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

Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Hauptstrasse 5, D-79104 Freiburg, Germany.
Psychiatry Research (Impact Factor: 2.47). 05/2003; 122(3):193-8. DOI: 10.1016/S0925-4927(03)00023-4
Source: PubMed


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.

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Available from: Eric Vermetten
    • "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 . "
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    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.
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    • "Tebartz van Elst et al. 2003; Hazlett et al. 2005; Grant et al. 2007; Rusch et al. 2007a, b; Carrasco et al. 2012; Bruehl et al. 2013), such as the ACC and OFC, and (para-)limbic regions, such as the amygdala (e.g. Schmahl et al. 2003; Weniger et al. 2009; Niedtfeld et al. 2013). Of note, BPD patients often show abnormal activity (e.g. "
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    ABSTRACT: A dysfunctional network of prefrontal and (para-)limbic brain region has been suggested to underlie emotional dysregulation in borderline personality disorder (BPD). Abnormal activity in this network may be due to structural alterations in white-matter tracts connecting prefrontal and (para-)limbic brain regions. To test this hypothesis, we investigated the structural integrity of major white-matter tracts connecting these regions in BPD. Using diffusion tensor imaging, we investigated fractional anisotropy (FA), axonal anisotropy (AD) and radial diffusivity (RD) in the uncinate fasciculus, the major white-matter tract connecting (para-)limbic and prefrontal brain regions, in 26 healthy controls (HC) and 26 BPD participants. To clarify the specificity of possible white-matter alterations among HC and BPD participants, FA, AD and RD were also investigated in the cingulum. We found distinct structural alterations in the uncinate fasciculus but not in the cingulum of BPD participants. Compared to HC participants, BPD participants showed lower FA and higher RD in the uncinate fasciculus. By contrast, AD did not differ in the uncinate fasciculus of HC and BPD participants. Our finding of abnormal FA and RD in the uncinate fasciculus indicates distinct white-matter alterations in BPD, presumably due to stress-induced myelin degeneration in the aftermath of stressful life events. Although these alterations may account for abnormal activity in brain regions implicated in emotion dysregulation, such as the amygdala, anterior cingulate cortex and prefrontal cortex, it remains to be determined whether these alterations are specific for BPD.
    Full-text · Article · Jun 2015 · Psychological Medicine
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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 [75], similar stress related changes have also been observed in the hippocampus, amygdala, white matter volume and prefrontal cortex [76] [77] [78]. There is therefore some variability for the genesis of OFC dysfunction noted among PNES subjects from prior psychological stressors. "
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    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.
    Full-text · Article · Jan 2015 · Medical Hypotheses
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