Abstract
BackgroundFunctional near-infrared spectroscopy (fNIRS) is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task. It may be used to identify neurophysiological differences between psychiatric disorders with overlapping symptoms, such as bipolar disorder (BD) and borderline personality disorder (BPD). Hence, this preliminary study aimed to compare the cerebral haemodynamic function of healthy controls (HC), patients with BD and patients with BPD.MethodsTwenty-seven participants (9 HCs, 9 patients with BD and 9 patients with BPD) matched for age, gender, ethnicity and education were recruited. Relative oxy-haemoglobin and deoxy-haemoglobin changes in the frontotemporal cortex was monitored with a 52-channel fNIRS system during a verbal fluency task (VFT). VFT performance, clinical history and symptom severity were also noted.ResultsCompared to HCs, both patient groups had lower mean oxy-haemoglobin in the frontotemporal cortex during the VFT. Moreover, mean oxy-haemoglobin in the left inferior frontal region is markedly lower in patients with BPD compared to patients with BD. Task performance, clinical history and symptom severity were not associated with mean oxy-haemoglobin levels.ConclusionsPrefrontal cortex activity is disrupted in patients with BD and BPD, but it is more extensive in BPD. These results provide further neurophysiological evidence for the separation of BPD from the bipolar spectrum. fNIRS could be a potential tool for assessing the frontal lobe function of patients who present with symptoms that are common to BD and BPD.
Highlights
Functional near-infrared spectroscopy is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task
bipolar disorder (BD) and borderline personality disorder (BPD) may not exist on a spectrum [6], and this hypothesis may be substantiated with objective and quantitative biomarkers, such as those obtained with neuroimaging techniques
healthy controls (HC) had higher global assessment of functioning (GAF) scores (F = 21, p ≤ 0.001) and lower Hamilton rating scale for depression (HAM-D) scores (F = 16.7, p ≤ 0.001) than patients with BD [GAF: p ≤ 0.001, 95% CI, (9.5 to 35); HAM-D: p = 0.006, 95% CI, (2.2 to 14.5)] and patients with BPD [GAF: p ≤ 0.001, 95% CI, (18.4 to 43.9); HAM-D: p ≤ 0.001, 95% CI, (7.3 to 19.2)], but patient groups did not differ in GAF or HAM-D scores
Summary
Functional near-infrared spectroscopy (fNIRS) is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task. It may be used to identify neurophysiological differences between psychiatric disorders with overlapping symptoms, such as bipolar disorder (BD) and borderline personality disorder (BPD) This preliminary study aimed to compare the cerebral haemodynamic function of healthy controls (HC), patients with BD and patients with BPD. Borderline personality disorder (BPD) is another chronic and serious psychiatric disorder characterised by a pervasive pattern of unstable emotional regulation, interpersonal relationships, selfimage and impulse control [1]. Despite this criteria, the boundary between BD and BPD is debatable, as it can be difficult to diagnose patients who present with both affective instability and impulsivity [2]. BD and BPD may not exist on a spectrum [6], and this hypothesis may be substantiated with objective and quantitative biomarkers, such as those obtained with neuroimaging techniques
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