Reduced cortical and subcortical volumes in female adolescents with borderline personality disorder

Richter, Júlia; Brunner, Romuald; Parzer, Peter; Resch, Franz; Stieltjes, Bram; Henze, Romy

doi:10.1016/j.pscychresns.2014.01.006

Cited by 28 publications

(26 citation statements)

References 53 publications

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“…Furthermore, one study reported no differences in the volume of the amygdala or hippocampus in adolescent BPD [80], while, in contrast, Richter and colleagues [83] reported reduced volumes in these structures, congruent with findings in the adult literature. A recent study also reported an association between atypical hippocampal asymmetry and BPD features in interaction with temperamental features [84].…”

Section: Structural Imaging and Spectroscopysupporting

confidence: 54%

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

Fonagy

Speranza

Luyten

et al. 2015

Eur Child Adolesc Psychiatry

131

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Borderline personality disorder (BPD) has onset in adolescence, but is typically first diagnosed in young adulthood. This paper provides a narrative review of the current evidence on diagnosis, comorbidity, phenomenology and treatment of BPD in adolescence. Instruments available for diagnosis are reviewed and their strengths and limitations discussed. Having confirmed the robustness of the diagnosis and the potential for its reliable clinical assessment, we then explore current understandings of the mechanisms of the disorder and focus on neurobiological underpinnings and research on psychological mechanisms. Findings are accumulating to suggest that adolescent BPD has an underpinning biology that is similar in some ways to adult BPD but differs in some critical features. Evidence for interventions focuses on psychological therapies. Several encouraging research studies suggest that early effective treatment is possible. Treatment development has just begun, and while adolescent-specific interventions are still in the process of evolution, most existing therapies represent adaptations of adult models to this developmental phase. There is also a significant opportunity for prevention, albeit there are few data to date to support such initiatives. This review emphasizes that there can be no justification for failing to make an early diagnosis of this enduring and pervasive problem.

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Section: Structural Imaging and Spectroscopysupporting

confidence: 54%

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

Fonagy

Speranza

Luyten

et al. 2015

Eur Child Adolesc Psychiatry

131

View full text Add to dashboard Cite

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“…The mutual relationship between 14 these changes is not clear as structural changes can result in functional changes and viceversa. Some evidence suggests that structural changes are already present in patients with BPD in limbic but not in cortical regions during adolescence (Richter et al, 2014). The paucity of studies, small sample sizes, and gender imbalance limit the extent of these results.…”

Section: Discussionmentioning

confidence: 99%

Mapping the brain correlates of borderline personality disorder: A functional neuroimaging meta-analysis of resting state studies

Visintin

Panfilis

Amore

et al. 2016

Journal of Affective Disorders

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To investigate the neural activity at rest in BPD, we conducted a set of meta-analyses of brain imaging studies performed at rest. A total of seven functional imaging studies (152 patients with BPD and 147 control subjects) were combined using whole-brain Signed Differential Mapping meta-analyses. Furthermore, two conjunction meta-analyses of neural activity at rest were also performed: with neural activity changes during emotional processing and with structural differences, respectively. We found altered neural activity in the regions of the default mode network (DMN) in BPD. Within the regions of the core DMN, patients with BPD showed greater activity in the anterior as well as in the posterior midline hubs relative to controls. Conversely, in the regions of the dorsal DMN they showed reduced activity compared to controls in the right lateral temporal complex and in bilateral orbitofrontal cortex. Increased activity in the precuneus was observed both at rest and during emotional processing. Reduced neural activity at rest in lateral temporal complex was associated with smaller volume of this area.Altered activity in the regions of the midline core as well as of the dorsal subsystem of the DMN may reflect difficulties with interpersonal and affective regulation in BPD. These findings suggest that changes in spontaneous neural activity could underlie core symptoms in BPD.

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“…Only recently were differences in the hippocampus bilaterally and the right amygdala found in adolescents with BPD as compared with a clinical group and a healthy control group using a very sensitive method to assess subcortical structures (30). However, these differences were not specific for BPD.…”

Section: Volumetric and Morphometric Studiesmentioning

confidence: 99%

“…However, these differences were not specific for BPD. Investigating whether adolescents with BPD had alterations in cortical thickness-which together with the cortical surface area determines the volume of gray matter (31,32)-did not reveal any differences in the BPD group as compared with a clinical group and a healthy control group (30). Structural brain differences have also been found to be associated with childhood maltreatment (33).…”

Section: Volumetric and Morphometric Studiesmentioning

confidence: 99%

Neurobiological Findings in Youth with Borderline Personality Disorder

Brunner

Henze

Richter

et al. 2014

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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This review summarizes recent neurobiological research into youth with borderline personality disorder (BPD) to better delineate the biological factors involved in the development of this disorder. Psychobiological studies when BPD first becomes manifest are of particular interest, because there are fewer confounding factors (e.g., duration of illness, drug abuse, medication, other therapeutic interventions) at this time. This article focuses on recent findings in the field of neuroimaging, neuropsychology, neuroendocrinology, genetics, and pain perception, and it aims to integrate these findings in a developmental psychopathology model of BPD. In studies of clinical samples of adults with BPD, structural imaging studies revealed abnormalities predominantly in the frontolimbic areas. Disturbances in emotional information processingparticularly involving negative stimuli-may mediate affective dysregulation as a core feature of BPD. Genetic studies could reveal that the stability of BPD traits in youth is largely influenced by a combination of genetic and non-shared environmental factors. Hyporesponsiveness to a laboratory stressor indicates an enduring alteration of the hypothalamicpituitary-adrenal axis. Findings of a higher pain threshold indicate that pain processing is already disturbed during the early stages of BPD, which could contribute to the initiation or maintenance of self-injurious behavior. All biological factors, together with environmental risk factors, may contribute to the core symptoms of BPD: severe emotional and behavioral dysregulation. Further research should investigate the development of BPD in youth by using longitudinal designs to determine whether the neurobiological factors are a cause, an effect, or an epiphenomenon of BPD.

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Reduced cortical and subcortical volumes in female adolescents with borderline personality disorder

Cited by 28 publications

References 53 publications

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

Mapping the brain correlates of borderline personality disorder: A functional neuroimaging meta-analysis of resting state studies

Neurobiological Findings in Youth with Borderline Personality Disorder

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