Magnetic resonance imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder. Psychiatry Res
ABSTRACT Borderline personality disorder (BPD) is a common disorder associated with emotional dysregulation and other symptoms that have 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.
Full-textDOI: · Available from: Eric Vermetten, Sep 27, 2015
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- "Similarly, several human studies have shown that early life adversity, such as prolonged orphanage rearing or poor care due to maternal depression, is related to larger amygdala volumes in adolescence compared to their peers, as well as an increased risk to develop affective psychopathology (Mehta et al., 2009; Tottenham et al., 2010; Lupien et al., 2011), although smaller medial temporal lobe volumes were found as well (Hanson et al., 2015). In adulthood, however, limited evidence was found for a difference in amygdala volumes between PTSD patients who were exposed to childhood maltreatment and controls in a small meta-analysis (Woon and Hedges, 2008), though smaller volumes have been reported in other studies (Vermetten et al., 2006; Weniger et al., 2008, 2009; Irle et al., 2009), as well as in adult borderline patients with a history of childhood abuse (Driessen et al., 2000; Schmahl et al., 2003), which is in line with our current results. With respect to the apparent discrepancy in amygdala volume differences between childhood and adulthood samples, the following could be hypothesized: Severe adversity during childhood could at first increase the sensitivity of the amygdala through dendritic growth and synaptic connectivity, as is found in rodents (Roozendaal et al., 2009), which may result in a larger total volume . "
ABSTRACT: Hippocampus and amygdala volumes in posttraumatic stress disorder (PTSD) related to childhood trauma are relatively understudied, albeit the potential importance to the disorder. Whereas some studies reported smaller hippocampal volumes, little evidence was found for abnormal amygdala volumes. Here we investigated hippocampus and amygdala volumes and shapes in an adult sample of PTSD patients related to childhood trauma. T1-weighted MR images were acquired from 12 female PTSD patients with trauma related to physical, sexual, and/or emotional abuse before age 18, and from 12 matched controls. Hippocampus and amygdala were segmented, and volumes were calculated and corrected for the total intracranial volume. Additionally, a shape analysis was done on the surface of the structures to explore abnormalities in specific subnuclei. Smaller right amygdala volumes were found in PTSD patients as compared with the controls. This difference appeared to be located specifically in the basolateral and superficial nuclei groups. Severity of sexual abuse during childhood was negatively correlated with the size of the amygdala. No difference in hippocampal volumes was found. Although our results are not conclusive, traumatic events in childhood might impede normal development of the amygdala, which could render a person more vulnerable to develop PTSD later in life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.07/2015; 233(3). DOI:10.1016/j.pscychresns.2015.07.016
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- "Delineating how other cortical/subcortical regions affect PNES and OFC dysfunction are subject to future study and are not addressed directly by the two-factor hypothesis. Early psychological stressors could lead to OFC dysfunction , similar stress related changes have also been observed in the hippocampus, amygdala, white matter volume and prefrontal cortex   . There is therefore some variability for the genesis of OFC dysfunction noted among PNES subjects from prior psychological stressors. "
ABSTRACT: Psychogenic nonepileptic seizures (PNES) often mimic epileptic seizures and occur in both people with and without epilepsy. Pathophysiology of conversion disorders such as PNES remains unclear though significant psychological, psychiatric and environmental factors have been correlated with a diagnosis of PNES. Many clinical signs that have been considered typical for PNES can also be found in frontal epileptic seizures. Given the resemblance of seizures and affective changes from Orbitofrontal cortical dysfunction to PNES like events and correlation of psychological and environmental stress to conversion disorders such as PNES, we propose a two-factor model for the pathogenesis of PNES. We hypothesize that patients with PNES could have a higher likelihood of having both Orbitofrontal cortical dysfunction and a history of psychological stressors rather than a higher likelihood of having either one or the other. We further explore the implications of this two-factor model, including possible therapies. Copyright © 2015 Elsevier Ltd. All rights reserved.Medical Hypotheses 01/2015; 84(4). DOI:10.1016/j.mehy.2015.01.034 · 1.07 Impact Factor
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- "Furthermore, both regions are important for emotional functioning and show strong connections with the activity of the hypothalamic pituitary adrenocortical (HPA) axis, which mediates neuroendocrine stress responses in humans. Both increased (Tottenham et al., 2010) and decreased (Driessen et al., 2000; Schmahl et al., 2003) amygdala volumes have previously been reported as neural markers following ELS. Also, associations of reduced hippocampal volumes and ELS are a common finding in clinical populations such as patients with affective disorders (Kronm€ uller et al., 2008; MacQueen and Frodl, 2010; Woon and Hedges, 2008). "
ABSTRACT: Early life stress (ELS) is known to have considerable influence on brain development and affective functioning. Previous studies in clinical populations have shown that hippocampus and amygdala, two central structures of limbic emotion processing circuits, are predominantly affected by early stress exposure. Given the inconsistent findings on ELS-related effects in healthy populations and the associations of ELS and affective functioning, the question arises which additional emotion-relevant variables need to be considered to better understand the effects of ELS. We therefore investigated the volume of hippocampus and amygdala in 25 high alexithymic (h-ALEX) and 25 low alexithymic (l-ALEX) individuals, which were matched with regard to ELS, but significantly differed in their degree of emotional functioning. Volumetric analyses were performed using FSL-FIRST, a method to automatically segment subcortical structures on T1-weighted magnetic resonance images. Alexithymia was assessed using the Toronto Alexithymia Scale and Bermond-Vorst Alexithymia Questionnaire. ELS was assessed by Childhood Trauma Questionnaire (CTQ) and Early Trauma Inventory. Our data showed that ELS was negatively associated with right hippocampus volume in h-ALEX individuals, while there was no such association in the l-ALEX group. Furthermore, ELS was positively associated with left amygdala volume in l-ALEX individuals, but not in individuals with high levels of alexithymia. The present study emphasizes a substantial relationship between intrapersonal factors such as alexithymia and neural alterations related to the experience of ELS. Longitudinal study designs are necessary to pursue the question of how emotional abilities interact with individual adaptations to early stress exposure on the neural level. © 2014 Wiley Periodicals, Inc.Hippocampus 09/2014; 24(9). DOI:10.1002/hipo.22293 · 4.16 Impact Factor