Peripheral inflammation is associated with emotional dysregulation, suicide attempts, and reduced microstructural integrity of white matter in young adults with borderline personality disorder.

Résumé

BACKGROUND: Borderline personality disorder (BPD) is a psychiatric condition characterized by functional impairment and high rates of suicide attempts. Although its pathophysiology is still unclear, emerging evidence suggests a role of peripheral inflammation. This study investigates the association between peripheral inflammatory markers and clinical, behavioural, and neuroimaging features in individuals with BPD.METHODS: Seventy-nine BPD patients and 26 controls underwent a multidimensional clinical evaluation, including emotional dysregulation and suicide attempt assessment, and blood sampling for serum cytokine profiling. All the participants received 3 T diffusion-weighted MRI to assess white-matter microstructural integrity. A composite inflammatory index was computed from cytokines' levels and white-matter microstructural integrity was examined in networks relevant to BPD, with a focus on the salience network (SN).RESULTS: BPD patients showed a significantly elevated inflammatory index (z-score, p = 0.035) primarily driven by increased GM-CSF serum levels (p  0.26, p