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. 2020 Feb 7;63(1):e9.
doi: 10.1192/j.eurpsy.2019.16.

Brain structure and symptom dimensions in borderline personality disorder

Igor Nenadić  1   2   3 , Annika Voss  3   4 , Bianca Besteher  3 , Kerstin Langbein  3 , Christian Gaser  3   4
Affiliations

Brain structure and symptom dimensions in borderline personality disorder

Igor Nenadić et al. Eur Psychiatry. .

Abstract

Background: Borderline personality disorder (BPD) presents with symptoms across different domains, whose neurobiology is poorly understood.

Methods: We applied voxel-based morphometry on high-resolution magnetic resonance imaging scans of 19 female BPD patients and 50 matched female controls.

Results: Group comparison showed bilateral orbitofrontal gray matter loss in patients, but no significant changes in the hippocampus. Voxel-wise correlation of gray matter with symptom severity scores from the Borderline Symptom List (BSL-95) showed overall negative correlation in bilateral prefrontal, right inferior temporal/fusiform and occipital cortices, and left thalamus. Significant (negative) correlations with BSL-95 subscores within the patient cohort linked autoaggression to left lateral prefrontal and insular cortices, right inferior temporal/temporal pole, and right orbital cortex; dysthymia/dysphoria to right orbitofrontal cortex; self-perception to left postcentral, bilateral inferior/middle temporal, right orbitofrontal, and occipital cortices. Schema therapy-based Young Schema Questionnaire (YSQ-S2) scores of early maladaptive schemas on emotional deprivation were linked to left medial temporal lobe gray matter reductions.

Conclusions: Our results confirm orbitofrontal structural deficits in BPD, while providing a framework and preliminary findings on identifying structural correlates of symptom dimensions in BPD, especially with dorsolateral and orbitofrontal cortices.

Keywords: Borderline Symptom List; Young Schema Questionnaire; borderline personality disorder; orbitofrontal cortex; voxel-based morphometry.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Voxel-based morphometry (VBM) group comparison of borderline personality disorder (BPD) patients and healthy controls (HC) at p < 0.001 (uncorrected).
Figure 2.
Figure 2.
Voxel-based morphometry (VBM) correlation analysis of gray matter and BSL total score in n = 18 patients with borderline personality disorders (BPD) at p < 0.001 (uncorrected).
Figure 3.
Figure 3.
Voxel-based morphometry (VBM) correlation analysis of gray matter and BSL self-perception (or self-image) subscore in n = 18 patients with borderline personality disorders (BPD) at p < 0.001 (uncorrected). Note that the precentral/postcentral cortex cluster (k=1928) also survived corrected for multiple comparisons at p<0.05 FWE.
Figure 4.
Figure 4.
Voxel-based morphometry (VBM) correlation analysis of gray matter and BSL dysphoria subscore in n = 18 patients with borderline personality disorders (BPD) at p < 0.001 (uncorrected).
See this image and copyright information in PMC

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