Characterizing brain structural and functional abnormalities in borderline personality disorder by seed-based d mapping approach.

Abstract

Borderline personality disorder (BPD) is a mental disorder characterized by extreme instability in mood, interpersonal relationships, self-image, and behavioral patterns. Its core symptoms include intense mood swings, strained interpersonal relationships, disturbed self-identity, impulsive behaviors, and cognitive and perceptual abnormalities. The etiology of BPD is complex, involving genetic, neurobiological, and psychosocial factors. Among neurobiological factors, neuroimaging studies have consistently reported inconsistent findings regarding amygdala volume in BPD patients-some MRI studies demonstrate a 15% increase, while others show a reduction. Such discrepancies may reflect the impact of heterogeneous patient populations, comorbidities, or differences in imaging protocols. Notably, structural and functional abnormalities in BPD are not limited to the amygdala but also involve multiple brain regions, including the prefrontal cortex, hippocampus, anterior cingulate cortex, and insula, which collectively contribute to impaired emotion regulation, interpersonal dysfunction, and other core symptoms. A systematic search was conducted on studies investigating brain neuroimaging differences between BPD patients and healthy controls (HC). Studies meeting the inclusion criteria were selected, and coordinate-based meta-analysis (CBMA) of brain structural and functional changes was performed using seed-based d mapping (SDM) software to explore potential abnormal brain structures and functions in BPD patients. After screening, a total of 26 studies were included. By integrating meta-analytic findings from four neuroimaging modalities-diffusion tensor imaging (DTI), structural magnetic resonance imaging (sMRI), functional magnetic resonance imaging (fMRI), and resting-state functional magnetic resonance imaging (rs-fMRI)-this study systematically summarized the characteristic changes in brain structure and function in BPD patients. Study results demonstrated that the neurobiological basis of BPD primarily involves structural and functional dysregulation of the frontolimbic system, particularly in brain regions linked to core mental functions like emotion regulation, self-cognition, and impulse control.