Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China.
Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China.
Br J Psychiatry. 2019 Jul;215(1):395-403. doi: 10.1192/bjp.2019.44. Epub 2019 Mar 8.
Whether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency.AimsTo detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder.
Web-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P < 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed.
Patients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder.
Our results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum.Declaration of interestNone.
边缘型人格障碍（BPD）和双相情感障碍是否为同一或不同疾病一直存在争议。目的：检测边缘型人格障碍和双相情感障碍患者的灰质体积（GMV）和灰质密度（GMD）改变是否存在相似或不同。
在网络发布数据库中进行了元分析，检索了所有比较边缘型人格障碍或双相情感障碍与健康对照组的基于体素的研究。我们纳入了 13 项边缘型人格障碍研究（395 例边缘型人格障碍患者和 415 名健康对照者）和 47 项双相情感障碍研究（2111 例双相情感障碍患者和 3261 名健康对照者）。从具有显著组间差异的簇中提取峰坐标。对峰坐标簇和阈值（未校正，P < 0.005）进行效应量符号差异映射元分析。联合分析确定了表现出共同容积改变模式的区域。还进行了相关性分析。
边缘型人格障碍患者双侧内侧前额皮质网络（mPFC）、双侧杏仁核和右侧海马旁回 GMV 和 GMD 减少；双相情感障碍患者双侧眶额皮质内侧（mOFC）、右侧岛叶和右侧丘脑 GMV 和 GMD 减少，右侧壳核 GMV 和 GMD 增加。多模态分析表明，两种疾病在右侧眶额皮质内侧的簇中体积较小。边缘型人格障碍患者双侧 mPFC 减少部分由患者年龄介导。双相情感障碍患者右侧壳核 GMV 和 GMD 增加与 Young 躁狂评定量表评分呈正相关。
我们的结果显示 GMV 和 GMD 改变存在不同模式，不支持双相情感障碍和边缘型人格障碍处于相同情感谱的假说。利益声明无。
