Structural Alterations in the Corpus Callosum Are Associated with Suicidal Behavior in Women with Borderline Personality Disorder.

Alexander Lischke,Martin Lotze,Hans J Grabe,Harald J Freyberger,Martin Domin,Renate Mentel,Dorothee Bernheim

doi:10.3389/fnhum.2017.00196

Abstract

Structural alterations in the corpus callosum (CC), the major white matter tract connecting functionally related brain regions in the two hemispheres, have been shown to be associated with emotional instability, impulsivity and suicidality in various mental disorders. To explore whether structural alterations of the CC would be similarly associated with emotional instability, impulsivity and suicidality in borderline personality disorder (BPD), we used diffusion tensor imaging (DTI) to assess the structural integrity of the CC in 21 BPD and 20 healthy control (HC) participants. Our hypothesis-driven analyses revealed a positive correlation between BPD participants’ suicidal behavior and fractional anisotropy (FA) in the splenium and genu of the CC and a negative correlation between BPD participants’ suicidal behavior and mean diffusivity (MD) in the splenium of CC. Our exploratory analyses suggested that suicidal BPD participants showed less FA and more MD in these regions than HC participants but that non-suicidal BPD participants showed similar FA and MD in these regions as HC participants. Taken together, our findings suggest an association between BPD participants’ suicidal behavior and structural alterations in regions of the CC that are connected with brain regions implicated in emotion regulation and impulse control. Structural alterations of the CC may, thus, account for deficits in emotion regulation and impulse control that lead to suicidal behavior in BPD. However, these findings should be considered as preliminary until replicated and extended in future studies that comprise larger samples of suicidal and non-suicidal BPD participants.

Highlights

The corpus callosum (CC) is the largest white matter tract in the human brain, connecting functionally related brain regions in the two hemispheres (Gazzaniga, 2000)
We used diffusion tensor imaging (DTI) to investigate the structural integrity of the CC, the major white matter tract connecting functionally related brain regions in the two hemispheres (Gazzaniga, 2000), in Borderline personality disorder (BPD)
As BPD is characterized by marked deficits in emotion regulation and impulse control, which often lead to suicidal behavior (Yen et al, 2004; Boisseau et al, 2013), we expected to find similar associations in BPD but not in healthy control (HC) participants

Summary

Introduction

The corpus callosum (CC) is the largest white matter tract in the human brain, connecting functionally related brain regions in the two hemispheres (Gazzaniga, 2000). Impaired inter-hemispheric communication has, been found to be related to cognitive, emotional and behavioral disturbances, including severe ones, like, for example, suicidal behavior (Amen et al, 2009; Matsuo et al, 2010; Cyprien et al, 2011). It is, not surprising that structural alterations of the CC are quite prevalent among mental disorders that are characterized by marked deficits in emotion regulation and impulse control, such as bipolar disorder (BD; Brambilla et al, 2003; Emsell et al, 2013) or attention-deficit/hyperactivity disorder (ADHD; Luders et al, 2009; Dramsdahl et al, 2012). Recent studies investigating microscopic alterations of CC, found structural differences between BPD and HC participants (Carrasco et al, 2012; Gan et al, 2016)

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Conclusion