Cortical morphology changes in women with borderline personality disorder: a multimodal approach

Abstract

Objective: Borderline personality disorder (BPD) is a devastating condition that causes intense disruption of patients' lives and relationships. Proper understanding of BPD neurobiology could help provide the basis for earlier and effective interventions. As neuroimaging studies of patients with BPD are still scarce, volumetric and geometric features of the cortical structure were assessed to ascertain whether structural cortical alterations are present in BPD patients. Methods: Twenty-five female outpatients with BPD underwent psychiatric evaluation (SCID-I and II) and a 1.5 T magnetic resonance imaging (MRI) brain scan. The control group comprised 25 healthy age-matched females. Images were processed with the FreeSurfer package, which allows analysis of cortical morphology with more detailed descriptions of volumetric and geometric features of cortical structure. Results: Compared with controls, BPD patients exhibited significant cortical abnormalities in the fronto-limbic and paralimbic regions of both hemispheres. Conclusion: Significant morphologic abnormalities were observed in patients with BPD on comparison with a healthy control group through a multimodal approach. This study highlights the involvement of regions associated with mood regulation, impulsivity, and social behavior in BPD patients and presents a new approach for further investigation through a method of structural analysis based on distinct and simultaneous volumetric and geometric parameters.

Morphometric hemispheric asymmetry of orbitofrontal cortex in women with borderline personality disorder: A multi-parameter approach

“…As such areas are associated with affective regulation, such reductions might be biological substrates of BPD symptomatology. In a recent neuroimaging study using the same approach, we observed significant morphological abnormalities of cortical thickness, volume, mean curvature, metric distortion, area and depth of sulcus in such areas among BPD patients (Araujo et al, 2014). Such findings are in agreement with previous structural neuroimaging studies involving BPD patients, and highlight the involvement of these areas in the regulation of mood reactivity, impulsivity and social behavior, considered dysfunctional in these patients (Araujo et al, 2014).…”

Abnormalities in Cortical Gray Matter Density in Borderline Personality Disorder

“…Lastly, the presence in our sample of both females and males overcome the limitation the two previous two studies including only females. As underlined by the authors [15] the inclusion of only female patients prevents to extend the results to all BPD patients.…”

“…However, as the authors underlined in the discussion, their findings cannot be generalized since the sample included only females with BPD. Furthermore, Freesurfer analysis of cortical morphology, being automated, could have a series of limitations such as errors regarding processes of segmentation, normalization and skull extraction [15]. Another study on female BPD using Freesurfer package showed reduced cortical thickness in prefrontal cortex, left tempoparietal junction, bilateral temporal poles and bilateral paracentral lobules [7].…”

Hemispheric asymmetry of the frontolimbic cortex in young adults with borderline personality disorder

“…The relatively weak sensitivity of the approach is further complicated by the variability of indices used (volume vs. area); surface area data tend to show greater variability across individuals . Second, although surface‐based methods provide some benefits relative to voxel‐based methods, most of the surface‐based studies reported thus far did not account for hemisphere asymmetry or lateralization , although hemispheric asymmetries underlie, at least in part, the divergence in findings . Lastly, previous studies showed that BPD diagnosis and some symptoms declined with patient's age, cohort age differences thus may be contributing to the inconsistencies among reports .…”