Cao Wanyi, Liu Ying, Zhong Mingtian, Liao Haiyan, Cai Sainan, Chu Jun, Zheng Shuxin, Tan Changlian, Yi Jinyao
Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Medical Psychological Institute, Central South University, Changsha, China.
Borderline Personal Disord Emot Dysregul. 2023 Jun 19;10(1):21. doi: 10.1186/s40479-023-00227-y.
Despite impulse control and emotion regulation being altered in borderline personality disorder (BPD), the specific mechanism of these clinical features remains unclear. This study investigated the functional connectivity (FC) abnormalities within- and between- default mode network (DMN), salience network (SN), and central executive network (CEN) in BPD, and examined the association between aberrant FC and clinical features. We aimed to explore whether the abnormal large-scale networks underlie the pathophysiology of impulsivity and emotion dysregulation in BPD.
Forty-one young, drug-naïve patients with BPD (24.98 ± 3.12 years, 20 males) and 42 healthy controls (HCs; 24.74 ± 1.29 years, 17 males) were included in resting-state functional magnetic resonance imaging analyses. Independent component analysis was performed to extract subnetworks of the DMN, CEN, and SN. Additionally, partial correlation was performed to explore the association between brain imaging variables and clinical features in BPD.
Compared with HCs, BPD showed significant decreased intra-network FC of right medial prefrontal cortex in the anterior DMN and of right angular gyrus in the right CEN. Intra-network FC of right angular gyrus in the anterior DMN was significantly negatively correlated with attention impulsivity in BPD. The patients also showed decreased inter-network FC between the posterior DMN and left CEN, which was significantly negatively correlated with emotion dysregulation.
These findings suggest that impaired intra-network FC may underlie the neurophysiological mechanism of impulsivity, and abnormal inter-network FC may elucidate the neurophysiological mechanism of emotion dysregulation in BPD.
尽管边缘型人格障碍(BPD)患者存在冲动控制和情绪调节方面的改变,但其临床特征的具体机制仍不清楚。本研究调查了BPD患者默认模式网络(DMN)、突显网络(SN)和中央执行网络(CEN)内部及之间的功能连接(FC)异常情况,并检验了异常FC与临床特征之间的关联。我们旨在探讨这些异常的大规模网络是否是BPD患者冲动性和情绪调节障碍病理生理学的基础。
纳入41名年轻、未使用过药物的BPD患者(24.98±3.12岁,男性20名)和42名健康对照者(HCs;24.74±1.29岁,男性17名)进行静息态功能磁共振成像分析。采用独立成分分析提取DMN、CEN和SN的子网络。此外,进行偏相关分析以探讨BPD患者脑成像变量与临床特征之间的关联。
与HCs相比,BPD患者前扣带回默认模式网络右侧内侧前额叶皮质以及右侧中央执行网络右侧角回的网络内FC显著降低。前扣带回默认模式网络右侧角回的网络内FC与BPD患者的注意力冲动性显著负相关。患者还表现出后扣带回默认模式网络与左侧中央执行网络之间的网络间FC降低,这与情绪调节障碍显著负相关。
这些发现表明,网络内FC受损可能是冲动性神经生理机制的基础,而异常的网络间FC可能阐明了BPD患者情绪调节障碍的神经生理机制。