Update on the Neurobiology of Borderline Personality Disorder: A Review of Structural, Resting-State and Task-Based Brain Imaging Studies.

Purpose of review: This review summarizes recent advances in research on the neurobiology of borderline personality disorder (BPD) according to structural brain imaging investigations and resting-state and task-based functional brain activation studies.

Recent findings: Extending established findings on differences in regional brain volumes and cortical thickness between BPD and healthy controls, recent research illuminates shared and distinct brain structural characteristics compared to other psychiatric diagnoses, and uncovers relations of these brain structures with transdiagnostic symptoms and clinical features. Resting-state functional brain imaging studies reveal disruptions among adolescents and adults with BPD in frontolimbic and default-mode networks, which primarily underlie affect regulation and self-referential processes, respectively. Recent task-based functional brain imaging research builds on existing neurobiological understanding of emotion and cognition in BPD by revealing novel intersections with interpersonal- and stress-related processes. Studies of psychological and pharmacological interventions suggest possible effects on neural regions underlying emotion processing and behavioral control. Recent advances in neurobiological research on BPD underscore the pathophysiology of affective, behavioral and self-interpersonal symptoms, with growing interest in adolescents with BPD and the impacts of psychological and biological interventions. Corresponding with the increased prominence of alternative dimensional models of personality disorder in recent years, there is a gradual rise in studies examining the relationships of brain structures and functional brain activation with BPD-relevant symptom dimensions, including within transdiagnostic samples.