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Neural mechanisms of non-suicidal self-injury and prospects for precision therapeutics
Luxi He1, Yinuo He1, Yaohan Wang1
1Department of Psychiatry, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China.
Background:
Non-suicidal self-injury (NSSI) is highly prevalent among adolescents and a strong risk factor for suicidal behavior. However, its neurobiological mechanisms remain incompletely understood, and traditional treatments face challenges of delayed efficacy and high relapse rates.
Objective:
This review synthesizes advances in the neurobiology of non-suicidal self-injury (NSSI) from multimodal studies and discusses prospects for precision, mechanism-based interventions.
Methods:
We focused on integrating findings from multimodal neuroimaging (fMRI, DTI, MRS, EEG/MEG), neuroimmunology, and the gut-brain axis literature.
Key Findings:
NSSI arises from dynamic imbalances across interconnected circuits: (1) a central pain disinhibition/attenuation phenotype; (2) prefrontal-limbic connectivity abnormalities underlying emotion and impulse dysregulation; (3) neuroimmune-metabolic dysregulation linking peripheral inflammation to brain connectivity and metabolism; and (4) emerging gut-brain axis influences on neural function.
Conclusion And Prospects:
NSSI is a disorder of "brain-body" interaction. Advancing its treatment requires longitudinal multi-omics data and advanced techniques (e.g., closed-loop neuromodulation) to validate mechanisms and propel the field toward precision medicine models.
