Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis
Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis
复制标题
边缘性人格障碍和双相情感障碍灰质改变的常见和独特模式：基于体素的荟萃分析
DOI：
10.1192/bjp.2019.44
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Ya-jing Meng
中科院分区：
文献类型：
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作者：
Hua Yu;Ya-jing Meng
背景边缘型人格障碍（BPD）和双相情感障碍是相同还是不同的障碍缺乏一致性。目的探讨BPD与双相情感障碍患者脑灰质体积（GMV）和灰质密度（GMD）的变化是否存在相似性或差异。方法检索基于网络的出版物数据库，对所有比较BPD或双相情感障碍与健康对照的基于体素的研究进行荟萃分析。我们纳入了13项BPD研究（395例BPD患者和415例健康对照）和47项双相情感障碍研究（2111例双相情感障碍患者和3261例健康对照）。从具有显著组差异的聚类中提取峰坐标。对聚类的峰值坐标和阈值进行了Meta分析（P < 0.005，未校正）。连接分析确定的地区，在这些地区的疾病表现出共同的模式体积改变。并进行相关性分析。结果BPD患者双侧内侧前额叶皮层网络（mPFC）、双侧杏仁核和右侧海马旁回GMV和GMD降低;双相障碍患者双侧内侧眶额叶皮层（mOFC）、右侧丘脑和右侧丘脑GMV和GMD降低，右侧壳核GMV和GMD升高。多模态分析表明，两种疾病的右内侧眶额皮质簇体积较小。BPD患者的双侧mPFC降低部分由患者年龄介导。双相情感障碍患者右侧壳核GMV和GMD的增加与Young躁狂量表评分呈正相关。结论双相情感障碍患者的GMV和GMD改变模式不同，不支持双相情感障碍和BPD在同一情感谱上的假设。利益声明无。
Background Whether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency. Aims To detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder. Method Web-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P < 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed. Results Patients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder. Conclusions Our results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum. Declaration of interest None.