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Psych Congress  

Clinical Symptoms Of Borderline Personality Disorder Are Associated With Cortical And Subcortical Abnormalities On Brain Magnetic Resonance Imaging (MRI)

Courtney McKenzie, MD
Henry Nasrallah, MD

Background: Borderline personality disorder (BPD) is a serious psychiatric illness characterized by affective instability, impulsivity, unstable relationships, identity disturbance and fear of abandonment. A substantial number of neuroimaging (MRI) studies have reported brain abnormalities in BPD. Some of these structural differences have been correlated with the symptoms of the disorder. Here, we review the association of various key symptoms of BPD with specific morphological brain changes in BPD.

Methods: Using key words in PubMed, we identified within the English literature controlled structural neuroimaging studies of BPD where the relationship of morphological brain changes with clinical symptoms was examined. 

Results: 13 of 22 articles correlated structural brain findings with clinical manifestations including impulsivity (decreased regional gray matter volumes and insula volume), suicide attempts (associated with decrement in left insular, anterior cingulate cortex gray matter volumes), childhood abuse (reduced regional volumes, decreased size of pituitary and hippocampus), aggressiveness/violence (reduced hippocampal and superior temporal gyrus volumes) and substance use (significantly larger bilateral putamen). 

Discussion: Many cortical and subcortical morphological changes have been documented in BPD. Studies that examined the relationship of key symptoms of BPD with the MRI structural findings appear to indicate that they are associated with reduction in the volume of several brain regions . The implications of these findings as potential biomarkers for BPD is discussed.

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