Amygdala Resting State Connectivity Differences between Bipolar II and Borderline Personality Disorders.
Amygdala Resting State Connectivity Differences between Bipolar II and Borderline Personality Disorders.
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DOI：
10.1159/000502440
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发表时间：
2019
影响因子：
3.2
通讯作者：
Gruber SA
中科院分区：
文献类型：
--
作者：
Reich DB;Belleau EL;Temes CM;Gonenc A;Pizzagalli DA;Gruber SA
边缘性人格障碍 (BPD) 和 II 型双相情感障碍 (BD II) 具有显着的临床重叠，可能导致诊断不准确和治疗建议不充分。然而，很少有研究探讨这两种疾病之间的临床和神经生物学差异。在临床上，一些先前的研究已将 BPD 与比 BD II 更大的冲动性和更频繁的负面情感转变联系起来，而先前的神经影像学研究强调了 BPD 和 BD II 中相似和不同的神经异常。值得注意的是，之前没有研究专门针对皮质边缘神经差异，而这些差异被认为是这些核心临床差异的基础。 BPD (n = 14) 和 BD II (n = 15) 患者完成了各种临床测量和 3T 的 RSFC 扫描。比较两组之间的全脑杏仁核静息态功能连接（RSFC）。相对于 BD II 组，BPD 参与者的冲动性、特质焦虑、更频繁的负面情感转变、更大的人际反应性情感不稳定、整体功能较低，并以杏仁核-额中回 RSFC 较低为特征。下杏仁核 - 额中回 RSFC 与更大的冲动、特质焦虑、情感转变、人际情感反应和功能障碍相关。目前的研究样本量较小，且缺乏对照组。这项初步研究表明杏仁核额叶 RSFC 可以区分 BPD 和 BD II。这些结果可能会指导未来旨在识别神经标记物的工作，这些标记物可以帮助解开这两种疾病，从而提高诊断准确性和适当的治疗实施。
Borderline personality disorder (BPD) and Bipolar II Disorder (BD II) have significant clinical overlap, leaving the potential for diagnostic inaccuracies and inadequate treatment recommendations. However, few studies have probed for clinical and neurobiological differences between the two disorders. Clinically, some prior studies have linked BPD with greater impulsivity and more frequent negative affective shifts than BD II, whereas previous neuroimaging studies have highlighted both similar and distinct neural abnormalities in BPD and BD II. Notably, no prior study has specifically targeted cortico-limbic neural differences, which have been hypothesized to underlie these core clinical differences. Individuals with BPD (n = 14) and BD II (n = 15) completed various clinical measures and a RSFC scan at 3T. Whole-brain amygdala resting state functional connectivity (RSFC) were compared between the two groups. Relative to the BD II group, BPD participants reported significantly higher levels of impulsivity, trait anxiety, more frequent negative affective shifts, greater interpersonally reactive affective instability, lower overall functioning, and were characterized by lower amygdala-middle frontal gyrus RSFC. Lower amygdala –middle frontal gyrus RSFC was associated with greater impulsivity, trait anxiety, affective shifts, interpersonal affective reactivity, and functional impairment. The current study consisted of small sample sizes and lacked a control group. This preliminary study suggests that amygdala-frontal RSFC may distinguish BPD from BD II. These results may guide future work aimed at identifying neural markers that can help disentangle these two disorders, leading to greater diagnostic accuracy and appropriate treatment implementation.
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