Converging Medial Frontal Resting State and Diffusion-Based Abnormalities in Borderline Personality Disorder
Converging Medial Frontal Resting State and Diffusion-Based Abnormalities in Borderline Personality Disorder
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DOI：
10.1016/j.biopsych.2014.08.026
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发表时间：
2016-01-15
影响因子：
10.6
通讯作者：
Pomarol-Clotet, Edith
中科院分区：
文献类型：
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作者：
Salvador, Raymond;Vega, Daniel;Pomarol-Clotet, Edith
背景技术背景：边缘型人格障碍（BPD）患者的心理特征，以冲动和情绪失调为核心症状，引导了对特定大脑区域（如大脑皮层-杏仁核复合体和前内侧皮层）异常的研究。然而，全脑成像研究到目前为止已经提供了高度异质性的结果，涉及不同的大脑locations.METHODS：功能静息状态和扩散磁共振成像数据采集BPD患者和在相同数量的匹配对照组（n = 60休息和n = 43扩散）。虽然平均扩散率和各向异性分数脑图像是从扩散数据生成的，但低频波动幅度和全局脑连接图像首次用于评估静息功能采集的BPD相关脑异常。使用p = 0.05校正阈值的全脑分析显示，BPD患者的膝和膝周结构的改变集中，额叶白色物质部分各向异性异常部分环绕平均扩散率和整体脑连通性增加的区域。此外，还发现了一组低频波动幅度增大（高静息活动），涉及左侧海马和杏仁核的一部分。反过来，这一集群表现出增加休息功能连接与前扣带回。结论：与多模式的方法，而不使用先验选定的区域，我们证明，结构和功能异常BPD涉及颞叶边缘和frontomedial结构，以及它们的连接。这些结构以前与BPD患者的行为和临床症状有关。
BACKGROUND: The psychological profile of patients with borderline personality disorder (BPD), with impulsivity and emotional dysregulation as core symptoms, has guided the search for abnormalities in specific brain areas such as the hippocampal-amygdala complex and the frontomedial cortex. However, whole-brain imaging studies so far have delivered highly heterogeneous results involving different brain locations.METHODS: Functional resting-state and diffusion magnetic resonance imaging data were acquired in patients with BPD and in an equal number of matched control subjects (n = 60 for resting and n = 43 for diffusion). While mean diffusivity and fractional anisotropy brain images were generated from diffusion data, amplitude of low-frequency fluctuations and global brain connectivity images were used for the first time to evaluate BPD-related brain abnormalities from resting functional acquisitions.RESULTS: Whole-brain analyses using a p = .05 corrected threshold showed a convergence of alterations in BPD patients in genual and perigenual structures, with frontal white matter fractional anisotropy abnormalities partially encircling areas of increased mean diffusivity and global brain connectivity. Additionally, a cluster of enlarged amplitude of low-frequency fluctuations (high resting activity) was found involving part of the left hippocampus and amygdala. In turn, this cluster showed increased resting functional connectivity with the anterior cingulate.CONCLUSIONS: With a multimodal approach and without using a priori selected regions, we prove that structural and functional abnormality in BPD involves both temporolimbic and frontomedial structures as well as their connectivity. These structures have been previously related to behavioral and clinical symptoms in patients with BPD.