Converging Medial Frontal Resting State and Diffusion-Based Abnormalities in Borderline Personality Disorder

Abstract

BACKGROUND: The psychological profile of patients with borderline personality disorder (BPD), with impulsivity and emotional dysregulation as core symptoms, has guided the search for abnormalities in specific brain areas such as the hippocampal-amygdala complex and the frontomedial cortex. However, whole-brain imaging studies so far have delivered highly heterogeneous results involving different brain locations. METHODS: Functional resting-state and diffusion magnetic resonance imaging data were acquired in patients with BPD and in an equal number of matched control subjects (n 5 60 for resting and n 5 43 for diffusion). While mean diffusivity and fractional anisotropy brain images were generated from diffusion data, amplitude of low-frequency fluctuations and global brain connectivity images were used for the first time to evaluate BPD-related brain abnormalities from resting functional acquisitions. RESULTS: Whole-brain analyses using a p 5 .05 corrected threshold showed a convergence of alterations in BPD patients in genual and perigenual structures, with frontal white matter fractional anisotropy abnormalities partially encircling areas of increased mean diffusivity and global brain connectivity. Additionally, a cluster of enlarged amplitude of low-frequency fluctuations (high resting activity) was found involving part of the left hippocampus and amygdala. In turn, this cluster showed increased resting functional connectivity with the anterior cingulate. CONCLUSIONS: With a multimodal approach and without using a priori selected regions, we prove that structural and functional abnormality in BPD involves both temporolimbic and frontomedial structures as well as their connectivity. These structures have been previously related to behavioral and clinical symptoms in patients with BPD.

Mapping the brain correlates of borderline personality disorder: A functional neuroimaging meta-analysis of resting state studies

“…First, we conducted a meta-analysis to identify the main effect of BPD diagnosis on task-independent neural function. Second, we carried out two further metaanalyses based on the imaging modality: fMRI studies (Das et al, 2014;; Doll et al, 2013;; Salvador et al, 2016;; Wolf et al, 2011) and PET studies (Lange et al, 2005;; Salavert et al, 2011;; Soloff et al, 2005) (Table S.1). Meta-analyses were performed separately for the BPD>HC and the HC>BPD contrasts using SDM software (Signed Differential Mapping, www.sdmproject.com).…”

Suicide attempters with Borderline Personality Disorder show differential orbitofrontal and parietal recruitment when reflecting on aversive memories

“…Suicide history information was obtained using the Columbia Suicide History Form (CSHF) (Salvador et al, 2014). The CSHF asks individuals about intent associated with each behavior and only self-injurious acts with intent to die are classified as suicide attempts.…”

Non redundant functional brain connectivity in schizophrenia

“…However, these patterns have been also observed in other psychiatric disorders such as depression , obsessive compulsive disorder (J. Hou et al 2012) and borderline personality disorder (Salvador et al 2014), and they probably relate to non-specific deficits occurring in all of them. On the other hand, abnormally increased ALFF in areas similar to those reported here has been also shown in schizophrenia.…”

“…These voxel based network methods have been latter applied to study connectivity abnormalities in several psychiatric disorders including schizophrenia (Cole et al 2011;Anticevic et al 2015), bipolar disorder (Anticevic et al 2013), major depressive disorder (Shen et al 2015), obsessive compulsive disorder (Anticevic et al 2014b; J. M. Hou et al 2014;Gottlich et al 2015) and borderline personality disorder (Salvador et al 2014).…”