基于多模态神经影像的非自杀性自伤情绪行为障碍神经机制与个性化rTMS调控研究

注册号:

Registration number:

ChiCTR2600117114 

最近更新日期:

Date of Last Refreshed on:

2026-01-20 10:23:11 

注册时间:

Date of Registration:

2026-01-20 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于多模态神经影像的非自杀性自伤情绪行为障碍神经机制与个性化rTMS调控研究

Public title:

Neural Mechanisms of Non-Suicidal Self-Injury Emotional Behavioral Disorders Based on Multimodal Neuroimaging and Personalized rTMS Regulation

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于多模态神经影像的非自杀性自伤情绪行为障碍神经机制与个性化rTMS调控研究

Scientific title:

Neural Mechanisms of Non-Suicidal Self-Injury Emotional Behavioral Disorders Based on Multimodal Neuroimaging and Personalized rTMS Regulation

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

尹倩兰 

研究负责人:

刘士远 

Applicant:

Yin Qianlan 

Study leader:

Liu Shiyuan 

申请注册联系人电话:

Applicant telephone:

+86 150 0864 4291

研究负责人电话:

Study leader's
telephone:

+86 175 0168 9461

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

yinqianlan@smmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

cjr.liushiyuan@vip.163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

Second Military Medical University

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市杨浦区翔殷路800号

研究负责人通讯地址:

上海市黄浦区凤阳路415号

Applicant address:

Xiangying road 800, Yangpu District, Shanghai

Study leader's address:

415 Fengyang Road, Huangpu District, Shanghai, China

申请注册联系人邮政编码:

Applicant postcode:

200433

研究负责人邮政编码:

Study leader's postcode:

200003

申请人所在单位:

海军军医大学

Applicant's institution:

Navy Medical University

研究负责人所在单位:

上海长征医院

Affiliation of the Leader:

Shanghai Changzheng Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025SL131

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海长征医院医学伦理委员会

Name of the ethic committee:

Shanghai Changzheng Hospital Medical Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2025-12-18 00:00:00

伦理委员会联系人:

欧阳慧

Contact Name of the ethic committee:

Ouyang Hui

伦理委员会联系地址:

上海市黄浦区凤阳路415号

Contact Address of the ethic committee:

415 Fengyang Road, Huangpu District, Shanghai, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 198 2121 9007

伦理委员会联系人邮箱:

Contact email of the ethic committee:

897954576@qq.com

研究实施负责(组长)单位:

上海长征医院

Primary sponsor:

Shanghai Changzheng Hospital

研究实施负责(组长)单位地址:

上海市黄浦区凤阳路415号

Primary sponsor's address:

415 Fengyang Road, Huangpu District, Shanghai, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海市

市(区县):

上海

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海长征医院

具体地址:

上海市黄浦区凤阳路415号

Institution
hospital:

Shanghai Changzheng Hospital

Address:

415 Fengyang Road, Huangpu District, Shanghai

经费或物资来源:

上海长征医院

Source(s) of funding:

Shanghai Changzheng Hospital

研究疾病:

非自杀性自伤  

Target disease:

Nonsuicide self injury

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在从神经机制层面揭示非自杀性自伤(NSSI)个体的情绪调节障碍与奖赏/惩罚敏感性异常,并评估个性化重复经颅磁刺激(rTMS)干预对该异常回路的可塑性调节效果。通过整合多模态神经影像技术(脑电图EEG与功能磁共振成像fMRI)及奖赏-损失学习任务,本研究拟系统探讨以下三个目标: 1、机制探索目标:比较NSSI个体与健康对照在奖赏-损失学习与情绪调节中的神经活动模式差异,识别关键异常脑区(如DLPFC与vmPFC)及其功能连接特征。 2、个体化干预目标:基于机制发现结果,为NSSI个体制定个性化rTMS刺激方案,利用个体结构MRI建立头模型并通过神经导航实现精准靶向刺激,验证rTMS对异常脑回路的神经调控作用。 3、纵向随访目标:采用前瞻性随机平行对照队列设计,在基线、干预后1个月及3个月进行多维度评估(包括自伤行为频率、情绪调节能力、奖赏学习行为表现及脑电/影像指标),系统评估rTMS干预对NSSI行为与神经功能的持续性改善效果。 本研究预期将揭示NSSI的核心神经机制,验证rTMS在改善其情绪与奖赏功能方面的可行性,为发展精准化、神经靶向的心理干预策略提供实证支持。  

Objectives of Study:

This study aims to elucidate the neural mechanisms underlying emotion regulation deficits and altered reward/punishment sensitivity in individuals with non-suicidal self-injury (NSSI), and to evaluate the modulatory effects of individualized repetitive transcranial magnetic stimulation (rTMS) on the plasticity of these abnormal neural circuits. By integrating multimodal neuroimaging techniques—including electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)—with a reward–loss learning task, the study is designed to systematically address the following three objectives: 1. Mechanistic Objective: To compare neural activity patterns during reward–loss learning and emotion regulation between individuals with NSSI and healthy controls, and to identify key abnormal brain regions (e.g., dorsolateral prefrontal cortex [DLPFC] and ventromedial prefrontal cortex [vmPFC]) and their functional connectivity characteristics. 2. Personalized Intervention Objective: Based on the mechanistic findings, to develop individualized rTMS stimulation protocols for participants with NSSI by constructing subject-specific head models from structural MRI and employing neuronavigation to achieve precise cortical targeting, thereby verifying the neural modulation effects of rTMS on the identified dysfunctional circuits. 3. Longitudinal Follow-up Objective: To adopt a prospective randomized parallel controlled cohort design, with multidimensional assessments conducted at baseline, one month, and three months after the intervention. Evaluation indices will include self-injury frequency, psychological health scales, emotion regulation capacity, reward–loss behavioral performance, and neurophysiological measures (EEG/fMRI). This approach will comprehensively assess the sustained effects of rTMS on NSSI behaviors and neural functioning. The expected outcomes will clarify the core neural mechanisms of NSSI and validate the feasibility of rTMS in improving emotional and reward-related dysfunctions, thereby providing a theoretical and technological foundation for precision, neuro-targeted psychological interventions.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

(1)有严重躯体疾病、精神病性障碍、知觉障碍、药物依赖或神经系统疾病史 (2)头部有金属植入物或外科手术史 (3)孕期或哺乳期 (4)近期有自杀企图或重症自杀倾向

Exclusion criteria:

(1) Severe physical illnesses, psychotic disorders, perceptual disorders, substance dependence, or history of neurological diseases; (2) Metal implants in the head or history of cranial surgery; (3) Pregnancy or lactation; (4) Recent suicide attempts or severe suicidal tendencies.

研究实施时间:

Study execute time:

From 2026-01-09 00:00:00 To 2028-05-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-01-20 00:00:00 To 2027-05-01 00:00:00

干预措施:

Interventions:

组别:

rTMS组

样本量:

30

Group:

rTMS group

Sample size:

干预措施:

刺激方案采用高频(10 Hz)重复经颅磁刺激(rTMS)。刺激部位靶向个体情绪调节障碍与奖赏学习的共同神经基础区域,包括额叶皮质和纹状体等关键脑区,并根据个体影像学结果进行个体化定位。刺激强度设定为个体运动阈值的110%至120%。干预频率为每个工作日一次,持续半个月;随后分别在干预后2周、1个月及3个月进行脑电及神经活动变化的随访评估。

干预措施代码:

none

Intervention:

The stimulation protocol employed high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS). The stimulation sites targeted neural regions underlying both emotional regulation deficits and reward learning, including key areas such as the prefrontal cortex and striatum, with individualized targeting based on neuroimaging results. Stimulation intensity was set at 110%–120% of the individual motor threshold. The intervention was administered once daily on weekdays for two weeks, followed by follow-up assessments of EEG and neural activity changes at 2 weeks, 1 month, and 3 months after the intervention.

Intervention code:

组别:

伪刺激组

样本量:

30

Group:

Sham stimulation group

Sample size:

干预措施:

模拟刺激,无实际磁场输出,保持噪声一致

干预措施代码:

none

Intervention:

Sham Stimulation: The control condition will employ sham rTMS, delivered using a coil orientation or device setting that mimics auditory and tactile sensations of real stimulation but produces no or minimal magnetic output.

Intervention code:

组别:

健康对照组

样本量:

60

Group:

Healthy control group

Sample size:

干预措施:

干预措施代码:

Intervention:

NA

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

上海 

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

上海长征医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Changzheng Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

自伤行为

指标类型:

主要指标

Outcome:

Self-injury

Type:

Primary indicator

测量时间点:

基线、半个月后、1个月后、3个月后

测量方法:

渥太华自伤量表

Measure time point of outcome:

After Baseline, 2 weeks, 1 month, and 3 months

Measure method:

Ottawa Self-Injury Scale

指标中文名:

奖赏-损失学习任务正确率

指标类型:

次要指标

Outcome:

Reward-punishment task accuracy

Type:

Secondary indicator

测量时间点:

基线、半个月后

测量方法:

奖赏-损失学习Eprime行为任务

Measure time point of outcome:

After Baseline and 2 weeks

Measure method:

Reward–Loss Learning Behavioral Task in E-Prime

指标中文名:

核磁脑电相关脑区活动

指标类型:

次要指标

Outcome:

fMRI-EEG Related Changes

Type:

Secondary indicator

测量时间点:

基线、半个月后

测量方法:

核磁下脑电

Measure time point of outcome:

After Baseline and 2 weeks

Measure method:

functional Magnetic Resonance Imaging–Electroencephalography(fMRI-EEG)

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

none

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 12 years
最大 Max age 30 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由独立统计人员使用R语言生成随机序列

Randomization Procedure (please state who generates the random number sequence and by what method):

Independent statisticians generate random sequences using R language.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

本研究采用双盲设计。受试者和研究者均不知分组信息,干预措施外观、包装及操作一致。数据分析由独立第三方在揭盲后进行,以保证结果的客观性与公正性。

Blinding:

Double-blind design: both participants and investigators are unaware of group allocation. Identical appearance and handling of interventions maintained until unblinding after analysis.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

none

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Electronic Data Capture, EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-01-20 10:22:50