Common and distinct patterns of gray matter alterations in borderline personality disorder and posttraumatic stress disorder: A dual meta-analysis

Lou, Jing; Sun, Ying; Cui, Zhixi; Gong, Lei

doi:10.1016/j.neulet.2020.135376

Cited by 13 publications

(4 citation statements)

References 49 publications

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“…The most robust meta‐analytic result of neuroimaging studies in BPD is hyperactivity of the amygdala and hippocampal area during emotional processing experiments 130‐132 , which seems to be accompanied by impairments in habituation of the amygdala to repeated negative stimuli 133‐138 . While earlier meta‐analyses found a reduction in hippocampal and amygdala volume in BPD 139,140 , a more recent and comprehensive meta‐analysis reported no gray matter alterations 141 . Although the amygdala is assumed to be involved in emotional evaluation and recognition of subjectively dangerous situations, its exclusive role in processing negative emotions has recently been challenged, as studies have shown that amygdala activation is only marginally involved in the prediction of subjective fear ratings 142 , correlates with the experiencing of positive emotions 143 , and might rather indicate saliency for faces than threats 144 .…”

Section: Neurobiologymentioning

confidence: 99%

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Leichsenring,

Fonagy,

Heim

et al. 2024

World Psychiatry

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Borderline personality disorder (BPD) was introduced in the DSM‐III in 1980. From the DSM‐III to the DSM‐5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self‐image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self‐mutilation behavior, and transient stress‐related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi‐structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self‐mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in outpatient and 22% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post‐traumatic stress disorder, attention‐deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various approaches have been empirically supported in randomized controlled trials, including dialectical behavior therapy, mentalization‐based therapy, transference‐focused therapy, and schema therapy. No approach has proved to be superior to others. Compared to treatment as usual, psychotherapy has proved to be more efficacious, with effect sizes between 0.50 and 0.65 with regard to core BPD symptom severity. However, almost half of the patients do not respond sufficiently to psychotherapy, and further research in this area is warranted. It is not clear whether some patients may benefit more from one psychotherapeutic approach than from others. No evidence is available consistently showing that any psychoactive medication is efficacious for the core features of BPD. For discrete and severe comorbid anxiety or depressive symptoms or psychotic‐like features, pharmacotherapy may be useful. Early diagnosis and treatment of BPD can reduce individual suffering and societal costs. However, more high‐quality studies are required, in both adolescents and adults. This review provides a comprehensive update of the BPD diagnosis and clinical characterization, risk factors, neurobiology, cognition, and management. It also discusses the current controversies concerning the disorder, and highlights the areas in which further research is needed.

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Section: Neurobiologymentioning

confidence: 99%

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Leichsenring,

Fonagy,

Heim

et al. 2024

World Psychiatry

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show abstract

“…In the last twenty years, several neuroimaging studies have tried to understand and delineate the neural bases of BPD. So far, neuroanatomical models of BPD indicate significant reduction in grey matter volume and density in the bilateral medial prefrontal cortex (mPFC) [7], medial orbital frontal cortex (OFC) [8,9], bilateral anterior cingulate cortex (ACC) [10], bilateral amygdale, and right parahippocampal gyrus [11,12]. An increase in grey matter volume and density has also been observed in the bilateral precuneus, right medium/paracingulate gyrus, and posterior cingulate gyrus [7].…”

Section: Introductionmentioning

confidence: 99%

Abnormal Brain Circuits Characterize Borderline Personality and Mediate the Relationship between Childhood Traumas and Symptoms: A mCCA+jICA and Random Forest Approach

Grecucci

Dadomo

Lapomarda

et al. 2023

Sensors

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Borderline personality disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study, we applied for the first time a combination of an unsupervised machine learning approach known as multimodal canonical correlation analysis plus joint independent component analysis (mCCA+jICA), in combination with a supervised machine learning approach known as random forest, to possibly find covarying gray matter and white matter (GM-WM) circuits that separate BPD from controls and that are also predictive of this diagnosis. The first analysis was used to decompose the brain into independent circuits of covarying grey and white matter concentrations. The second method was used to develop a predictive model able to correctly classify new unobserved BPD cases based on one or more circuits derived from the first analysis. To this aim, we analyzed the structural images of patients with BPD and matched healthy controls (HCs). The results showed that two GM-WM covarying circuits, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC. Notably, these circuits are affected by specific child traumatic experiences (emotional and physical neglect, and physical abuse) and predict symptoms severity in the interpersonal and impulsivity domains. These results support that BPD is characterized by anomalies in both GM and WM circuits related to early traumatic experiences and specific symptoms.

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“…2 of 31 cortex (ACC) [10], bilateral amygdale and right parahippocampal gyrus [11,12]. On the other hand, they also showed an increase of grey matter volume and density in the bilateral praecuneus, right medium / paracingulate gyrus and posterior cingulate gyrus [7].…”

Section: Introductionmentioning

confidence: 99%

Two Grey–White Matter Circuits Separate Borderline Personality Disorder From Controls and Mediate the Relationship Between Specific Childhood Traumas and Symptoms. A mCCA+jICA and Random Forest Approach

Grecucci¹,

Dadomo²,

Lapomarda³

et al. 2023

Preprint

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Borderline Personality Disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study we applied for the first time an unsupervised machine learning approach known as mCCA+jICA, in combination with a supervised machine learning approach known as Random Forest, to possibly find covarying GM-WM circuits that separate BPD from controls and that are also predictive of this diagnosis. To this aim, we analyzed the structural images of patients with BPD and matched HCs. Results showed that two GM-WM covarying circuits, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC. Notably, these circuits are affected by specific child traumatic experiences (emotional and physical neglect, and physical abuse) and predict symptoms severity in the interpersonal and impulsivity domains. These results support that BPD is characterized by anomalies in GM and WM circuits related to early traumatic experiences and specific symptoms.

show abstract

Common and distinct patterns of gray matter alterations in borderline personality disorder and posttraumatic stress disorder: A dual meta-analysis

Cited by 13 publications

References 49 publications

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Abnormal Brain Circuits Characterize Borderline Personality and Mediate the Relationship between Childhood Traumas and Symptoms: A mCCA+jICA and Random Forest Approach

Two Grey–White Matter Circuits Separate Borderline Personality Disorder From Controls and Mediate the Relationship Between Specific Childhood Traumas and Symptoms. A mCCA+jICA and Random Forest Approach

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