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Structural brain abnormalities and suicidal behavior in borderline personality disorder.

Abstract：

BACKGROUND:Structural brain abnormalities have been demonstrated in subjects with BPD in prefrontal and fronto-limbic regions involved in the regulation of emotion and impulsive behavior, executive cognitive function and episodic memory. Impairment in these cognitive functions is associated with increased vulnerability to suicidal behavior. We compared BPD suicide attempters and non-attempters, high and low lethality attempters to healthy controls to identify neural circuits associated with suicidal behavior in BPD. METHODS:Structural MRI scans were obtained on 68 BPD subjects (16 male, 52 female), defined by IPDE and DIB/R criteria, and 52 healthy controls (HC: 28 male, 24 female). Groups were compared by diagnosis, attempt status, and attempt lethality. ROIs were defined for areas reported to have structural or metabolic abnormalities in BPD, and included: mid-inf. orbitofrontal cortex, mid-sup temporal cortex, anterior cingulate, insula, hippocampus, amygdala, fusiform, lingual and parahippocampal gyri. Data were analyzed using optimized voxel-based morphometry implemented with DARTEL in SPM5, co-varied for age and gender, corrected for cluster extent (p < .001). RESULTS:Compared to HC, BPD attempters had significantly diminished gray matter concentrations in 8 of 9 ROIs, non-attempters in 5 of 9 ROIs. Within the BPD sample, attempters had diminished gray matter in Lt. insula compared to non-attempters. High lethality attempters had significant decreases in Rt. mid-sup. temporal gyrus, Rt. mid-inf. orbitofrontal gyrus, Rt. insular cortex, Lt. fusiform gyrus, Lt. lingual gyrus and Rt. parahippocampal gyrus compared to low lethality attempters. CONCLUSIONS:Specific structural abnormalities discriminate BPD attempters from non-attempters and high from low lethality attempters.

journal_name

J Psychiatr Res

journal_title

Journal of psychiatric research

authors

Soloff PH,Pruitt P,Sharma M,Radwan J,White R,Diwadkar VA

doi

10.1016/j.jpsychires.2012.01.003

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

516-25

issue

4

eissn

0022-3956

issn

1879-1379

pii

S0022-3956(12)00004-0

journal_volume

46

pub_type

杂志文章

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