Amygdala Volume and Depressive Symptoms in Patients With Borderline Personality Disorder

Zetzsche, T.; Frodl, Thomas; Preuss, Ulrich W.; Schmitt, Gisela; Seifert, Doerthe; Leinsinger, Gerda; Born, Christine; Reiser, Maximilian; Möller, Hans‐Jürgen; Meisenzahl, Eva

doi:10.1016/j.biopsych.2005.11.020

Cited by 87 publications

(50 citation statements)

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“…The literature, however, provides heterogeneous results on both structures. Concerning the amygdala, some studies reported a decreased volume, 35 some did not find any significant difference [51][52][53] and others revealed increased amygdalar volume in patients with BPD. 16 This inconsistency may at least partly be due to small sample sizes, psychotropic medications and comorbidities.…”

Section: Discussionmentioning

confidence: 97%

“…16 This inconsistency may at least partly be due to small sample sizes, psychotropic medications and comorbidities. 11 Zetzsche and colleagues, 52 for instance, found increased amygdalar volumes in patients with BPD who had comorbid MDD compared with those without MDD. The heterogeneity of results is even greater for volumetric alterations in the ACC.…”

Section: Discussionmentioning

confidence: 99%

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Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder

Kuhlmann

Bertsch

Schmidinger

et al. 2013

J Psychiatry Neurosci

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IntroductionPsychosocial stress plays an important role in the development and manifestation of borderline personality disorder (BPD). Early life stress and traumatization are risk factors for BPD, and reports of traumatic childhood abuse are frequent in patients with BPD.1 Furthermore, patients with BPD ex peri ence psychosocial daily hassles more intensely than healthy individuals, indicating a reactivity and vulnerability to stress.2 Kuo and Linehan 3 measured higher skin conductance response in patients with BPD, which is positively correlated with stress. Moreover, the acute symptoms of patients with BPD are precipitated by acute stress. They show higher dissoci ative symptom scores than subjective stress ratings in comparison to healthy individuals and patients with major depressive and panic disorders. 4 Furthermore, high dissociation scores in patients with BPD correlate with greater childhood trauma and greater hypothalamus-pituitary-adrenal (HPA) axis reactivity to stress, 5 indicating a link between traumatic childhood experiences, endocrine stress response and acute symptoms. Under subjective stress, patients with BPD display a higher pain threshold, 6 and self-injurious behaviour is used as a means of stress reduction.7 It seems plausible that these stress-related symptoms may be linked to dysregulations in the functioning of the HPA axis, which is crucially involved in the body's response to stress. Correspondingly, patients with BPD show signs of abnormal cortisol reactivity and feedback regulation, indicating disturbed HPA axis functioning, although findings on baseline cortisol, HPA feedback sensitivity and cortisol responses to psychosocial stress in Background: Experiences of early life stress, increased psychological arousal and the body's physiologic stress response seem to play an important role in the pathogenesis and maintenance of borderline personality disorder (BPD). In the present study, we investigated alterations in grey matter of central stress-regulating structures in female patients with BPD. Methods: We examined T 1 -weighted structural magnetic resonance imaging scans of unmedicated, right-handed female patients with BPD (according to DSM-IV criteria) and healthy controls matched for age, intelligence and education using fully automated DARTEL voxel-based morphometry. Our regions of interest analyses included the hippocampus, amygdala, anterior cingulate cortex (ACC) and hypothalamus. Results: We enrolled 30 patients and 33 controls in our study. The grey matter of patients with BPD was reduced in the hippocampus, but increased in the hypothalamus compared with healthy participants. Hypothalamic volume correlated positively with the history of traumatization in patients with BPD. No significant alterations were found in the amygdala and ACC. Limitations: This study is limited by the lack of measures of corticotropin-releasing hormone, adrenocorticotropic hormone and cortisol levels. Furthermore, moderate sample size and comorbid disorders need to be considered. Conclusion: Our ...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder

Kuhlmann

Bertsch

Schmidinger

et al. 2013

J Psychiatry Neurosci

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“…In an attempt to explore the potential of the abovementioned dysconnectivity as a biological marker for BPD, it is recommended that future studies should also carry out functional connectivity analyses in the most commonly documented comorbidities of BPD, which are MDD, attention deficit hyperactivity disorder (ADHD), and PTSD. PTSD is of particular interest given that both BPD and PTSD are highly related to experiences of trauma (Zetzsche et al, 2006;Pagura et al, 2010;Philipsen et al, 2010;Stein et al, 2010), and many common neurobiological abnormalities have been identified between the two (O'Neill et al, 2013). Although MDD was the only comorbidity that was allowed in our BPD sample, which increased the homogeneity of the sample, this in itself may limit the generalisability of the findings given the high occurrence of other/additional comorbidities found in the wider population of individuals with BPD.…”

Section: Discussionmentioning

confidence: 99%

Dysregulation between emotion and theory of mind networks in borderline personality disorder

O’Neill

D'Souza

Samson

et al. 2015

Psychiatry Research: Neuroimaging

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a b s t r a c tIndividuals with borderline personality disorder (BPD) commonly display deficits in emotion regulation, but findings in the area of social cognitive (e.g., theory of mind, ToM) capacities have been heterogeneous. The aims of the current study were to investigate differences between patients with BPD and controls in functional connectivity (1) between the emotion and ToM network and (2) in the default mode network (DMN). Functional magnetic resonance imaging was used to investigate 19 healthy controls and 17 patients with BPD at rest and during ToM processing. Functional coupling was analysed. Significantly decreased functional connectivity was found for patients compared with controls between anterior cingulate cortex and three brain areas involved in ToM processes: the left superior temporal lobe, right supramarginal/inferior parietal lobes, and right middle cingulate cortex. Increased functional connectivity was found in patients compared with controls between the precuneus as the DMN seed and the left inferior frontal lobe, left precentral/middle frontal, and left middle occipital/ superior parietal lobes during rest. Reduced functional coupling between the emotional and the ToM network during ToM processing is in line with emotion-regulation dysfunctions in BPD. The increased connectivity between precuneus and frontal regions during rest might be related to extensive processing of internal thoughts and self-referential information in BPD.

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“…Two subsequent studies also reported decreased amygdala volume in BPD compared to controls in relatively small samples (Schmahl et al, 2003;Tebartz van Elst et al, 2003), although a recent study showed no difference in amygdala volume compared to controls (Brambilla et al, 2004) and a VBM extension study showed decreases only in the left hippocampus/amygdala complex (Rusch et al, 2003;Tebartz van Elst et al, 2003). A recent larger study employing a software package 'BRAINS' showed no difference in amygdala volume in BPD compared to controls, although those BPD patients with a concurrent major depressive episode had larger amygdala volumes compared to those without (Zetzsche et al, 2006).…”

Section: Borderline Personality Disorder As a Prototype Of Emotion Dymentioning

confidence: 98%

Amygdala–Prefrontal Disconnection in Borderline Personality Disorder

New

Hazlett

Buchsbaum

et al. 2007

Neuropsychopharmacol

258

160

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Abnormal fronto-amygdala circuitry has been implicated in impulsive aggression, a core symptom of borderline personality disorder (BPD). We examined relative glucose metabolic rate (rGMR) at rest and after m-CPP (meta-chloropiperazine) with 18 fluorodeoxyglucose (FDG) with positron emission tomography (PET) in 26 impulsive aggressive (IED)-BPD patients and 24 controls. Brain edges/amygdala were visually traced on MRI scans co-registered to PET scans; rGMR was obtained for ventral and dorsal regions of the amygdala and Brodmann areas within the prefrontal cortex (PFC). Correlation coefficients were calculated between rGMR for dorsal/ventral amygdala regions and PFC. Additionally, amygdala volumes and rGMR were examined in BPD and controls. Correlations PFC/amygdala Placebo: Controls showed significant positive correlations between right orbitofrontal (OFC) and ventral, but not dorsal, amygdala. Patients showed only weak correlations between amygdala and the anterior PFC, with no distinction between dorsal and ventral amygdala. Correlations PFC/amygdala: m-CPP response: Controls showed positive correlations between OFC and amygdala regions, whereas patients showed positive correlations between dorsolateral PFC and amygdala. Group differences between interregional correlational matrices were highly significant. Amygdala volume/metabolism: No group differences were found for amygdala volume, or metabolism in the placebo condition or in response to meta-chloropiperazine (m-CPP). We demonstrated a tight coupling of metabolic activity between right OFC and ventral amygdala in healthy subjects with dorsoventral differences in amygdala circuitry, not present in IED-BPD. We demonstrated no significant differences in amygdala volumes or metabolism between BPD patients and controls.

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Amygdala Volume and Depressive Symptoms in Patients With Borderline Personality Disorder

Cited by 87 publications

References 100 publications

Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder

Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder

Dysregulation between emotion and theory of mind networks in borderline personality disorder

Amygdala–Prefrontal Disconnection in Borderline Personality Disorder

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