A brain MRI study in subjects with borderline personality disorder.

BACKGROUND There have been only a few brain computed tomography imaging studies, with mostly negative findings, in subjects with borderline personality disorder (BPD). This is the first MRI study which evaluated the structural abnormalities of the brain in subjects with the sole diagnosis of BPD. METHODS Twenty-five subjects with BPD were compared with age-, gender-matched healthy comparison subjects (n=25) on volumes of the frontal lobes, the temporal lobes, the lateral ventricles, and the cerebral hemispheres in brain magnetic resonance imaging. RESULTS Subjects with BPD had a significantly smaller frontal lobe compared to comparison subjects (multivariate regression analysis, t=2.225, df=46, P=0.031). There were no significant differences in volumes of the temporal lobes, the lateral ventricles, and the cerebral hemispheres between subjects with and without BPD. LIMITATIONS Strict inclusion and exclusion criteria employed in the present study may make it difficult to generalize our findings. The gray matter and white matter of the brain were not measured separately. Differences in head tilt during image acquisition were not corrected. CONCLUSIONS The current study reports a smaller frontal lobe volume on brain MRI in subjects with BPD compared with healthy comparison subjects. This finding may serve as a potentially useful biological variable that may allow for subtyping BPD.

[1]  K. Doghramji,et al.  The demographic profile of borderline personality disorder. , 1986, The Journal of clinical psychiatry.

[2]  A. B. Hollingshead,et al.  Social Class and Mental Illness: A Community Study. , 1958 .

[3]  A. Damasio,et al.  Individuals with sociopathic behavior caused by frontal damage fail to respond autonomically to social stimuli , 1990, Behavioural Brain Research.

[4]  F. Frankenburg,et al.  DSM-III Disorders in the Families of Borderline Outpatients , 1988 .

[5]  Roberta F. White,et al.  Neurobehavioral study of borderline personality disorder. , 1993, Journal of psychiatry & neuroscience : JPN.

[6]  B. Glueck,et al.  Organic brain dysfunction and the borderline syndrome. , 1981, The Psychiatric clinics of North America.

[7]  Charles L Truwit,et al.  High Resolution Atlas of Cranial Neuroanatomy , 1994 .

[8]  Denckla Mb,et al.  Revised Neurological Examination for Subtle Signs (1985). , 1985 .

[9]  Stephen J. DeArmond,et al.  Structure of the human brain : a photographic atlas , 1974 .

[10]  M M Weissman,et al.  Epidemiology of borderline personality disorder. , 1991, Hospital & community psychiatry.

[11]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[12]  P. Tyrer What are the borders of borderline personality disorder? , 1994, Acta psychiatrica Scandinavica. Supplementum.

[13]  P. Links,et al.  Repeat neurobehavioral study of borderline personality disorder. , 1996, Journal of psychiatry & neuroscience : JPN.

[14]  H. Nurnberg,et al.  The comorbidity of borderline personality disorder and other DSM-III-R axis II personality disorders. , 1991, The American journal of psychiatry.

[15]  J. Bobes,et al.  Brain glucose metabolism in borderline personality disorder. , 1997, Journal of psychiatric research.

[16]  K O Lim,et al.  Brain magnetic resonance imaging: approaches for investigating schizophrenia. , 1990, Schizophrenia bulletin.

[17]  R. Reich,et al.  Reported pathological childhood experiences associated with the development of borderline personality disorder. , 1997, The American journal of psychiatry.

[18]  C. Coffey,et al.  Quantitative cerebral anatomy of the aging human brain , 1992, Neurology.

[19]  J. Haxby,et al.  Lack of age-related differences in temporal lobe volume of very healthy adults. , 1994, AJNR. American journal of neuroradiology.

[20]  S. Charles Schulz,et al.  Positron-Emission Tomography and Personality Disorders , 1994, Neuropsychopharmacology.

[21]  E. Hollander,et al.  Neuropsychiatric impairment in impulsive personality disorders , 1993, Psychiatry Research.

[22]  F. Quitkin,et al.  Neurologic soft signs in schizophrenia and character disorders. Organicity in schizophrenia with premorbid asociality and emotionally unstable character disorders. , 1976, Archives of general psychiatry.

[23]  A. Luxen,et al.  Temporal glucose metabolism in borderline personality disorder , 1994, Psychiatry Research: Neuroimaging.

[24]  H. Akiskal,et al.  Borderline: an adjective in search of a noun. , 1985, The Journal of clinical psychiatry.

[25]  M. Fava,et al.  A quantitative magnetic resonance imaging study of cerebral and cerebellar gray matter volume in primary unipolar major depression: Relationship to treatment response and clinical severity , 1997, Biological Psychiatry.

[26]  S. Snyder,et al.  CT scans of patients with borderline personality disorder. , 1983, The American journal of psychiatry.

[27]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[28]  P. Renshaw,et al.  Structural abnormalities in brain magnetic resonance images of depressed children. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  R. Edelman,et al.  Magnetic resonance imaging (2) , 1993, The New England journal of medicine.

[30]  K. Krishnan,et al.  Magnetic resonance imaging in biological psychiatry , 1991, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[31]  T. Swirsky-Sacchetti,et al.  Neuropsychological function in borderline personality disorder. , 1993, Journal of clinical psychology.

[32]  In Kyoon Lyoo,et al.  Regional atrophy of the corpus callosum in subjects with Alzheimer's disease and multi-infarct dementia , 1997, Psychiatry Research: Neuroimaging.

[33]  Paul A. Bottomley,et al.  19F magnetic resonance imaging , 1977 .

[34]  R. Hamer,et al.  Ventricular enlargement in teenage patients with schizophrenia spectrum disorder. , 1983, The American journal of psychiatry.

[35]  P. Andrulonis,et al.  Comparison of Borderline Personality Subcategories to Schizophrenic and Affective Disorders , 1984, British Journal of Psychiatry.

[36]  R. Kikinis,et al.  An Automated Registration Algorithm for Measuring MRI Subcortical Brain Structures , 1997, NeuroImage.

[37]  F. Frankenburg,et al.  The Revised Diagnostic Interview for Borderlines: Discriminating BPD from other Axis II Disorders , 1989 .

[38]  In Kyoon Lyoo,et al.  The corpus callosum and lateral ventricles in children with attention-deficit hyperactivity disorder: A brain magnetic resonance imaging study , 1996, Biological Psychiatry.

[39]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[40]  D. Pickar,et al.  Cerebral structure in borderline personality disorder , 1989, Psychiatry Research.

[41]  C. Coffey,et al.  Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. , 1993, Archives of general psychiatry.

[42]  L. Siever,et al.  Lateral ventricular enlargement in schizotypal personality disorder , 1995, Psychiatry Research.

[43]  J. Gunderson,et al.  The diagnostic interview for borderline patients. , 1981, The American journal of psychiatry.