Icahn School of Medicine at Mount Sinai, New York, NY, USA.
James J Peters VA Medical Center, New York, NY, USA.
Psychopharmacology (Berl). 2019 Aug;236(8):2485-2500. doi: 10.1007/s00213-019-05289-x. Epub 2019 Jun 15.
Borderline personality disorder (BPD) is a pervasive psychiatric disorder characterized by emotion dysregulation, impulsivity, impaired self-perceptions, and interpersonal relationships and currently affects 1-3% of the US population as reported by Torgersen et al. (Arch Gen Psychiatry 58:590-596, Torgersen et al. 2001), Lenzenweger et al. (Biol Psychiatry 62:553-564, Lenzenweger et al. 2007), and Tomko et al. (J Personal Disord 28:734-750, Tomko et al. 2014). One major obstacle to our understanding of the neural underpinnings of BPD is a lack of valid animal models that translate the key known features of the disorder to a system that is amenable to study.
To summarize the etiology, major symptoms, and symptom triggers of BPD and then propose a blueprint for building an animal model of BPD by choosing key components of the disorder that can be implemented in rodents.
We identify the role of early life stress and subsequent mild stress in adulthood as contributing etiological factors and the potential use of altered communication between frontal cortices and the amygdala in extinction and habituation, increased impulsivity, dysregulation of the hypothalamic pituitary axis (HPA), and increased neuroinflammation as biological markers of BPD. Building upon these features of BPD, we propose a two-hit animal model that uses maternal abandonment to alter maturation of the HPA axis and mild secondary adult stress to evoke behavioral symptoms such as increased impulsivity and impaired extinction, habituation, and social interactions.
Through exploration of the etiology, symptom presentation, and altered neurological function, we propose an animal model of BPD. We believe that a number of existing animal paradigms that model other mental health disorders should be combined in a unique way to reflect the etiology, symptom presentation, and altered neurological function that is evident in BPD. These model, when compared with available human data, will inform research and treatment in humans for better understanding of systems from the micro-molecular level to more global physiology underlying BPD.
边缘型人格障碍(BPD)是一种普遍存在的精神障碍,其特征为情绪调节障碍、冲动、自我认知受损以及人际关系受损。Torgersen 等人(Arch Gen Psychiatry 58:590-596,Torgersen 等人,2001 年)、Lenzenweger 等人(Biol Psychiatry 62:553-564,Lenzenweger 等人,2007 年)和 Tomko 等人(J Personal Disord 28:734-750,Tomko 等人,2014 年)报道,目前美国有 1%-3%的人患有该疾病。我们对 BPD 神经基础的理解存在一个主要障碍,即缺乏可将该疾病的关键已知特征转化为可用于研究的系统的有效动物模型。
总结 BPD 的病因、主要症状和症状触发因素,然后通过选择可在啮齿动物中实施的疾病关键成分,为 BPD 动物模型的构建提出一个蓝图。
我们确定了早期生活压力和随后成年期轻度压力作为促成病因的因素,以及改变前额皮质和杏仁核之间的通讯在消退和习惯形成、冲动性增加、下丘脑-垂体轴(HPA)失调以及神经炎症增加等方面的潜在作用,这些都是 BPD 的生物学标志物。基于 BPD 的这些特征,我们提出了一种两击动物模型,该模型使用母体遗弃来改变 HPA 轴的成熟,并用轻度的成年期二次应激来引发冲动性增加以及消退、习惯形成和社交互动受损等行为症状。
通过对病因、症状表现和神经功能改变的探索,我们提出了一种 BPD 动物模型。我们认为,应该以独特的方式结合现有的模拟其他心理健康障碍的动物模型,以反映 BPD 中明显的病因、症状表现和神经功能改变。与现有的人类数据进行比较,这些模型将为人类的研究和治疗提供信息,以更好地了解从微观分子水平到 BPD 更广泛生理学的系统。