边缘型人格障碍青少年的局部一致性改变及其与认知功能的关系。
Altered regional homogeneity and its association with cognitive function in adolescents with borderline personality disorder.
机构信息
From the Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Yi, Fu); the National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, Hunan, P.R. China (Yi, Fu); the National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Yi); the Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Zhang); the Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Jiang, Xiao); the Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, Calif., USA (Chen).
From the Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Yi, Fu); the National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, Hunan, P.R. China (Yi, Fu); the National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Yi); the Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Zhang); the Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China (Jiang, Xiao); the Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, Calif., USA (Chen)
出版信息
J Psychiatry Neurosci. 2023 Jan 3;48(1):E1-E10. doi: 10.1503/jpn.220144. Print 2023 Jan-Feb.
BACKGROUND
Adolescents with borderline personality disorder often have cognitive impairment, but the underlying mechanism for this is not clear. This study was aimed at assessing alterations in regional homogeneity using resting-state functional MRI (fMRI) in adolescents with borderline personality disorder, and evaluating the associations between regional homogeneity and cognitive testing scores.
METHODS
We enrolled 50 adolescents with borderline personality disorder (age 12-17 years) and 21 age- and sex-matched healthy controls. We performed regional homogeneity and seed-based functional connectivity analysis for both groups. We also performed correlative analysis for regional homogeneity and cognitive testing scores.
RESULTS
Compared with healthy controls, adolescents with borderline personality disorder had reduced regional homogeneity values in the frontal cortex (including the left inferior orbitofrontal cortex and the bilateral superior frontal cortex) as well as in the left precuneus in the default mode network. Adolescents with borderline personality disorder also had higher regional homogeneity values in several cortical regions: the right middle temporal gyrus, the right cuneus, the right precentral gyrus and the left middle occipital gyrus. Regional homogeneity values in the left middle occipital gyrus, left inferior orbitofrontal cortex and right superior frontal gyrus were associated with cognitive testing scores in adolescents with borderline personality disorder. We also found increased functional connectivity between the left middle occipital gyrus and right superior frontal gyrus in adolescents with borderline personality disorder.
LIMITATIONS
This study had a modest sample size, with a possible case selection bias for patients with more severe illness. This cohort also included patients with comorbidities or taking psychotropic medications, which may have confounded study results.
CONCLUSION
Alterations in regional homogeneity and functional connectivity in brain regions that involve the limbic-cortical circuit could be neural correlates for cognitive impairment in adolescents with borderline personality disorder.
背景
边缘型人格障碍青少年常伴有认知障碍，但其中的潜在机制尚不清楚。本研究旨在通过静息态功能磁共振成像（rs-fMRI）评估边缘型人格障碍青少年的局部一致性变化，并评估局部一致性与认知测试评分之间的相关性。
方法
我们纳入了 50 名边缘型人格障碍青少年（12-17 岁）和 21 名年龄和性别匹配的健康对照者。我们对两组进行了局部一致性和种子点功能连接分析。我们还对局部一致性和认知测试评分进行了相关性分析。
结果
与健康对照组相比，边缘型人格障碍青少年的额皮质（包括左侧眶额下回和双侧额上回）和默认模式网络中的左侧楔前叶的局部一致性值降低。边缘型人格障碍青少年的几个皮质区域的局部一致性值较高：右侧颞中回、右侧楔叶、右侧中央前回和左侧中枕叶。边缘型人格障碍青少年的左侧中枕叶、左侧眶额下回和右侧额上回的局部一致性值与认知测试评分相关。我们还发现边缘型人格障碍青少年的左侧中枕叶与右侧额上回之间的功能连接增加。
局限性
本研究样本量较小，可能存在更严重疾病的患者选择偏倚。该队列还包括合并症或服用精神药物的患者，这可能会混淆研究结果。
结论
边缘型人格障碍青少年边缘-皮质回路相关脑区的局部一致性和功能连接的改变可能是其认知障碍的神经生物学标志物。
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