There is no definitive neural marker of suicidal thoughts and behaviors (STBs) or nonsuicidal self-injury (NSSI), and relative to adults, research in youth is more limited. This comprehensive review focuses on magnetic resonance imaging studies reporting structural and functional neural correlates of STBs and NSSI in youth to 1) elucidate shared and independent neural alternations, 2) clarify how developmental processes may interact with neural alterations to confer risk, and 3) provide recommendations based on convergence across studies. Forty-seven articles were reviewed (STBs = 27; NSSI = 20), and notably, 63% of STB articles and 45% of NSSI articles were published in the previous 3 years. Structural magnetic resonance imaging research suggests reduced volume in the ventral prefrontal and orbitofrontal cortices among youth reporting STBs, and there is reduced anterior cingulate cortex volume related to STBs and NSSI. With regard to functional alterations, blunted striatal activation may characterize STB and NSSI youth, and there is reduced frontolimbic task-based connectivity in suicide ideators and attempters. Resting-state functional connectivity findings highlight reduced positive connectivity between the default mode network and salience network in attempters and show that self-injurers exhibit frontolimbic alterations. Together, suicidal and nonsuicidal behaviors are related to top-down and bottom-up neural alterations, which may compromise approach, avoidance, and regulatory systems. Future longitudinal research with larger and well-characterized samples, especially those integrating ambulatory stress assessments, will be well positioned to identify novel targets that may improve early identification and treatment for youth with STBs and NSSI.

中文翻译：

---

与青年自杀和非自杀性自伤相关的神经关联

没有明确的自杀念头和行为 (STB) 或非自杀性自伤 (NSSI) 的神经标记，并且相对于成年人，对青少年的研究更为有限。这篇综合综述侧重于报告青少年 STB 和 NSSI 的结构和功能神经相关性的磁共振成像研究，以 1) 阐明共享和独立的神经交替，2) 阐明发育过程如何与神经改变相互作用以产生风险，以及 3) 提供基于跨研究趋同的建议。审查了 47 篇文章（STBs = 27；NSSI = 20），值得注意的是，63% 的 STB 文章和 45% 的 NSSI 文章是在过去 3 年内发表的。结构磁共振成像研究表明，报告 STB 的青年人的腹侧前额叶和眶额叶皮质体积减少，并且与 STB 和 NSSI 相关的前扣带皮层体积减少。关于功能改变，纹状体激活迟钝可能是 STB 和 NSSI 青年的特征，并且自杀想法者和企图者的前脑边缘任务连接性降低。静息状态功能连接性发现强调了尝试者中默认模式网络和显着性网络之间的正连接性降低，并表明自伤者表现出前肢改变。总之，自杀和非自杀行为与自上而下和自下而上的神经改变有关，这可能会损害接近、回避和调节系统。未来对更大且特征明确的样本进行纵向研究，尤其是那些整合了动态压力评估的样本，