Effects of Repetitive Transcrannial Magnetic Stimulation on Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) refers to a series of direct and consequently repeated injuries to one's body without suicidal intent. At present, it has become an important issue of mental disorders. This article focuses on the formation mechanism of NSSI and the intervention effect of rTMS on NSSI patients. At the same time, NSSI patients are collected, a treatment plan is designed to complete a two-week treatment, and the results are analyzed. The aim is to provide theoretical basis for the clinical diagnosis and treatment of NSSI, and also to provide reference for the clinical diagnosis and treatment of NSSI patients.

Study Overview

• Status: Enrolling by invitation
• Conditions: NSSI
• Intervention / Treatment: Other: rTMS stimulation of left M1

Detailed Description

Research Objective Non suicidal self injury (NSSI) behavior is a common behavioral issue in psychiatric and psychiatric clinics. Studies have shown that NSSI is on the rise in China and has become an important mental health issue. Non suicidal self injury and suicide have similar clinical manifestations. Therefore, this study will intervene in the treatment of NSSI patients, understand the occurrence of NSSI in psychiatric outpatient and inpatient wards, and observe the efficacy of repeated transcranial magnetic stimulation intervention in NSSI patients, in order to explore the current occurrence status and biopsychological etiology of NSSI in psychiatric clinical practice.

Research Process If you agree to participate in this study, please read and sign this informed consent form before participating in any of the following procedures.

Research location: All research processes and evaluation interviews were conducted at the Affiliated Brain Hospital of Nanjing Medical University.

Study participants: Participants clinically diagnosed with non suicidal self injury participated in this study, aged 10-60 years, regardless of gender. All participants entered the study after signing the informed consent form.

Research Procedures This study first clarifies your diagnosis by conducting interviews to understand your physical health status, course of illness, family history, previous medical treatment, and examination results. We will assign a number to each participant, establish a medical record, and then perform corresponding psychological assessments, magnetic resonance imaging examinations, and repeat transcranial magnetic stimulation therapy for two weeks (a total of 10 times).

Possible Benefits All clinical scale evaluations, imaging examinations, and repeated transcranial magnetic stimulation interventions related to the study are free of charge. Your research doctors and evaluators will conduct timely clinical observations of changes in your condition, and provide you with systematic research follow-up and evaluation. These evaluations will help make reasonable judgments about your disease status and treatment effectiveness, and thus guide treatment decisions more scientifically. In addition, free treatment with repeated transcranial magnetic stimulation is also beneficial for the improvement of your condition. The research team will coordinate with relevant staff in the hospital and department where you are seeking medical treatment to provide convenience in basic clinical services such as doctor appointments, registration, and waiting, in order to save your visit time.

Privacy and Confidentiality Issues If you decide to participate in this study, your participation in the experiment and your personal information during the experiment will be kept confidential. Responsible research doctors and other researchers will use your medical information for research, but will not disclose your personal information. If you are harmed by participating in this study, you can receive free treatment and/or corresponding compensation.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Jiangsu
    • Nanjing, Jiangsu, China, 210029
      • Nanjing Brain Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Meets the NSSI diagnostic criteria recommended in DSM-5;
2. The Chinese version of the Brief International Neuropsychiatric Interview (MINI) screen for diagnostic compliance;
3. Age :10-55 years old;
4. Right hand;
5. The paitent voluntarily participate and sign the informed consent form for this study (signed by participants under the age of 18 and their families);
6. Able to understand written language and cooperate with questionnaire surveys.

Exclusion Criteria:

1. History of severe substance abuse;
2. The patient has other serious mental disorders, neurological disorders, or physical illnesses; 3、Previously experienced epileptic seizures;

4、Pregnant or lactating women; 5、Contraindications to magnetic resonance imaging and transcranial magnetic stimulation; 6、Unable or refused to provide written informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Effects of rTMS on NSSI; Exploring the effectiveness of rTMS intervention in NSSI patients using the Ottawa Self Injury Scale and other scales as research subjects	Other: rTMS stimulation of left M1; This study employed low-frequency repetitive transcranial magnetic stimulation (low-frequency rTMS) targeting the left primary motor cortex (M1 area). The stimulation intensity was set at 110% of the resting motor threshold (RMT). The single-session stimulation protocol was as follows: continuous stimulation at 1 Hz for 60 seconds, followed by a 5-second interval, with this cycle repeated 20 times. Thus, the total number of pulses per session was 1,200. Two sessions were administered daily, with a 40-minute interval between sessions. Treatment was conducted for 5 consecutive days per week, with 2 rest days, for a total of 2 weeks (10 treatment days). Each patient received a total of 24,000 pulses throughout the entire course. Sham stimulation utilized identical stimulation parameters as active stimulation (including frequency, intensity, duration, and number of repetitions), but employed a sham coil. This coil was identical in appearance to the active stimulation coil, producing simila
Experimental: rs-fMRI-functional connectivity; Based on rs fMRI technology, imaging methods were used to analyze the brain images of patients and explore the changes in functional connectivity of brain regions before and after intervention in two groups of subjects.	Other: rTMS stimulation of left M1; This study employed low-frequency repetitive transcranial magnetic stimulation (low-frequency rTMS) targeting the left primary motor cortex (M1 area). The stimulation intensity was set at 110% of the resting motor threshold (RMT). The single-session stimulation protocol was as follows: continuous stimulation at 1 Hz for 60 seconds, followed by a 5-second interval, with this cycle repeated 20 times. Thus, the total number of pulses per session was 1,200. Two sessions were administered daily, with a 40-minute interval between sessions. Treatment was conducted for 5 consecutive days per week, with 2 rest days, for a total of 2 weeks (10 treatment days). Each patient received a total of 24,000 pulses throughout the entire course. Sham stimulation utilized identical stimulation parameters as active stimulation (including frequency, intensity, duration, and number of repetitions), but employed a sham coil. This coil was identical in appearance to the active stimulation coil, producing simila

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ottawa Self-injury Inventory	OSI was evaluated by professionally trained doctors (non experimental intervention) at baseline and two weeks after treatment to assess the effectiveness of the treatment. Comparing the differences in self harm thoughts and behaviors between the baseline period and the intervention group and the control group, p<0.05 indicates a significant difference.	2 weeks
Magnetic resonance imaging		2 weeks

Collaborators and Investigators

• Sponsor: Nanjing Medical University

Study record dates

Study Major Dates

• Study Start (Actual): June 30, 2024
• Primary Completion (Estimated): May 30, 2027
• Study Completion (Estimated): June 15, 2027

Study Registration Dates

• First Submitted: July 10, 2024
• First Submitted That Met QC Criteria: August 1, 2024
• First Posted (Actual): August 6, 2024

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 23, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior
• Other Study ID Numbers: 2023-KY035-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No