Transdiagnostic and Disorder-Specific Neural Correlates of Emotion Processing in Major Depressive Disorder and Borderline Personality Disorder: Coordinate-Based and Image-Based Comparative Meta-Analyses.

Background: Major depressive disorder (MDD) and borderline personality disorder (BPD) involve substantial impairments in negative and positive emotion processing. This meta-analysis aims to identify both transdiagnostic and disorder-specific neural abnormalities during the processing of negative and positive stimuli for MDD and BPD.

Methods: The current coordinate-based and image-based meta-analyses comprised 42 functional magnetic resonance imaging studies involving MDD (42 negative studies vs. 22 positive studies; 1532 patients with MDD vs. 1481 healthy controls) and 25 involving BPD (23 negative studies vs. 7 positive studies; 522 patients with BPD vs. 519 healthy controls).

Results: Compared with healthy controls, patients with MDD exhibited hyporeactivity in the left precentral gyrus during negative emotion processing and decreased activation in left temporal lobe, insula, and bilateral anterior cingulate cortex during positive emotion processing, while patients with BPD displayed hyperreactivity in the left hippocampus and amygdala and hyporeactivity in the right inferior frontal gyrus during negative emotion processing. Compared with BPD, patients with MDD exhibited greater hyporeactivity in the bilateral anterior cingulate cortex during negative emotion processing and in the left middle temporal gyrus during positive emotion processing. The transdiagnostic hyporeactivity of BPD and MDD was mainly located in the left inferior and right middle frontal gyrus during negative emotion processing.

Conclusions: Our findings highlight both distinct and transdiagnostic neural mechanisms of emotion processing in MDD and BPD.