Borderline Personality Disorder Research

Borderline Personality Disorder Brain & Medical Issues

    Amygdala Hyper-Reactivity in Borderline Personality Disorder: Implications for Emotional Dysregulation

Biological Psychiatry
Prepublication Article Abstract
Nelson Donegan <mailto:nelson.donegan@yale.edu>, Charles A. Sanislow, Hilary
P. Blumberg, Robert K. Fulbright, Cheryl Lacadie, Pawel Skudlarski, John C.
Gore, Ingrid R. Olson, Thomas H. McGlashan and Bruce E. Wexler
Accepted 6/6/2003

"Background: Disturbed interpersonal relations and emotional dysregulation
are fundamental aspects of Borderline Personality Disorder (BPD). The
amygdala plays important roles in modulating vigilance and generating
negative emotional states and is often abnormally reactive in disorders of
mood and emotion. The objective of this study was to assess amygdala
reactivity in BPD patients relative to normal controls. We hypothesize that
amygdala hyper-reactivity contributes to hypervigilance, emotional
dysregulation, and disturbed interpersonal relations in BPD.

Methods: Using functional magnetic resonance imaging, we examined neural
responses to 20-sec blocks of neutral, happy, sad, and fearful facial
expression (or a fixation point) in 15 BPD and 15 normal control subjects.
The DSM IV-diagnosed BPD patients and the normal control subjects were
assessed by a clinical research team in a medical school psychiatry
department."

September 2003

  A voxel-based morphometric MRK study in female patients with borderline personality disorder

Neuroimage. 2003 Sep;20(1):385-92
Rusch N, Elst LT, Ludaescher P, Wilke M, Huppertz HJ, Thiel T, Schmahl C, Bohus M, Lieb K, Hesslinger B, Hennig J, Ebert D.
Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany

"Subtle prefrontal and limbic structural abnormalities have been reported in borderline personality disorder (BPD). In order to further validate the previously reported findings and to more precisely describe the nature of the structural change we performed a voxel-based morphometric (VBM) study in patients with BPD...Gray matter volume loss was found in the left amygdala. No other differences in gray or white matter volume or density were found anywhere else in the brain. Our findings support the hypothesis that temporolimbic abnormalities play a role in the pathophysiology of BPD. Prefrontal structural alterations in BPD were not observed in this study."

July 2003

  Neural correlates of memories of abandonment in women with and without borderline personality disorder

Biol Psychiatry. 2003 Jul 15;54(2):142-51. 
Related Articles, Schmahl CG, Elzinga BM, Vermetten E, Sanislow C, McGlashan TH, Bremner JD.
Department of Psychiatry and Psychotherapy, University of Freiburg Medical
School, Freiburg, Germany.

BACKGROUND: Borderline personality disorder (BPD) is a common psychiatric disorder that is often linked to early stressors. One particularly salient feature of the disorder is fear of abandonment. This pilot study was conducted to measure neural correlates of memories of abandonment in women with and without BPD. METHODS: Twenty women with a history of childhood sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal abandonment events. Brain blood flow during exposure to abandonment and neutral scripts was compared among women with and without BPD. RESULTS: Memories of abandonment were associated with greater increases in blood flow in bilateral dorsolateral prefrontal cortex (middle frontal gyrus, Brodmann's areas 9 and 10) as well as right cuneus (area 19) in women with BPD than in women without BPD. Abandonment memories were associated with greater decreases in right anterior cingulate (areas 24 and 32) in women with BPD than in women without BPD. CONCLUSIONS: These findings implicate dysfunction of dorsolateral and medial prefrontal cortex including anterior cingulate, left temporal cortex, and visual association cortex in memories of abandonment in women with BPD. These brain areas may mediate symptoms of BPD.

July 2003

  Impulsivity and prefrontal hypometabolism in borderline personality disorder.

Psychiatry Res. 2003 Jul 30;123(3):153-63.
Soloff PH, Meltzer CC, Becker C, Greer PJ, Kelly TM, Constantine D.
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. soloffph@msx.upmc.edu

"Prefrontal hypoperfusion and decreased glucose uptake in the prefrontal cortex (PFC) are found in violent criminal offenders, murderers and aggressive psychiatric patients. These abnormalities may be independent of diagnosis and associated with impulsive-aggression as a personality trait. Impulsive-aggression is a clinical characteristic of borderline personality disorder (BPD) where it is associated with assaultive and suicidal behaviors...There were no significant areas of increased uptake in BPD subjects compared to control subjects. Covarying for measures of impulsivity or impulsive-aggression rendered insignificant the differences between groups. Decreased glucose uptake in medial orbital frontal cortex may be associated with diminished regulation of impulsive behavior in BPD."

July 2003

  Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study.

Biol Psychiatry. 2003 Jul 15;54(2):163-71. Related Articles, Links 
Tebartz van Elst L, Hesslinger B, Thiel T, Geiger E, Haegele K, Lemieux L, Lieb K, Bohus M, Hennig J, Ebert D.
Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany.

BACKGROUND: Dual frontolimbic brain pathology has been suggested as a possible correlate of impulsivity and aggressive behavior. One previous study reported volume loss of the hippocampus and the amygdala in patients with borderline personality disorder. We measured limbic and prefrontal brain volumes to test the hypothesis that frontolimbic brain pathology might be associated with borderline personality disorder... RESULTS: We found a significant reduction of hippocampal and amygdala volumes in borderline personality disorder. There was a significant 24% reduction of the left orbitofrontal and a 26% reduction of the right anterior cingulate cortex in borderline personality disorder. Only left orbitofrontal volumes correlated significantly with amygdala volumes. CONCLUSIONS: While volume loss of a single brain structure like the hippocampus is quite an unspecific finding in neuropsychiatry, the patterns of volume loss of the amygdala, hippocampus, and left orbitofrontal and right anterior cingulate cortex might differentiate borderline personality disorder from other neuropsychiatric conditions.

April 2003

  Magnetic resonance imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder.

Psychiatry Res. 2003 Apr 1;122(3):193-8.
Schmahl CG, Vermetten E, Elzinga BM, Douglas Bremner J.
Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Hauptstrasse 5, D-79104 Freiburg, Germany. christian_schmahl@psyallg.ukl.uni-freiburg.de

Borderline personality disorder has "been hypothesized to be related to dysfunction of limbic brain areas including hippocampus and amygdala. The purpose of this study was to measure hippocampal and amygdala volumes in BPD. Hippocampal and amygdala volumes were measured with magnetic resonance imaging (MRI) in 10 patients with BPD and 23 control subjects. Patients with BPD had a 21.9% smaller mean amygdala volume and a 13.1% smaller hippocampal volume, compared to controls. These findings are consistent with the hypothesis that alterations in the hippocampus and amygdala are associated with BPD."

March - April 2003

  Positron emission tomography in female patients with Borderline personality disorder.

J Psychiatr Res. 2003 Mar-Apr;37(2):109-15.
Juengling FD, Schmahl C, Hesslinger B, Ebert D, Bremner JD, Gostomzyk J, Bohus M, Lieb K.
Department of Nuclear Medicine, PET group, University of Freiburg Medical School, Hugstetterstr. 55, D-79106, Freiburg, Germany.

Frontal brain imaging study done on 12 females with BPD with no depression and on no medications against 12 healthy females. Those with BPD had "significant frontal and prefrontal hypermetabolism" and significant hypometabolism in the hippocampus and cuneus. This study shows "limbic and prefrontal dysfunction" in people with BPD...Dysfunction in this network of brain regions, which has been implicated in the regulation of emotion, may underlie symptoms of BPD."

2002

  Serum cholesterol and leptin levels in patients with borderline personality disorder.

Neuropsychobiology. 2002;45(4):167-71. 
Atmaca M, Kuloglu M, Tezcan E, Gecici O, Ustundag B.
Department of Psychiatry, Firat University, School of Medicine, Elazig, Turkey. matmaca_p@yahoo.com

"...patients with borderline personality disorder have lower cholesterol and leptin levels than healthy controls. Low serum cholesterol and leptin levels are associated with all dimensions of the disorder - impulsivity, aggression and suicidality - but are not associated with the presence and the severity of comorbid depression."

November - December 2000

  Biological markers in schizotypal and borderline personality disorders

Encephale 2000 Nov-Dec;26(6):42-54  (Article in French)
Ajamieh A, Ansseau M.
Service de Psychiatrie et de Psychologie Medicale, CHU du Sart Tilman, B-4000 Liege, Belgique.

"A preliminary but growing body of evidence supports the existence of biological substrates in personality disorders. Based on a review of the literature, the article deals with the major biological markers: genetic, cognitive, biochemical, electrophysiological and organic markers, of schizotypal and borderline personality disorders. In addition, the article compares these findings in these two types of pathological personality. In the field of genetics, we notice several indices in favour of a relationship between schizotypal personality disorder (SPD) and chronic schizophrenia. In contrast, in borderline personality disorder (BPD), indices were lacking for such a relationship between this disorder and one of the axis I diagnosis, or a clear genetic transmission. In the field of cognitive tests, we can note in both SPD and BPD, that the abnormalities which would be at the level of temporal and frontal lobes, may be implicated in the observable cognitive troubles in these two disorders. In the field of neurobiochemistry, the dopaminergic and serotonergic systems seem to be implicated in the etiology of SPD while several data point out the fact that several neurotransmitter systems (dopaminergic, serotonergic, noradrenergic and cholinergic) seem to be involved in the etiology of BPD. Finally, in the field of electrophysiology, we notice that some of these tests observed in SPD (smooth pursuit eye movements, evoked potentials, modification of the electrodermic response) seem reinforcing the relationship between SPD and schizophrenia while those observed in BPD seem reinforcing either a relationship between BPD and depression (sleep studies), or a relationship between BPD and schizophrenia (evoked potentials, smooth pursuit eye movements)."

February 1998

 

August 1990

  Altered platelet alpha 2-adrenergic receptor binding sites in borderline personality disorder.