State-Dependent Cross-Brain Information Flow in Borderline Personality Disorder
State-Dependent Cross-Brain Information Flow in Borderline Personality Disorder
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DOI：
10.1001/jamapsychiatry.2017.1682
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发表时间：
2017-09-01
期刊：
影响因子：
25.8
通讯作者：
Meyer-Lindenberg, Andreas
中科院分区：
文献类型：
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作者：
Bilek, Edda;Stoessel, Gabriela;Meyer-Lindenberg, Andreas
虽然边缘型人格障碍（BPD）是最常见的、负担最重的、代价最高的精神疾病之一，其特征是反复的人际冲突和不稳定的人际关系，但社会互动缺陷的神经生物学机制仍然知之甚少。和参与者从2012年5月25日到2015年12月4日，在大学环境中，在2个链接的功能磁共振成像扫描仪中研究了成对的参与者，检查了BPD中的跨脑信息流。参与者进行了一项联合注意力任务。每对包括健康对照个体（HC）和当前符合DSM-IV BPD标准的患者（cBPD）（n = 23）、缓解2年或更长时间的患者（rBPD）（n = 17）或第二HC（n = 20）。组进行了匹配的年龄和教育level.Main结果和measurements一个测量的跨脑神经coupingwas计算以下先前发表的工作，以表明右颞顶交界网络（以前显示主机神经耦合能力的健康）之间的同步流。这一措施是来自一个独立的成分分析对比的时间进程之间的真正相互作用的参与者与自举控制pairs.Results样本包括23名妇女与cBPD（平均[SD]年龄，26.8 [5.7]岁），17例rBPD女性（平均[SD]年龄，28.5 [4.3]岁）和80例HC（平均[SD]年龄，24.0 [3.4]岁]），发现神经耦合与障碍状态相关（eta（2）= 0.17; P = 0.007）：虽然HC-HC对显示出同步的神经反应，但cBPD-HC对表现出仅高于基于排列的数据水平的显著较低的神经耦合（eta（2）= 0.16; P = 0.009）。在rBPD-HC和HC-HC对中的神经耦合之间没有发现差异。患者的神经耦合与儿童期逆境显著相关（T = 2.3; P = 0.03）。结论和相关性本研究提供了BPD的核心诊断和临床特征的神经相关性。结果表明，hyperscanning可以提供临床社会神经科学的状态相关的生物标志物。此外，BPD的至少一些神经缺陷可能比目前假设的人格障碍更可逆。
IMPORTANCE Although borderline personality disorder (BPD)-one of the most common, burdensome, and costly psychiatric conditions-is characterized by repeated interpersonal conflict and instable relationships, the neurobiological mechanism of social interactive deficits remains poorly understood.OBJECTIVE To apply recent advancements in the investigation of 2-person human social interaction to investigate interaction difficulties among people with BPD.DESIGN, SETTING, AND PARTICIPANTS Cross-brain information flow in BPD was examined from May 25, 2012, to December 4, 2015, in pairs of participants studied in 2 linked functional magnetic resonance imaging scanners in a university setting. Participants performed a joint attention task. Each pair included a healthy control individual (HC) and either a patient currently fulfilling DSM-IV criteria for BPD (cBPD) (n = 23), a patient in remission for 2 years or more (rBPD) (n = 17), or a second HC (n = 20). Groups were matched for age and educational level.MAIN OUTCOMES AND MEASURES A measure of cross-brain neural couplingwas computed following previously published work to indicate synchronized flow between right temporoparietal junction networks (previously shown to host neural coupling abilities in health). This measure is derived from an independent component analysis contrasting the time courses of components between pairs of truly interacting participants compared with bootstrapped control pairs.RESULTS In the sample including 23 women with cBPD (mean [SD] age, 26.8 [5.7] years), 17 women with rBPD (mean [SD] age, 28.5 [4.3] years), and 80 HCs (mean [SD] age, 24.0 [3.4] years]) investigated as dyads, neural coupling was found to be associated with disorder state (eta(2) = 0.17; P = .007): while HC-HC pairs showed synchronized neural responses, cBPD-HC pairs exhibited significantly lower neural coupling just above permutation-based data levels (eta(2) = 0.16; P = .009). No difference was found between neural coupling in rBPD-HC and HC-HC pairs. The neural coupling in patients was significantly associated with childhood adversity (T = 2.3; P = .03).CONCLUSIONS AND RELEVANCE This study provides a neural correlate for a core diagnostic and clinical feature of BPD. Results indicate that hyperscanningmay deliver state-associated biomarkers for clinical social neuroscience. In addition, at least some neural deficits of BPD may be more reversible than is currently assumed for personality disorders.