Comparing Neurocognitive Profile of Patients with Borderline Personality and Bipolar–II Disorders

Akbari, V; Rahmatinejad, Parvin; Mohammadi, Somayeh

doi:10.18502/ijps.v14i2.990

Cited by 9 publications

(15 citation statements)

References 37 publications

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“…This is in line with earlier reports of lower prefrontal cortex glucose metabolism [ 12 ] and lower connectivity between the prefrontal cortex and amygdala [ 13 ] in BPD compared to BD. The lower prefrontal cortex activity in patients with BPD may be linked to poorer response inhibition, planning [ 50 ], decision-making [ 51 ] and psychosocial functioning [ 52 ] in these patients compared to those with BD. Furthermore, frontotemporal oxy-haemoglobin changes measured with the fNIRS protocol used in this study has been previously shown to distinguish patients with major depression from both HCs and patients with BD or schizophrenia [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study

Husain

Tang²,

Tam

et al. 2021

BMC Psychiatry

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Background Functional near-infrared spectroscopy (fNIRS) is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task. It may be used to identify neurophysiological differences between psychiatric disorders with overlapping symptoms, such as bipolar disorder (BD) and borderline personality disorder (BPD). Hence, this preliminary study aimed to compare the cerebral haemodynamic function of healthy controls (HC), patients with BD and patients with BPD. Methods Twenty-seven participants (9 HCs, 9 patients with BD and 9 patients with BPD) matched for age, gender, ethnicity and education were recruited. Relative oxy-haemoglobin and deoxy-haemoglobin changes in the frontotemporal cortex was monitored with a 52-channel fNIRS system during a verbal fluency task (VFT). VFT performance, clinical history and symptom severity were also noted. Results Compared to HCs, both patient groups had lower mean oxy-haemoglobin in the frontotemporal cortex during the VFT. Moreover, mean oxy-haemoglobin in the left inferior frontal region is markedly lower in patients with BPD compared to patients with BD. Task performance, clinical history and symptom severity were not associated with mean oxy-haemoglobin levels. Conclusions Prefrontal cortex activity is disrupted in patients with BD and BPD, but it is more extensive in BPD. These results provide further neurophysiological evidence for the separation of BPD from the bipolar spectrum. fNIRS could be a potential tool for assessing the frontal lobe function of patients who present with symptoms that are common to BD and BPD.

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Section: Discussionmentioning

confidence: 99%

Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study

Husain

Tang²,

Tam

et al. 2021

BMC Psychiatry

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“…The quality assessment for included studies is presented in Supplementary Table S1 . Overall summary scores ranged from 0.55 [ 52 , 56 ] to 0.95 [ 3 , 37 ]. Thirty-three percent of studies scored between 0.85 and 1.0, 56% between 0.70 and 0.84, and 10% between 0.55 and 0.69.…”

Section: Resultsmentioning

confidence: 99%

Impulsivity in Bipolar Disorder: State or Trait?

et al. 2022

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Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.

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“…Akbari et al ( 40 ) found that euthymic patients with BD-II and BPD had a poorer performance than HC in most neurocognitive domains, specifically in cognitive flexibility and set-shifting, decision-making, sustained and selective attention and problem-solving. In addition, BPD patients had more elevated response inhibition deficits than BD-II patients, which may contribute to greater impulsivity and poor affect regulation.…”

Section: Resultsmentioning

confidence: 99%

“…Discrepancies were resolved by two independent researchers, IG and AVG. 147 full-text articles were assessed for eligibility and a total of 28 studies published since 1980 met the inclusion and exclusion criteria: 19 focused on assessing clinical features (19,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), six evaluated neuropsychological functioning (40)(41)(42)(43)(44)(45) and three assessed similarities and differences in neuroimaging aspects (46)(47)(48). The study selection process can be seen in Figure 1.…”

Section: Eligibility Of Studiesmentioning

confidence: 99%

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Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies

et al. 2021

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Background: Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) have clinically been evolving as separate disorders, though there is still debate on the nosological valence of both conditions, their interaction in terms of co-morbidity or disorder spectrum and their distinct pathophysiology.Objective: The objective of this review is to summarize evidence regarding clinical features, neuropsychological performance and neuroimaging findings from cross-diagnostic studies comparing BD and BPD, to further caracterize their complex interplay.Methods: Using PubMed, PsycINFO and TripDataBase, we conducted a systematic literature search based on PRISMA guidelines of studies published from January 1980 to September 2019 which directly compared BD and BPD.Results: A total of 28 studies comparing BD and BPD were included: 19 compared clinical features, 6 neuropsychological performance and three neuroimaging abnormalities. Depressive symptoms have an earlier onset in BPD than BD. BD patients present more mixed or manic symptoms, with BD-I differing from BPD in manic phases. BPD patients show more negative attitudes toward others and self, more conflictive interpersonal relationships, and more maladaptive regulation strategies in affective instability with separate pathways. Impulsivity seems more a trait in BPD rather than a state as in BD. Otherwise, BD and BPD overlap in depressive and anxious symptoms, dysphoria, various abnormal temperamental traits, suicidal ideation, and childhood trauma. Both disorders differ and share deficits in neuropsychological and neuroimaging findings.Conclusion: Clinical data provide evidence of overlapping features in both disorders, with most of those shared symptoms being more persistent and intense in BPD. Thus, categorical classifications should be compared to dimensional approaches in transdiagnostic studies investigating BPD features in BD regarding their respective explanatory power for individual trajectories.Systematic Review Registration: The search strategy was pre-registered in PROSPERO: CRD42018100268.

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Comparing Neurocognitive Profile of Patients with Borderline Personality and Bipolar–II Disorders

Cited by 9 publications

References 37 publications

Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study

Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study

Impulsivity in Bipolar Disorder: State or Trait?

Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies

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