Abstract
Bipolar disorder (BD) and borderline personality disorder (BPD) share many behavioral features, such as periods of marked affective lability and instability. Although there is a symptomatic overlap, the two disorders may be differentiated based on longitudinal course, phenomenology, and treatment responsiveness. In addition, the emotional changes in BPD are generally influenced by interpersonal factors, whereas BD episodes tend to be more sustained. We performed a literature review on the structural MRI features of both disorders and compared the findings. There are differences in areas of white and gray matter volumes and thickness in BP and BPD. BPD primarily affects the fronto-limbic network, in particular, the amygdala, hippocampus, and orbitofrontal cortex, whereas BP affects both cortical and subcortical areas. There are a limited number of large studies, and many studies examined in this review did not adjust for confounding factors or motion artifacts, which limit the utility of current data.
Highlights
BackgroundEver since early studies demonstrated an association between ventriculomegaly and schizophrenia, neuroimaging has been seen as a potentially influential tool in diagnostic psychiatry [1]
Other studies examined in this review suggested that patients with borderline personality disorder (BPD) have decreased amygdala volumes compared to healthy controls, whereas amygdala volumes are normal in Bipolar disorder (BD) patients [17,18]
Imaging studies performed suggest that BD and BPD are unlikely to localize to abnormalities within single, discrete neuroanatomic structures
Summary
Ever since early studies demonstrated an association between ventriculomegaly and schizophrenia, neuroimaging has been seen as a potentially influential tool in diagnostic psychiatry [1]. That is, neuroimaging has the potential to assist a clinician in delving closer to the organic source of the psychopathology as opposed to using behavioral factors alone. Borderline personality disorder (BPD) is a complex mental disorder characterized by profound difficulties in regulating emotions, impulsivity, self-harming and suicidal behavior, interpersonal instability, and an intense fear of abandonment [3]. BPD has been heavily investigated with structural and functional MRI studies over the previous decades to detect possible organic changes underpinning the emotionally intense behavioral manifestations [4]. Bipolar disorder (BD) is a serious mental disorder characterized by episodic affective instability, with the disease course fluctuating between depression, mania, and hypomania [2].
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