Cortical dysfunction and impulsivity in non-suicidal self-injury: a multimodal study using TMS-EEG and fNIRS.

OBJECTIVES

This study aimed to investigate the cortical excitability differences between adolescents with NSSI and healthy controls using concurrent TMS-EEG and fNIRS.

METHODS

Fifty-three participants aged 12-18 years were recruited, including 27 with NSSI and 26 healthy controls, matched for age. Independent samples t-tests were used to compare groups on the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ) and Suicidal Ideation Scale (SIOSS). fNIRS results were used to assess brain activation, and TMS-EEG was used to measure cortical excitability.

RESULTS

The NSSI group exhibited significantly higher scores on both the ANSAQ and SIOSS compared to the healthy controls. fNIRS results showed reduced prefrontal and temporal lobe activation in the NSSI group. TMS-EEG analysis indicated heightened P30 amplitudes in the left and right prefrontal cortex in the NSSI group.

CONCLUSIONS

Adolescents with NSSI exhibit abnormal cortical excitability, particularly in the prefrontal regions, which may contribute to impulsive behaviors and cognitive control difficulties. This study highlights the potential of combining TMS-EEG and fNIRS to explore the neurophysiological substrates of NSSI, providing preliminary evidence that may guide future research on diagnostic and therapeutic strategies.