Abstract
Objective
The relationship between borderline personality disorder (BPD) and bipolar II disorder (BIP‐II) is disputed but understudied. Here, we investigated brain glucose metabolism in these patient groups and healthy control subjects (HCs).
Methods
Sixty‐five subjects, 22 BPD (19 females); 22 BIP‐II (17 females); 21 HC (14 females) were examined using 2‐deoxy‐2[18F]‐fluoro‐d‐glucose Positron‐Emission Tomography (PET) scanning. Only patients without reciprocal comorbidity were recruited; BPD participants without bipolar spectrum pathology; BIP‐II participants without cluster A/B personality pathology. Groups were compared pairwise. Associations with mood state and childhood trauma were analyzed.
Results
Both patient groups exhibited hypometabolism compared with HCs in insula, brainstem and frontal white matter. Additionally, BPD patients showed hypometabolism in hypothalamus, midbrain and striatum; and BIP‐II patients in cerebellum. Uncorrected analyses showed cortical areas of higher metabolism in BIP‐II than BPD, and associations with clinical variables differed between the groups.
Conclusion
Reduced metabolism in the insula regions were shown in both disorders, suggesting shared pathophysiological mechanisms. The observed patterns of altered metabolism specific to each patient group, as well as the uncorrected results, may also suggest differential pathophysiology. However, these latter findings must be interpreted cautiously given the non‐significant corrected results in the direct comparison between the disorders.
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