Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis
Open accessAbstract
Background: Whether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency. Aims: To detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder. Method: Web-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds ( P < 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed. Results: Patients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder. Conclusions: Our results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum. Declaration of interest: None.
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The ongoing development of the prefrontal cortex, which is crucial for impulse control and emotional regulation, might make adolescents more vulnerable to the impulsive and unstable behaviors associated with BPD.
“Third, the ongoing development of the prefrontal cortex, which is crucial for impulse control and emotional regulation, might make adolescents more vulnerable to the impulsive and unstable behaviors associated with BPD (32, 33).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [33]
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References 84 · Cited by 65
- Authors
- Yu, H., Meng, Y.-J., Li, X.-J., Zhang, C., Liang, S., Li, M.-L., Li, Z., Guo, W., Wang, Q., Deng, W., Ma, X., Coid, J., & Li, T.
- Affiliations
- West China Medical Center of Sichuan University (CN)
- West China Hospital of Sichuan University (CN)
- Corresponding author
- Li, Tao
- ORCID
- Venue
- The British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2019-03-08
- Volume
- 215
- Issue
- 01
- Pages
- 395-403
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2922410969
- Cited by
- 65
- References
- 84
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 5 · 2023: 5 · 2022: 14 · 2021: 9 · 2020: 7 · 2019: 5
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (91332205, 81630030, 81601172, 81130024, 81461168029, 81501174)
- Sichuan University (ZY2016203, ZY2016103)
- National Key Research and Development Program of China (2016YFC0904300)
- West China Hospital, Sichuan University (ZY2016203, 1.3.5, ZY2016103)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- borderline personality disorder, bipolar disorder, gray matter volume, gray matter density, medial prefrontal cortex, amygdala, parahippocampal gyrus, insula, thalamus, putamen, mania
- MeSH terms
- Adult, Bipolar Disorder, Borderline Personality Disorder, Brain, Female, Humans, Magnetic Resonance Imaging, Male, Young Adult, Neuroimaging, Gray Matter
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