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Neural mechanisms and neuromodulation therapies for non-suicidal self-injury

Molecular Psychiatry (2025)Cite this article

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Abstract

Non-suicidal self-injury (NSSI) refers to intentional self-inflicted bodily harm without suicidal intent. NSSI has been linked to various neurobiological dysfunctions, but its precise neural mechanisms have not been fully elucidated. Clinically, conventional pharmacological and psychotherapeutic interventions often exhibit prolonged treatment durations, delayed onset of efficacy, and considerable side effects, limiting their ability to effectively target the core pathological mechanisms of NSSI. These limitations highlight the urgent need for novel therapeutic approaches. Neuromodulation techniques, which have the potential to directly modulate neural activity, have recently been explored as promising interventions for NSSI. However, research in this field remains in its early stages. Existing evidence is limited and heterogeneous, with substantial interindividual variability in treatment response and a lack of high-quality, systematic clinical data. This review synthesizes findings from recent neuroimaging studies to examine the neural circuits potentially involved in NSSI from four key domains: emotion regulation, reward feedback, pain processing, and impulse control. By elucidating the underlying neurobiological mechanisms, summarizing current evidence on neuromodulation, and exploring future directions for therapeutic innovation and optimization, this review aims to provide a foundation for advancing neuromodulation-based treatments for NSSI.

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Fig. 1: Key brain regions involved in emotion regulation, reward feedback, pain processing, and impulse control in NSSI.
Fig. 2: Neuromodulation techniques for treating NSSI: optimization and future prospects.

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Acknowledgements

The authors would like to thank Prof. Yuhui Wan, Department of Health Promotion and Behavioral Sciences, Anhui Medical University, Prof. Jiajia Zhu, Department of Radiology, The First Affiliated Hospital of Anhui Medical University, and Dr. Bing Leng, Anhui Medical University, for their collective contributions to this work.

Funding

This work was supported by National Natural Science Foundation of China (Grant Nos. U24A20702 and 32071054) and Research Fund of Anhui Institute of Translational Medicine (Grant No. 2021zhyx-B10).

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Author notes

  1. These authors contributed equally: Dongpeng Wu, Shaoyang Wang, Hongping Wang.

Authors and Affiliations

  1. Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China

    Dongpeng Wu

  2. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Anhui Province, Hefei, 230022, China

    Shaoyang Wang & Yanghua Tian

  3. Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China

    Hongping Wang

  4. The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China

    Jiahua Zhang & Yanghua Tian

Authors
  1. Dongpeng Wu
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  2. Shaoyang Wang
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  3. Hongping Wang
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  4. Jiahua Zhang
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  5. Yanghua Tian
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Contributions

DW, SW, and HW conducted the literature search, drafted the initial manuscript, and contributed to manuscript editing. DW and JZ were responsible for figure preparation and assisted with figure interpretation. YT oversaw the entire review process, ensuring its accuracy and completeness, and was responsible for the final submission. All authors critically reviewed the manuscript and approved the final submitted version.

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Correspondence to Yanghua Tian.

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Wu, D., Wang, S., Wang, H. et al. Neural mechanisms and neuromodulation therapies for non-suicidal self-injury. Mol Psychiatry (2025). https://doi.org/10.1038/s41380-025-03125-7

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