Altered Neural Activity in Adolescent Major Depressive Disorder With Nonsuicidal Self‐Injury: A Resting‐State Functional Magnetic Resonance Imaging Meta‐Analysis

Background Resting‐state functional magnetic resonance imaging (rs‐fMRI) reveals diverse neural activity patterns in adolescent major depressive disorder (MDD) with nonsuicidal self‐injury (NSSI; nsMDD). However, the reported results are inconsistent. The aim of this study was to conduct a meta‐analysis to identify consistent patterns of brain activity alterations in adolescent nsMDD. Methods A systematic search was conducted across PubMed, Web of Science, Embase, Google Scholar, Wanfang, and CNKI for rs‐fMRI studies that compared nsMDD patients with healthy controls (HCs), up to June 30, 2025. Significant cluster coordinates were extracted for comprehensive analysis. We utilized regional homogeneity (ReHo) and amplitude of low‐frequency fluctuations (ALFFs) analyses. Activation likelihood estimation (ALE) was used to identify regions of aberrant spontaneous neural activity in adolescent nsMDD compared to HCs. Results Eight studies (249 adolescent nsMDD and 278 HCs) were included. The ALE meta‐analysis revealed increased activity in the left lingual gyrus (LING; Brodmann area [BA] 18) in adolescent nsMDD compared to HCs (voxel size = 200 mm 3 ; p < 0.05). Decreased activity was observed in the right posterior cingulate cortex (PCC; BA 29) in adolescent nsMDD compared to HCs (voxel size = 360 mm 3 ; p < 0.05). Jackknife sensitivity analyses demonstrated robust reproducibility in five of eight tests for the left LING and in six of eight tests for the right PCC. Conclusions This meta‐analysis confirms consistent alterations in specific brain regions in adolescent nsMDD, highlighting the potential of rs‐fMRI to refine diagnostic and therapeutic strategies.