Neural correlates of early- and late-onset nonsuicidal self-injury: Distinctions in resting-state functional...

Nonsuicidal self-injury (NSSI) is a major global health concern, yet the neurophysiological significance of the age of onset remains poorly understood. This cross-sectional study (2019-2022) examined differences in resting-state functional connectivity (rsFC) among young Korean adults (aged 19-29) with early-onset NSSI, late-onset NSSI, and healthy controls, with a focus on emotion regulation networks.

Following screening of 215 individuals, 91 unmedicated participants with NSSI and 84 healthy controls were included in the rsFC analysis. The NSSI group was subdivided into early-onset (onset before age 14) and late-onset (onset at or after age 14) groups.

The early-onset NSSI group exhibited increased rsFC within the sensorimotor network (SMN), specifically between the postcentral and pre/postcentral gyri, relative to the late-onset NSSI group at the permutation level (p_perm < 0.001; matrix-wide q_FDR = 0.211). Nominal permutation-level associations between DERS scores and rsFC were also observed, but these did not reach the threshold for matrix-wide FDR correction and should be interpreted as exploratory.

The exploratory, cross-sectional design and reliance on retrospective self-report of NSSI onset limit causal inference. The modest subgroup sample sizes and the exploratory nature of the findings may also affect the robustness of the results, highlighting the need for larger longitudinal studies.

These exploratory findings suggest that the age of NSSI onset may be associated with potentially distinct rsFC profiles. Pending longitudinal replication, onset age represents a key candidate variable for understanding the neurobiology of NSSI.