Columbia College of Physicians & Surgeons, New York, NY 10024, USA.
Curr Psychiatry Rep. 2013 Oct;15(10):399. doi: 10.1007/s11920-013-0399-7.
Borderline personality disorder (BPD) has been recognized as heterogeneous, etiologically, stemming from many combinations of genetic and environmental factors BPD never occurs alone: it is always accompanied by traits of other personality disorders and by various symptom-conditions, especially mood disorders. The controversy about linkage between BPD and bipolar disorder could not be resolved when the debate relied only on clinical description. Some twin-studies suggested modest overlap between BPD and bipolar disorder. Current neuroimaging research points to similarities in brain changes among several conditions characterized by emotional over-reactivity to stress: bipolar disorder, certain cases of BPD and attention-deficit hyperactivity (ADHD). These include alterations in the limbic system (e.g., amygdala and hippocampus) and neocortex (especially the prefrontal cortex). An important subset of BPD exists in which brain changes are essentially identical with those of bipolar disorder. Relevant brain-change findings and treatment implications are summarized in this article.
边缘型人格障碍（BPD）已被认为具有异质性，其病因源于遗传和环境因素的多种组合。BPD 从不单独发生：它总是伴随着其他人格障碍的特征和各种症状状况，特别是情绪障碍。当争论仅依赖于临床描述时，BPD 与双相情感障碍之间的联系争议无法解决。一些双胞胎研究表明，BPD 和双相情感障碍之间存在适度的重叠。当前的神经影像学研究指出，在几种以对压力的情绪过度反应为特征的情况下，大脑变化存在相似之处：双相情感障碍、某些 BPD 病例和注意缺陷多动障碍（ADHD）。这些变化包括边缘系统（例如杏仁核和海马体）和新皮质（特别是前额叶皮层）的改变。BPD 中有一个重要的亚组，其大脑变化与双相情感障碍基本相同。本文总结了相关的大脑变化发现和治疗意义。
