Localizing the structural and functional alteration networks associated with borderline personality disorder

Area of Science:

• Neuroscience
• Psychiatry
• Neuroimaging

Background:

• Neuroimaging studies show heterogeneous structural and functional alterations in borderline personality disorder (BPD).
• A network-level framework is emerging to explain the neural basis of BPD by converging distributed alterations.
• Understanding these networks is crucial for elucidating the pathophysiology of BPD.

Purpose of the Study:

• To integrate findings from numerous neuroimaging studies on BPD.
• To identify specific brain networks associated with BPD using a functional connectivity network mapping (FCNM) approach.
• To explore the relationship between identified BPD networks and neurotransmitter distributions.

Main Methods:

• Meta-analysis of 96 publications involving 2325 BPD patients and 2356 healthy controls.
• Integration of gray matter volume, task-activation, and resting-state activity data.
• Projection of alterations onto a functional connectome and correlation with 19 neurotransmitter maps.

Main Results:

• Three distinct networks were identified: gray matter volume alterations (somatomotor, subcortical), task-activation changes (ventral attention network), and resting-state alterations (default mode network).
• The structural network correlated with serotonin transporter distribution.
• The task-induced activation network showed associations with noradrenergic and cholinergic systems.

Conclusions:

• BPD may involve structural deficits in somatic-emotional integration.
• Functional dysregulation in salience detection and self-referential processing characterizes BPD.
• Identified brain networks and their relation to neurotransmitters provide a framework for understanding BPD inconsistencies.