School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy.
J Affect Disord. 2023 Nov 15;341:335-345. doi: 10.1016/j.jad.2023.09.001. Epub 2023 Sep 4.
Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by emotion dysregulation, impulsivity, and interpersonal disturbances. Several structural and functional neuroimaging abnormalities have been described in BPD. In particular, resting-state functional magnetic resonance imaging (rs-fMRI) studies have recently suggested various connectivity alterations within and between large-scale brain networks in BPD. This review aimed at providing an updated summary of the evidence reported by the available rs-fMRI studies in BPD individuals.
A search on PubMed, Scopus, and Web of Science was performed to identify rs-fMRI alterations in BPD. A total of 15 studies met our inclusion criteria.
Overall, aberrant resting-state functional connectivity (rs-FC) within and between default mode network (DMN), salience network (SN), and central executive network (CEN) were observed in BPD compared to healthy controls, as well as selective functional impairments in bilateral amygdala, anterior and posterior cingulate cortex, hippocampus, and prefrontal cortex.
The observational design, small sample size, prevalence of females, high rates of concurrent comorbidities and medications, and heterogeneity across imaging methodologies limit the generalizability of the results.
The identification of altered patterns of rs-FC within and between selective brain networks, including DMN, SN, and CEN, could further our knowledge of the clinical symptoms of BPD, and therefore, future studies with multimodal methodologies and longitudinal designs are warranted to further explore the neural correlates of this disorder.
边缘型人格障碍（BPD）是一种严重的精神疾病，其特征为情绪失调、冲动和人际困扰。多项结构和功能神经影像学异常已在 BPD 中被描述。特别是，静息态功能磁共振成像（rs-fMRI）研究最近表明，BPD 患者的大脑内和大脑间的大尺度网络存在各种连接异常。本综述旨在提供一份有关 BPD 患者静息态功能磁共振研究证据的最新总结。
在 PubMed、Scopus 和 Web of Science 上进行了搜索，以确定 BPD 中的 rs-fMRI 改变。共有 15 项研究符合我们的纳入标准。
与健康对照组相比，BPD 患者的默认模式网络（DMN）、突显网络（SN）和中央执行网络（CEN）内和之间的静息态功能连接（rs-FC）存在异常，双侧杏仁核、前后扣带回皮质、海马体和前额叶皮质的功能也存在选择性损伤。
观察性设计、样本量小、女性患病率高、同时存在多种合并症和药物的比例高、以及成像方法学的异质性限制了结果的普遍性。
识别 DMN、SN 和 CEN 等选择性大脑网络内和之间 rs-FC 的改变模式，可能会进一步加深我们对 BPD 临床症状的认识。因此，未来需要采用多模态方法和纵向设计的研究来进一步探索这种疾病的神经相关性。
