Objective To construct a predictive model for the risk of non-suicidal self-injury(NSSI)in young and middle-aged patients with major depressive disorder based on the decision tree algorithm.Methods Young and middle-aged patients with major depressive disorder admitted to the Chongqing Mental Health Center from January 2021 to June 2023 were selected as the research subjects and their clinical data were collected.According to whether NSSI occurred or not,the patients were divided into the NSSI group(n=72)and the non-NSSI group(n=82).Univariate and multivariate logistic regression analyses were used to analyze the risk factors of NSSI in young and middle-aged patients with major depressive disorder.A deci-sion tree predictive model was established based on the results of logistic regression analysis and the Chi-square Automatic Interaction Detection(CHAID)algorithm.The predictive value of the model was evaluated using Receiver Operating Characteristic(ROC)curve.Results The incidence of NSSI in 154 young and mid-dle-aged patients with major depressive disorder was 46.8％.The results of single-factor analysis showed that there were no statistically significant differences(P＞0.05)in gender,age,education level,occupation,family composition,only child status,relationship status,fertility status,main place of residence,family economic source,and housing conditions between the two groups.Statistically significant differences(P＜0.05)were observed in living conditions,family economic status,duration of depression,SSRS score,PSS-Fa score,and DS score between the two groups.Multi-factor logistic regression analysis showed that lower family economic lev-el,longer duration of depression,SSRS score＜20 points,PSS-Fa score＜6 points,and DS score ≥47.2 points were independent risk factors for NSSI in young and middle-aged patients with major depressive disorder(P＜0.05).The constructed decision tree model had five layers and ten nodes,with family economic situation,duration of depression,SSRS score,and PSS-Fa score selected as the nodes of the model,among which the PSS-Fa score was the most important predictive factor.ROC curve analysis showed that the AUC of the model was 0.881(95％CI:0.844-0.918).Conclusion There are many influencing factors for the occurrence of NSSI in young and middle-aged patients with major depressive disorder.The decision tree model constructed based on these factors has a high predictive value for the risk of NSSI in young and middle-aged patients with major depressive disorder.

Objective:To investigate the effect of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) on motor performance, quality of life, sleep quality, neuropsychological status, and mood in patients with Meige syndrome.Methods:The clinical data of 17 patients with Meige syndrome accepted bilateral GPi-DBS in Department of Neurosurgery, People's Hospital of Peking University from May 2019 to March 2021 were retrospectively analyzed. Established and validated rating scales were used to assess the motor performance, quality of life, sleep quality, neuropsychological status, and mood at baseline, and 1 and 2 years after GPi-DBS.Results:Burke-Fahn-Marsden dystonia rating scale (BFMDRS) motor total scores decreased from 14.4±6.2 at baseline to 4.3±2.2 and 3.5±1.9 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). BFMDRS disability total scores decreased from 6.2±4.0 at baseline to 2.8±2.0 and 2.2±1.5 at 1 and 2 years after GPi-DBS, with significant differences ( P<0.05). In 36-item Short-Form Health Survey (SF-36), the scores of physical function, role-physical, general health sub-items at 1 and 2 years after GPi-DBS were significantly higher than those at baseline ( P<0.05). No significant differences were noted in scores of sleep quality, neuropsychological function, or mood scales at 1 and 2 years after GPi-DBS compared with those at baseline ( P>0.05). Conclusion:Bilateral GPi-DBS is effective and safe in Meige syndrome, which can improve dystonic symptom and quality of life without adverse effects on sleep quality, neuropsychological function, or emotional status.

Objective:To explore the pathogenesis of glossopharyngeal neuralgia (GPN) in central nervous system from perspective of brain morphology.Methods:A prospective study was performed. Twenty-seven patients with right primary GPN admitted to Department of Neurosurgery, People's Hospital of Peking University from April 2019 to June 2023 and 27 healthy subjects (controls) matched with age, gender, dominant hand, and education level during the same period were recruited. These patients were divided into GPN with neurovascular compression group ( n=18) and GPN without neurovascular compression ( n=9) based on intraoperative presence of neurovascular compression. SPM8 software based on Matlab R2017b programming platform and VBM8 toolbox were used to process the whole-brain high-resolution 3D-T1 brain structural image data of the participants and analyze the differences in the gray matter volume of each brain region between the 2 groups. Pearson correlation was applied to analyze the correlations of gray matter volumes in brain regions enjoying significant difference with baseline data and pain characteristics of these GPN patients. Results:Compared with controls, patients with GPN had significantly reduced gray matter volumes in the left anterior cingulate gyrus, middle temporal gyrus, transverse temporal gyrus, precentral gyrus, postcentral gyrus, right insula, thalamus, inferior parietal lobule, precentral gyrus, middle temporal gyrus, and inferior temporal gyrus ( P<0.05, FDR corrected). Compared with GPN patients with neurovascular compression, GPN patients without neurovascular compression had significantly reduced gray matter volume in the bilateral anterior cingulate gyrus ( P<0.05, FDR corrected). Changes of gray matter volume in the right insula were negatively correlated with disease duration of GPN patients ( r=-0.521, P=0.005). Conclusion:GPN patients have extensive gray matter atrophy in the brain, which may play an essential role in GPN development and maintenance.