Neural correlates of clinical improvement in response to N-acetylcysteine in adolescents with non-suicidal self-injury
Open accessAbstract
Non-suicidal self-injury (NSSI) is a serious clinical problem that is common in adolescents. Novel, biologically-informed approaches for treating NSSI in adolescents are needed to prevent negative outcomes such as chronic NSSI and future suicide attempts. N-acetylcysteine (NAC) has been used successfully to address other conditions that involve repetitive maladaptive behaviors and may have utility in addressing NSSI. This study explored neural circuit changes following an open-label, 8-week trial of NAC in female adolescents with NSSI. We measured whole-brain resting-state functional connectivity (RSFC) of the amygdala and the nucleus accumbens before and after treatment using resting-state functional neuroimaging. Usable neuroimaging data from both pre- and post-treatment were available for 18 participants. Reduction in NSSI frequency was associated with a decrease in left amygdala RSFC with right supplementary motor area (SMA), but with an increase in right amygdala RSFC with right inferior frontal cortex. For nucleus accumbens, a reduction in NSSI frequency was associated with a decrease in connectivity between right nucleus accumbens and left superior medial frontal cortex. We also report change in similar circuits accompanying clinical improvement in depression and global psychopathology measures. These preliminary findings suggest amygdala and nucleus accumbens-based circuits as potential treatment targets, and set the stage for future research designed to confirm these neural targets using randomized, placebo-controlled designs to confirm clinical efficacy and mechanisms of effect.
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In NSSI youth undergoing an 8-week open-label N-acetylcysteine trial, reductions in NSSI frequency after treatment associate with decreases in left amygdala-right SMA and right nucleus accumbens-left superior medial frontal cortex RSFC, and increases in right amygdala-right inferior frontal cortex RSFC.
“Reductions in NSSI frequency after treatment associate with decreases in left amygdala-right SMA and right nucleus accumbens-left superior medial frontal cortex RSFC, and increases in right amygdala-right inferior frontal cortex RSFC (108).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [108]
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Neural correlates associated with suicide and nonsuicidal self-injury in youth
Auerbach, R. P., Pagliaccio, D., Allison, G. O., Alqueza, K. L., & Alonso, M. F. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.06.002 · Cited by 204 · see citing works
- Authors
- Cullen, K. R., Schreiner, M. W., Klimes-Dougan, B., Eberly, L. E., LaRiviere, L. L., Lim, K. O., Camchong, J., & Mueller, B. A.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Cullen, Kathryn R.
- Venue
- Progress in Neuro-Psychopharmacology and Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 99
- Pages
- 109778
- ISSN
- 0278-5846 (ISSN-L)
- PMC
- PMC7058485
- OpenAlex
- W2986135401
- Cited by
- 34
- References
- 52
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 3 · 2020: 1
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Minnesota
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- non-suicidal self-injury, N-acetylcysteine, adolescents, resting-state functional connectivity, amygdala, nucleus accumbens, supplementary motor area, inferior frontal cortex, depression, treatment response
- MeSH terms
- Acetylcysteine, Adolescent, Amygdala, Female, Humans, Nucleus Accumbens, Self-Injurious Behavior, Young Adult, Functional Neuroimaging
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