Franczak Łukasz, Podwalski Piotr, Wysocki Patryk, Dawidowski Bartosz, Jędrzejewski Adam, Jabłoński Marcin, Samochowiec Jerzy
Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland.
Independent Clinical Psychology Unit, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland.
J Clin Med. 2024 Nov 16;13(22):6906. doi: 10.3390/jcm13226906.
: Impulsivity is one of the overlapping symptoms common to borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD), but the neurobiological basis of these disorders remains uncertain. This systematic review aims to identify abnormalities in the gray and white matter associated with impulsivity in BPD and ADHD. : We conducted a systematic search of the PubMed, Embase, and SCOPUS databases, adhering to PRISMA guidelines. Studies that investigated gray and white matter alterations in BPD or ADHD populations and their relationship with impulsivity were included. We reviewed information from 23 studies involving 992 participants, which included findings from structural MRI and DTI. : The review identified various nonhomogeneous changes associated with impulsivity in BPD and ADHD. BPD was mainly associated with abnormalities in the prefrontal cortex (PFC) and limbic areas, which correlated negatively with impulsivity. In contrast, impulsivity associated with ADHD was associated with structural changes in the caudate nucleus and frontal-striatal pathways. Despite the overlapping symptoms of impulsivity, the neurobiological mechanisms appeared to differ between the two disorders. : These findings emphasize the distinct neurostructural correlates of impulsivity in BPD and ADHD. While both disorders show impulsivity as one of their main symptoms, the fundamental brain structures associated with this trait are different. BPD is primarily associated with abnormalities in the prefrontal cortex and limbic system, whereas the alterations seen in ADHD tend to focus on the caudate nucleus and frontostriatal pathways. Further research is needed to clarify these differences and their implications for treatment.
冲动性是边缘型人格障碍（BPD）和注意力缺陷多动障碍（ADHD）共有的重叠症状之一，但这些障碍的神经生物学基础仍不明确。本系统综述旨在确定与BPD和ADHD冲动性相关的灰质和白质异常。
我们遵循PRISMA指南，对PubMed、Embase和SCOPUS数据库进行了系统检索。纳入了调查BPD或ADHD人群灰质和白质改变及其与冲动性之间关系的研究。我们回顾了来自23项研究的信息，涉及992名参与者，其中包括结构MRI和DTI的研究结果。
该综述确定了与BPD和ADHD冲动性相关的各种非均匀变化。BPD主要与前额叶皮质（PFC）和边缘区域的异常有关，这些异常与冲动性呈负相关。相比之下，与ADHD相关的冲动性与尾状核和额叶 - 纹状体通路的结构变化有关。尽管存在冲动性的重叠症状，但这两种障碍的神经生物学机制似乎有所不同。
这些发现强调了BPD和ADHD中冲动性不同的神经结构相关性。虽然这两种障碍都将冲动性作为主要症状之一，但与该特征相关的基本脑结构是不同的。BPD主要与前额叶皮质和边缘系统的异常有关，而ADHD中所见的改变往往集中在尾状核和额纹状体通路上。需要进一步研究来阐明这些差异及其对治疗的影响。
