摘要目的:基于表面形态学分析存在自伤行为的青少年大脑皮质结构改变，并研究皮质结构改变与临床情绪表现的相关性。方法:纳入2023年4月至2024年6月于常州市第一人民医院心理门诊就诊的有自伤行为的青少年38例(自伤组)及性别、年龄、受教育年限相匹配的健康志愿者41例(HC组)，收集两组被试的薄层T1加权磁共振数据及临床资料。均接受17项汉密尔顿抑郁量表(17-item Hamilton depression scale，HAMD-17)及汉密尔顿焦虑量表(Hamilton anxiety scale，HAMA)评估。使用DPABISurf软件进行预处理与运算，提取差异显著脑区的皮质参数，采用SPSS 29.0进行Spearman相关分析评价自伤组内差异显著脑区皮质参数与HAMD-17及HAMA的相关性。结果:与HC组相比，自伤组皮质厚度变薄的显著区域主要涉及左侧躯体感觉和运动皮质、左侧中央旁小叶/中扣带皮质、左侧后扣带皮质、前运动皮质(MNI：团块1：x＝－17.73，y＝－32.81，z＝43.87；团块2：x＝－35.97，y＝－8.72，z＝52.01；团块3：x＝－18.94，y＝－41.39，z＝65.94)(均 P<0.05)；脑沟深度变浅的区域位于左侧眶/极额叶皮质(MNI：x＝－39.9，y＝47.92，z＝－5.42)( P<0.05)；平均曲率变大的区域位于右侧顶叶上皮质(MNI：x＝21.89，y＝－61.89，z＝50.55)( P<0.05)。Spearman相关性分析发现，自伤组感兴趣区皮质厚度与临床情绪评分呈负相关(HAMD-17： r＝－0.385，－0.332，均 P<0.05；HAMA： r＝－0.395，－0.481，均 P<0.05)，主要涉及左侧辅助运动区、左侧前运动皮质及左侧躯体感觉和运动皮质。 结论:有自伤行为的青少年感知及执行皮质存在表面形态学异常，且与临床情绪表现相关。

abstractsObjective:To explore the cortical abnormalities in brain regions in adolescent with self-injury and the correlation between cortical structural changes and clinical emotional manifestations.Methods:From April 2023 to June 2024, totally 38 adolescents with self-injury(self-injury group) from psychological outpatient department of First People’s Hospital of Changzhou and 41 healthy volunteers (HC group) matched with age, gender and years of education were selected.T1-weighted magnetic resonance imaging and clinical data of all participants were collected. All of them were investigated by the 17-item Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA). Image preprocessing and surface-based morphometry analysis were performed by the DPABISurf software. Cortical parameters from regions showing significant differences were extracted, which were then evaluated the correlation with the emotional scores based on Spearman correlation analysis by SPSS 29.0 software.Results:Compared with HC group, self-injury group showed reduced thickness in areas primarily involving the left somatosensory and motor cortex, left paracentral lobular and mid cingulate cortex, left posterior cingulate cortex and premotor cortex(MNI: cluster 1: x=-17.73, y=-32.81, z=43.87, cluster 2: x=-35.97, y=-8.72, z=52.01, cluster 3: x=-18.94, y=-41.39, z=65.94)(all P<0.05). Lower sulcal depth in the left orbital and polar frontal cortex (MNI: x=-39.9, y=47.92, z=-5.42) ( P<0.05) and higher mean curvature in the right superior parietal cortex (MNI: x=21.89, y=-61.89, z=50.55) ( P<0.05) were found in the self-injury group. In the self-injury group, Spearman correlation analysis revealed negative correlations between cortical thickness in the regions of interest and clinical emotional scores (HAMD-17: r=-0.385, -0.332, P<0.05; HAMA: r=-0.395, -0.481, P<0.05), primarily involving the left supplementary motor area, left premotor cortex and the left somatosensory and motor cortex. Conclusion:The perception and execution cortex of adolescents with self-injury shows surface morphological abnormalities, which may be relevant to clinical emotional manifestations.