Brain glucose metabolism in borderline personality disorder

Fuente, JoséManuel De la; Goldman, Serge; Stanus, Etienne; Vizuete, Coro; Morlán, Ignacio; Bobes, Julio; Mendlewicz, Julien

doi:10.1016/s0022-3956(97)00001-0

Cited by 156 publications

(74 citation statements)

References 45 publications

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“…We did not find a difference in the orbitofrontal cortical area between depressed patients with BPD and MDD without BPD in contrast to findings from both lesion (Butter et al, 1970;Grafman et al, 1996;Heinrichs, 1989;Raleigh et al, 1979) and neuroimaging studies (De La Fuente et al, 1997;Goyer et al, 1994;New et al, 2002New et al, , 2004Siever et al, 1999) that suggest a role for the orbitofrontal cortex in impulsive aggression. Our sample of depressed women with BPD did not differ significantly in terms of clinical measures of aggression and impulsivity from the depressed women without BPD (see Table 1).…”

Section: Orbitofrontal Cortex In Mdd With Bpd Compared To Mddcontrasting

confidence: 99%

“…Functional neuroimaging studies of brain glucose metabolism in borderline and other aggressive and impulsive patients have also implicated the anterior cingulate area. In agreement with our findings, most studies of BPD found low relative glucose metabolism and regional cerebral blood flow (rCBF) in the anterior cingulate gyrus at rest (De La Fuente et al, 1997;Goyer et al, 1994). PET studies report that FEN responses are blunted in the orbitofrontal cortex and anterior cingulate gyrus (Siever et al, 1999) in impulsive aggressive subjects compared to healthy controls, as are m-CPP responses (New et al, 2002), although not all studies agree (Soloff et al, 2000).…”

Section: Anterior Cingulate In Mdd With Bpd Compared To Mddsupporting

confidence: 87%

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Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Oquendo

Krunic

Parsey

et al. 2005

Neuropsychopharmacol

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Previous neuroimaging studies of major depression have not controlled for the presence of personality disorders characterized by impulsive aggressive behavior, such as borderline personality disorder (BPD). Using positron emission tomography (PET), we studied regional glucose uptake in response to fenfluramine (FEN) in depressed subjects with BPD (n ¼ 11) and depressed patients without Cluster B Axis II disorders (n ¼ 8). Subjects were scanned while medication-free after a single blind placebo administration and after FEN on a second day. Brain responses were measured by PET imaging of [ 18 F]fluorodeoxyglucose (FDG) and serial prolactin levels. Scans were compared at a voxel level using statistical parametric mapping. Correlations of changes in relative regional cerebral uptake (rCMRglu) with clinical measures were assessed. Depressed borderline patients had greater relative activity in parietotemporal cortical regions (BA 40, BA 22, and BA 42) before and after FEN activation compared to those without BPD. They also had less relative uptake in the anterior cingulate cortex (BA 32) at baseline compared to depressed patients without BPD and FEN abolished this difference. Impulsivity was positively correlated with rCMRglu in superior and middle frontal cortex (BA 6 and 44). Hostility was positively correlated with rCMRglu in temporal cortical regions (BA 21 and 22). In conclusions, borderline pathology in the context of a Major Depressive Disorder is associated with altered activity in parietotemporal and anterior cingulate cortical regions. Controlling for the presence of BPD in future imaging studies of mood disorders may elucidate similarities and differences in regional serotonergic function in these two often comorbid disorders.

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Section: Orbitofrontal Cortex In Mdd With Bpd Compared To Mddcontrasting

confidence: 99%

Section: Anterior Cingulate In Mdd With Bpd Compared To Mddsupporting

confidence: 87%

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Oquendo

Krunic

Parsey

et al. 2005

Neuropsychopharmacol

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“…An 18 FDG-PET study reported reduced glucose metabolism in BPD patients compared to healthy controls in PFC, and anterior cingulate bilaterally (De La Fuente et al, 1997). In response to serotonergic challenge, specifically impulsive-aggressive BPD patients demonstrate decreased metabolism in anterior cingulate and PFC, compared to controls (New et al, 2002;Siever et al, 1999b;Soloff et al, 2003).…”

Section: Borderline Personality Disorder As a Prototype Of Emotion Dymentioning

confidence: 99%

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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“…if the regions shown to have elevated and decreased metabolism comprise parts of anterior cingulate cortex (ACC). A second functional brain imaging study employing FDG-PET was conducted in a series of 10 patients (eight women and two men) with BPD and a DIB score of 7 or higher (De la Fuente et al, 1997). This investigation revealed decreased metabolism in premotor areas and dorsolateral prefrontal cortex, parts of the ACC (BA 25), as well as thalamic, caudate and lenticular nuclei, in BPD patients as compared to controls.…”

Section: Brain Metabolism Under Resting Conditions Assessed With Fdg-petmentioning

confidence: 99%

Neuroimaging in borderline personality disorder

Schmahl¹,

Bremner²

2006

Journal of Psychiatric Research

171

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Neuroimaging has become one of the most important methods in the investigation of the neurobiological underpinnings of borderline personality disorder. Structural and functional imaging studies have revealed dysfunction in different brain regions which seem to contribute to borderline symptomatology. This review presents relevant studies using different methodologies: volumetry of limbic and prefrontal regions, investigations of brain metabolism under resting conditions, studies of serotonergic neurotransmission, and challenge studies using emotional, stressful, and sensory stimuli. Dysfunction in a frontolimbic network is suggested to mediate much, if not all of the borderline symptomatology.

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Brain glucose metabolism in borderline personality disorder

Cited by 156 publications

References 45 publications

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Amygdala–Prefrontal Disconnection in Borderline Personality Disorder

Neuroimaging in borderline personality disorder

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