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. 2008 Jul;42(9):727-33.
doi: 10.1016/j.jpsychires.2007.07.015. Epub 2007 Sep 7.

Frontolimbic structural changes in borderline personality disorder

Michael J Minzenberg  1 , Jin Fan, Antonia S New, Cheuk Y Tang, Larry J Siever
Affiliations

Frontolimbic structural changes in borderline personality disorder

Michael J Minzenberg et al. J Psychiatr Res. 2008 Jul.

Abstract

Objective: Frontolimbic dysfunction is observed in borderline personality disorder (BPD), with responses to emotional stimuli that are exaggerated in the amygdala and impaired in the anterior cingulate cortex (ACC). This pattern of altered function is consistent with animal models of stress responses and depression, where hypertrophic changes in the amygdala and atrophic changes in the ACC are observed. We tested the hypothesis that BPD patients exhibit gross structural changes that parallel the respective increases in amygdala activation and impairment of rostral/subgenual ACC activation.

Methods: Twelve unmedicated outpatients with BPD by DSM-IV and 12 normal control (NC) subjects underwent a high-resolution T1-weighted structural MRI scan. Relative gray matter concentration (GMC) in spatially-normalized images was evaluated by standard voxel-based morphometry, with voxel-wise subject group comparisons by t test constrained to amygdala and rostral/subgenual ACC.

Results: The BPD group was significantly higher than NC in GMC in the amygdala. In contrast, the BPD group showed significantly lower GMC than the NC group in left rostral/subgenual ACC.

Conclusions: This sample of BPD patients exhibits gross structural changes in gray matter in cortical and subcortical limbic regions that parallel the regional distribution of altered functional activation to emotional stimuli among these same subjects. While the histological basis for GMC changes in adult clinical populations is poorly-known at present, the observed pattern is consistent with the direction of change, in animal models of anxiety and depression, of neuronal number and/or morphological complexity in both the amygdala (where it is increased) and ACC (where it is decreased).

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Figures

Figure 1
Figure 1. Statistical parametric map of relative increase in gray matter concentration in bilateral amygdala in BPD group compared to Control group
Colored areas represent significant between-group differences in signal intensity of gray matter (expressed as color-coded t statistics), overlaid on MNI single-subject template. Colored areas represent regions where BPD group has significantly increased gray matter concentration (e.g. bilateral amygdala). See text for details of image analysis. Image orientation according to neurological convention (e.g. right hemisphere to the right).
Figure 2
Figure 2. Statistical parametric map of relative decrease in gray matter concentration in subgenual anterior cingulate cortex in BPD group compared to Control group
Colored area represents significant between-group differences in signal intensity of gray matter concentration (expressed as color-coded t statistic), overlaid on MNI single-subject template. Colored area in frontal cortex represents region where BPD group has significantly decreased gray matter concentration (subgenual ACC). See text for details of image analysis.
See this image and copyright information in PMC

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