학술논문
Amygdala Resting State Connectivity Differences between Bipolar II and Borderline Personality Disorders.
Document Type
Academic Journal
Author
Reich DB; Laboratory for the Study of Adult Development, McLean Hospital, Belmont, Massachusetts, USA, dbreich@partners.org.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA, dbreich@partners.org.; Belleau EL; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA.; Temes CM; Laboratory for the Study of Adult Development, McLean Hospital, Belmont, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Gonenc A; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA.; Pizzagalli DA; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA.; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA.; Gruber SA; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA.
Source
Publisher: Karger Country of Publication: Switzerland NLM ID: 7512895 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0224 (Electronic) Linking ISSN: 0302282X NLM ISO Abbreviation: Neuropsychobiology Subsets: MEDLINE
Subject
Language
English
Abstract
Background: 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.
Methods: Individuals with BPD (n = 14) and BD II (n = 15) completed various clinical measures and a resting state functional imaging scan at 3T. Whole-brain amygdala resting state functional connectivity (RSFC) was compared between the two groups.
Results: 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.
Limitations: The current study consisted of small sample sizes and lacked a control group.
Conclusions: 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.
(© 2019 S. Karger AG, Basel.)
Methods: Individuals with BPD (n = 14) and BD II (n = 15) completed various clinical measures and a resting state functional imaging scan at 3T. Whole-brain amygdala resting state functional connectivity (RSFC) was compared between the two groups.
Results: 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.
Limitations: The current study consisted of small sample sizes and lacked a control group.
Conclusions: 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.
(© 2019 S. Karger AG, Basel.)