Mesiotemporal Volume Loss Associated with Disorder Severity: A VBM Study in Borderline Personality Disorder

Abstract

Results of MRI volumetry in Borderline Personality Disorder (BPD) are inconsistent. Some, but not all, studies reported decreased hippocampus, amygdala, and/or prefrontal volumes. In the current study, we used rater-independent voxel-based morphometry (VBM) in 33 female BPD patients and 33 healthy women. We measured gray matter (GM) volumes of the whole brain and of three volumes of interest (VOI), i.e., the hippocampus/parahippocampal gyrus, the amygdala and the anterior cingulate gyrus (ACC). Analyses were conducted using lifetime diagnoses of posttraumatic stress disorder (PTSD) and major depression (MD) as covariates. We used adversive childhood experiences and the numbers of BPD criteria (as an indicator of disorder severity) to investigate associations with GM volumes. We did not find volume differences between BPD patients and healthy subject, neither of the whole brain nor of the three VOIs, independent of presence or absence of comorbid PTSD and MD. We also did not find a relationship between childhood maltreatment and the patients’ brain volumes. However, within the patient group, the number of BPD criteria fulfilled was inversely correlated with left hippocampal/parahippocampal volume (x=-32, y=-23, z=-18, k=496, t=5.08, p=.007). Consequently, mesiotemporal GM volumes do not seem to differentiate patients from healthy subjects, but might be associated with symptom severity within the BPD group.

Specificity of abnormal brain volume in major depressive disorder: A comparison with borderline personality disorder

“…However, compared to MDD, research explicitly investigating ACC volumes in BPD is relatively scarce and with less consistent findings. While some studies have reported ACC volume reduction in BPD compared to HC (Tebartz van Elst et al, 2003;Hazlett et al, 2005;Minzenberg et al, 2008;Soloff et al, 2008;Whittle et al, 2009;Niedtfeld et al, 2013), and while one study even demonstrated an association between reduction of ACC GMV and severity of BPD symptoms (Niedtfeld et al, 2013), other investigations could not confirm abnormal volume of the ACC in BPD compared to HC (Kuhlmann et al, 2013, Labudda et al, 2013O'Neill et al, 2013). Currently available meta-analyses of structural MRI investigations in BPD have restricted their focus to specific regions of interest such as amygdala and hippocampus but have not included the ACC (Nunes et al, 2009;Hall et al, 2010;Ruocco et al, 2012).…”

Cortisol and IL-6 Responses to Stress in Female Children Presenting at a Sexual Abuse Clinic

“…At the time of the present study, girls were the predominant patient group at the Teddy Bear Clinic. Moreover, the development of long-term psychopathological sequelae following childhood sexual abuse has been noted to be increased in adult female patients (Labudda et al 2013;Young and Korszun 2010).…”

“…Early life stress may have a priming effect on the HPA axis resulting in a lifelong imbalance in stress modulation (Juruena 2013). Additionally, early life stress and HPA axis dysfunction have been associated with decreased hippocampal volumes (Labudda et al 2013). In female patients, greater severity of BPD is associated with decreased volumes in the left hippocampus and the parahippocampal area (Labudda et al 2013).…”

“…Additionally, early life stress and HPA axis dysfunction have been associated with decreased hippocampal volumes (Labudda et al 2013). In female patients, greater severity of BPD is associated with decreased volumes in the left hippocampus and the parahippocampal area (Labudda et al 2013). Thus, there is a growing need to determine possible biomarkers at the first presentation of early life stress related to sexual abuse (Ayer et al 2013).…”

Brain structural anomalies in borderline and avoidant personality disorder patients and their associations with disorder-specific symptoms

“…In ACC, several studies have indicated that BPD patients show reduced volumes relative to healthy controls (Goodman et al, 2011; Hazlett et al, 2005; Minzenberg et al, 2008; Niedtfeld et al, 2013; Soloff et al, 2008), including one study where greater ACC volume in BPD patients predicted less BPD symptom severity (Niedtfeld et al, 2013). However, other recent reports have specifically examined volumetric differences in ACC and have not found evidence for a difference between BPD patients and healthy controls (Depping et al, 2015; Kuhlmann et al, 2013; Labudda et al, 2013). Thus, similar to amygdala, studies examining structural abnormalities in MPFC, DLPFC, and ACC in BPD relative to healthy controls have reached varying conclusions.…”