Age-related parieto-occipital and other gray matter changes in borderline personality disorder: A meta-analysis of cortical and subcortical structures

Abstract

Previous research suggests that core borderline personality disorder (BPD) symptoms increase or decrease in severity with advancing age. While structural neuroimaging studies show smaller limbic and prefrontal gray matter volumes (GMV) in primarily adult and adolescent BPD patients, respectively, findings are inconsistent. Using the effect-size signed differential mapping (ES-SDM) meta-analytic method, we investigated the relationship between advancing age and GMV abnormalities in BPD patients. A total of nine voxel-based morphometry (VBM) studies comparing regional GMV of 256 BPD patients and 272 healthy control subjects were included.Meta-analysis identified lower GMV in the right superior/middle temporal gyri and higher GMV in the right supplementary motor area of BPD patients. Meta-regression showed that increasing Age-Related Gray Matter Changes in Borderline Personality 2 age was significantly associated with increased GMV in the left superior parieto-occipital gyri, with younger-aged patients starting at lower GMV compared to controls. In contrast, increasing age was associated with decreased GMV in the right amygdala. These findings suggest that while GMV deficits in limbic structures may become pronounced with advancing age in the course of BPD, parieto-occipital rather than frontal GMV deficits could be especially prominent in younger-aged BPD patients.

Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe

“…However, an enlarged hypothalamus and dysregulated HPA axis, and a reduced volume of the amygdala and hippocampus are found in patients with a history of early trauma and posttraumatic stress disorder (PTSD) [ 26 , 27 , 28 ]. In addition, the finding of reductions in gray matter volume of amygdala in older BPD patients has been interpreted as reflecting a reversible progressive pathology [ 29 ]. Emotional regulation difficulties of BPD patients are related with insufficient capacity of cognitive processes of prefrontal cortex (PFC) activity [ 30 ].…”

Brain grey-matter volume alteration in adult patients with bipolar disorder under different conditions: a voxel-based meta-analysis

“…17 Importantly for the present application, AES-SDM has been successfully used in neuropsychiatric populations. [18][19][20] Because many studies have been published since the most recent meta-analysis, 14 it is an opportune time to perform an updated meta-analysis assessing grey-matter volumes in patients with bipolar disorder, using the latest version of AES-SDM. Our meta-analysis included larger studiesespecially those with negative findings -and gave the study the power to detect at least moderate differences.…”

Narcissistic and Borderline Personality Disorders: Relationship With Oxidative Stress

“…There are no FDA-approved treatments for these disorders, in part due to a lack of understanding of their underlying biological mechanism. Progress has been made using scientific approaches such as high-resolution brain imaging (Kimmel et al, 2016), neuroendocrinology (Lee et al, 2012), and measures of neurotransmitter function (Coccaro et al, 1989). The results of this work generally point to altered neurophysiological indices of stress reactivity in personality disorder as related to transdiagnostic dimensions such as affective instability, trauma exposure, and aggression.…”