Common and distinct patterns of gray matter alterations in young adults with borderline personality disorder and major depressive disorder

Young adults with borderline personality disorder (BPD) and major depressive disorder (MDD) have a relatively high comorbidity rate; however, whether they share a neurobiological basis remains controversial. Although previous studies have reported respective brain alterations, the common and distinct gray matter changes between two disorders are still inconsistent. We conducted a meta-analysis using anisotropic effect size-based algorithms (ASE-SDM) to identify consistent findings from whole-brain voxel-based morphometry (VBM) studies of gray matter volume (GMV) in 274 young adults (< 45 years old) with BPD and 1576 with MDD. Compared with healthy controls, the young adults with BPD showed GMV reduction mainly in the prefrontal cortex including the inferior frontal gyrus and superior frontal gyrus, medial temporal network, and insula, whereas the MDD showed GMV alteration in the visual network (fusiform gyrus and inferior temporal gyrus), sensorimotor network (bilateral postcentral gyrus (PoCG) and right cerebellum) and left caudate nucleus. The GMV differences between these two disorders were concentrated in the left orbitofrontal cortex, cingulate cortex, right insula, and cerebellum. The meta-regression of the MDD group showed a negative association between disease duration and the right middle cingulate gyrus as well as negative associations between depressive symptoms and brain regions of the right cerebellum and the left PoCG. Our results identified common and distinct patterns of GMV alteration between BPD and MDD, which may provide neuroimage evidence for the disorder comorbidity mechanisms and partly indicate the similar and different biological features in emotion regulation of the two disorders. This study was registered with PROSPERO (CRD42020212758).

Automated summary

A meta-analysis was conducted to explore the common and distinct gray matter volume (GMV) alterations in young adults with borderline personality disorder (BPD) and major depressive disorder (MDD). Results showed that BPD was associated with GMV reduction in the prefrontal cortex, medial temporal network, and insula, while MDD was associated with GMV alteration in the visual and sensorimotor networks. Differences in GMV between the two disorders were observed in the orbitofrontal cortex, cingulate cortex, insula, and cerebellum.