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2016 ; 200
(ä): 266-74
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Brain structural anomalies in borderline and avoidant personality disorder
patients and their associations with disorder-specific symptoms
#MMPMID27155069
Denny BT
; Fan J
; Liu X
; Guerreri S
; Mayson SJ
; Rimsky L
; McMaster A
; Alexander H
; New AS
; Goodman M
; Perez-Rodriguez M
; Siever LJ
; Koenigsberg HW
J Affect Disord
2016[Aug]; 200
(ä): 266-74
PMID27155069
show ga
BACKGROUND: Borderline personality disorder (BPD) and avoidant personality
disorder (AvPD) are characterized by hyper-reactivity to negatively-perceived
interpersonal cues, yet they differ in degree of affective instability. Recent
work has begun to elucidate the neural (structural and functional) and
cognitive-behavioral underpinnings of BPD, although some initial studies of brain
structure have reached divergent conclusions. AvPD, however, has been almost
unexamined in the cognitive neuroscience literature. METHODS: In the present
study we investigated group differences among 29 BPD patients, 27 AvPD patients,
and 29 healthy controls (HC) in structural brain volumes using voxel-based
morphometry (VBM) in five anatomically-defined regions of interest: amygdala,
hippocampus, medial prefrontal cortex (MPFC), dorsolateral prefrontal cortex
(DLPFC), and anterior cingulate cortex (ACC). We also examined the relationship
between individual differences in brain structure and self-reported anxiety and
affective instability in each group. RESULTS: We observed reductions in MPFC and
ACC volume in BPD relative to HC, with no significant difference among patient
groups. No group differences in amygdala volume were found. However, BPD and AvPD
patients each showed a positive relationship between right amygdala volume and
state-related anxiety. By contrast, in HC there was an inverse relationship
between MPFC volume and state and trait-related anxiety as well as between
bilateral DLPFC volume and affective instability. LIMITATIONS: Current sample
sizes did not permit examination of gender effects upon structure-symptom
correlations. CONCLUSIONS: These results shed light on potentially protective, or
compensatory, aspects of brain structure in these populations-namely, relatively
reduced amygdala volume or relatively enhanced MPFC and DLPFC volume.