重度抑郁症和边缘性人格障碍中情绪加工的跨诊断及特定障碍神经关联：基于坐标和基于图像的比较性荟萃分析
Transdiagnostic and Disorder-Specific Neural Correlates of Emotion Processing in Major Depressive Disorder and Borderline Personality Disorder: Coordinate-Based and Image-Based Comparative Meta-Analyses.
作者信息
Peng Wanrong, Liu Suyao, Yi Jinyao
机构信息
Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, China.
Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, China.
出版信息
Biol Psychiatry Cogn Neurosci Neuroimaging. 2025 Apr 1. doi: 10.1016/j.bpsc.2025.03.009.
BACKGROUND
Major depressive disorder (MDD) and borderline personality disorder (BPD) involve substantial impairments in negative and positive emotion processing. This meta-analysis aims to identify both transdiagnostic and disorder-specific neural abnormalities during the processing of negative and positive stimuli for MDD and BPD.
METHODS
The current coordinate-based and image-based meta-analyses comprised 42 functional magnetic resonance imaging studies involving MDD (42 negative studies vs. 22 positive studies; 1532 patients with MDD vs. 1481 healthy controls) and 25 involving BPD (23 negative studies vs. 7 positive studies; 522 patients with BPD vs. 519 healthy controls).
RESULTS
Compared with healthy controls, patients with MDD exhibited hyporeactivity in the left precentral gyrus during negative emotion processing and decreased activation in left temporal lobe, insula, and bilateral anterior cingulate cortex during positive emotion processing, while patients with BPD displayed hyperreactivity in the left hippocampus and amygdala and hyporeactivity in the right inferior frontal gyrus during negative emotion processing. Compared with BPD, patients with MDD exhibited greater hyporeactivity in the bilateral anterior cingulate cortex during negative emotion processing and in the left middle temporal gyrus during positive emotion processing. The transdiagnostic hyporeactivity of BPD and MDD was mainly located in the left inferior and right middle frontal gyrus during negative emotion processing.
CONCLUSIONS
Our findings highlight both distinct and transdiagnostic neural mechanisms of emotion processing in MDD and BPD.
背景
重度抑郁症（MDD）和边缘型人格障碍（BPD）在负性和正性情绪加工方面存在显著损害。本荟萃分析旨在确定MDD和BPD在处理负性和正性刺激时的跨诊断及特定障碍的神经异常。
方法
当前基于坐标和基于图像的荟萃分析包括42项功能磁共振成像研究，其中涉及MDD的研究有42项（负性研究42项与正性研究22项；MDD患者1532例与健康对照1481例），涉及BPD的研究有25项（负性研究23项与正性研究7项；BPD患者522例与健康对照519例）。
结果
与健康对照相比，MDD患者在负性情绪加工期间左侧中央前回反应性降低，在正性情绪加工期间左侧颞叶、岛叶和双侧前扣带回皮质激活减少，而BPD患者在负性情绪加工期间左侧海马和杏仁核反应性增强，右侧额下回反应性降低。与BPD患者相比，MDD患者在负性情绪加工期间双侧前扣带回皮质以及在正性情绪加工期间左侧颞中回的反应性降低更为明显。BPD和MDD的跨诊断反应性降低主要位于负性情绪加工期间的左侧额下回和右侧额中回。
结论
我们的研究结果突出了MDD和BPD在情绪加工方面独特的和跨诊断的神经机制。
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