Abstract
Patients with Borderline Personality Disorder (BPD) showed reduced volume of amygdala and hippocampus, but similar findings are evident in Posttraumatic Stress Disorder (PTSD). Applying voxel-based morphometry (VBM) in a larger cohort of patients with BPD, we sought to extend earlier findings of volume abnormalities in limbic regions and to evaluate the influence of co-occurring PTSD in BPD patients. We used voxel-based morphometry to study gray matter volume (GMV) in 60 healthy controls (HC) and 60 patients with BPD. Subgroup analyses on 53 patients concerning the role of co-occurring PTSD were conducted. Additionally, regression analyses were calculated to assess the relation between borderline symptom severity as well as dissociative experiences and GMV. Differences in local GMV between patients with BPD and HC were observed in the amygdale and hippocampus as well as in the fusiform and cingulate gyrus. Co-occurring PTSD was accompanied by increased GMV in the superior temporal gyrus and dorsolateral prefrontal cortex. Independent of co-occurring PTSD, severity of BPD symptoms predicted smaller GMV in the amygdala and dorsal ACC. Dissociation was positively related to GMV in the middle temporal gyrus. We could replicate earlier findings of diminished limbic GMV in patients with BPD and additionally show that patients with co-morbid PTSD feature increased GMV in prefrontal regions associated with cognitive control.
Highlights
Borderline Personality Disorder (BPD) is a highly prevalent disorder [1,2,3] with instability in interpersonal relationships and self-image as well as emotion dysregulation as its core symptoms [4]
Up until now, it remains unclear whether abnormalities in gray matter volume (GMV) of the limbic system are exclusively attributable to BPD
The whole-brain analysis illustrated less GMV compared to healthy control subjects (HC) in the fusiform gyrus (BA37)/inferior temporal gyrus and lingual gyrus
Summary
Borderline Personality Disorder (BPD) is a highly prevalent disorder [1,2,3] with instability in interpersonal relationships and self-image as well as emotion dysregulation as its core symptoms [4]. Earlier studies on brain structure in BPD found diminished gray matter volume (GMV) in amygdala, hippocampus, cingulate cortex, frontal lobe, and parietal cortex [5,6,7,8,9,10,11,12,13,14,15,16,17]. Reduced volume of the hippocampus and amygdala are commonly observed in patients with Posttraumatic Stress Disorder (PTSD, for a metaanalysis, see [19]), and in women with a history of sexual abuse in childhood [20,21] Both conditions are highly prevalent in patients with BPD. Up until now, it remains unclear whether abnormalities in GMV of the limbic system are exclusively attributable to BPD
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