Studies of neurobiological mechanisms in borderline personality disorder (BPD) have increased our understanding of the pathophysiology of its development and course. Less is known about how psychotherapy may influence these neurobiological factors, and also whether biomarkers may predict psychotherapy outcomes. We conducted a systematic review using PRISMA guidelines. Fourteen studies providing data from 467 participants diagnosed with BPD met inclusion criteria to: (a) investigate biomarkers predicting response to psychotherapy for BPD; or (b) examine neurobiological factors altered by psychotherapy. Neuroimaging studies (n = 11) used mostly functional magnetic resonance imaging methods to scope brain regions related to emotion regulation and cognitive control. Three studies examined genetic or neuroendocrine markers. The evidence suggests that psychotherapy alters neural activation and connectivity of regions subserving executive control and emotion regulation. Additionally, hypoactivation in prefrontal and cingulate regions predicted treatment response. Further work in this area may inform personalised treatment approaches in clinical practice for BPD through elucidating neural mechanisms of evidence-based psychotherapy.

对边缘性人格障碍（BPD）的神经生物学机制的研究增加了我们对其发展和过程的病理生理学的了解。心理疗法如何影响这些神经生物学因素，以及生物标志物是否可以预测心理疗法的结果，人们所知甚少。我们使用PRISMA指南进行了系统的审查。提供来自467位被诊断为BPD的参与者的数据的十四项研究符合纳入标准，以：（a）研究预测对BPD心理疗法反应的生物标志物；或（b）检查心理治疗改变的神经生物学因素。神经影像学研究（ñ = 11）主要使用功能性磁共振成像方法来确定与情绪调节和认知控制有关的大脑区域。三项研究检查了遗传或神经内分泌标志物。有证据表明，心理治疗会改变神经激活和维持执行控制和情绪调节的区域的连通性。此外，前额叶和扣带状区域的过度激活可预测治疗反应。通过阐明循证心理治疗的神经机制，该领域的进一步工作可能会为BPD临床实践中的个性化治疗方法提供信息。