Altered cortical structure and networks associated with psychosocial adversity and pain hyposensitivity in adolescents with non-suicidal self-injury.

BACKGROUND: Non-suicidal self-injury (NSSI) is prevalent among adolescents. Adverse psychosocial factors (e.g., childhood trauma, peer bullying) and altered pain hyposensitivity are core risk factors for NSSI. These factors have been associated with structural changes in brain regions involved in pain processing, which may relate to differences in pain perception. However, the specific relationship between cortical structure and pain perception in NSSI adolescents remains unclear. This study aims to investigated cortical structure and structural covariance network alterations in NSSI adolescents, analyzing associations with pain sensitivity changes and adverse psychosocial factors. METHOD: 44 NSSI adolescents and 37 healthy controls underwent MRI scans and clinical assessments. Cortical thickness (CT) and surface area (CSA) values per brain region were obtained for both groups and used to generate a structural covariance matrix. Group comparisons of cortical structure and network properties were performed, followed by correlation analyses integrating psychosocial questionnaires and pain sensitivity metrics. RESULTS: The NSSI group showed significantly reduced CT in the right cingulate isthmus cortex. This reduction negatively correlated with the severity of peer bullying and childhood trauma, as well as the bilateral pain tolerance. Regarding structural covariance networks, the NSSI group exhibited reduced global properties, alongside two key nodal alterations: a decrease in nodal betweenness centrality in the rostral left middle frontal gyrus (based on CT), which correlated with childhood trauma severity, and an increase in nodal degree centrality in the left lingual gyrus (based on CSA), which was associated with experiences of physical bullying. CONCLUSIONS: This study revealed brain structure and structural network alterations in NSSI adolescents, linked to changed pain perception and adverse psychosocial factors. Our findings suggest associations between adverse psychosocial factors and altered pain perception in NSSI, which coincide with brain structural and network changes and may reflect heightened vulnerability to NSSI behavior. TRIAL REGISTRATION: Clinical trial number: not applicable.