Department of Psychology, University of Toronto Scarborough, Toronto, Canada.
Psychiatry Res. 2012 Mar 31;201(3):245-52. doi: 10.1016/j.pscychresns.2012.02.012. Epub 2012 Apr 15.
Borderline personality disorder (BPD) is a genetically influenced psychiatric illness with disruptions in neural systems supporting cognition and emotion regulation. Volumetric decreases of the hippocampus and amygdala may characterize BPD and serve as putative endophenotypes for the illness. The purpose of the present study was to evaluate whether the magnitude of these volume reductions and their associations with state-of-illness factors and psychiatric disorders which often co-occur with BPD warrant their consideration as potential endophenotypes. Volumetric magnetic resonance imaging results from 11 studies comprising 205 BPD patients and 222 healthy controls were quantitatively synthesized using meta-analytic techniques. Patients showed an average 11% and 13% decrease in the size of the hippocampus and amygdala, respectively. These volumetric differences were not attenuated in patients being treated with psychotropic medications. Comorbid depression, post-traumatic stress disorder, and substance use disorders were unrelated to volumetric decreases in either structure. These findings suggest modest volume reductions of the amygdala and hippocampus bilaterally in BPD which cannot be attributed to illness state or comorbid psychopathology. Decreased volumes of these key limbic structures may hold promise as candidate endophenotypes for BPD.
边缘型人格障碍（BPD）是一种具有遗传影响的精神疾病，其神经认知和情绪调节系统受到干扰。海马体和杏仁核的体积减少可能是 BPD 的特征，并可作为该疾病的潜在内表型。本研究的目的是评估这些体积减少的程度及其与疾病状态因素和与 BPD 常共存的精神障碍之间的关联是否表明它们可作为潜在的内表型。使用荟萃分析技术对包括 205 名 BPD 患者和 222 名健康对照者的 11 项研究的体积磁共振成像结果进行了定量综合。患者的海马体和杏仁核分别平均缩小了 11%和 13%。这些体积差异在接受精神药物治疗的患者中并未减弱。共病的抑郁、创伤后应激障碍和物质使用障碍与两种结构的体积减少均无关。这些发现表明，BPD 双侧的杏仁核和海马体体积适度减少，不能归因于疾病状态或共病精神病理学。这些关键边缘结构的体积减少可能有望成为 BPD 的候选内表型。
