSSI in adolescents. As we examine brain connectivity in this group, we will explore key psychological dimensions such as emotion regulation (and others) that could mediate the link between circuitry abnormalities and NSSI. In keeping with the NIH initiative RDoC, we focus not on diagnosis but on a specific behavior (i.e., NSSI); to increase homogeneity of the NSSI group we will include several constraints: medication-naive, girls only, a narrow range of age and pubertal development, and no history of SA. This project may represent the first study to examine neural circuitry of NSSI in adolescents, and thus will be a major step forward in uncovering neurobiological mechanisms that underlie NSSI. Elucidating the neural correlates of NSSI is especially important during adolescence; early intervention during a time of increased neuroplasticity could prevent entrenchment of aberrant behavior and promote healthy neurodevelopment. This project will provide the foundation for future longitudinal studies that will examine (a) predictors for course of psychopathology and treatment response, and (2) the impact of treatment on aberrant connectivity patterns in adolescents with NSSI (i.e., mechanisms of successful treatment.) PUBLIC HEALTH RELEVANCE: Deliberate self harm (DSH) occurs frequently in adolescents and poses considerable public health risks. Development of improved identification and treatment strategies depends on improving current understanding of underlying disease mechanisms. Results from the proposed study will yield new information to shed light on the pathophysiology of DSH in adolescence. These results will provide important guidance for future research investigating the impact of treatment on abnormal mechanisms in adolescents with DSH.