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==Overview== | ==Overview== | ||
The MRI changes observed in borderline PD are found in [[hypothalamus]] and [[limbic system]]. The volumetric changes in gray matter in various regions of brain are associated with rest of PDs. | |||
==MRI== | |||
Variable data regarding findings on MRI in PD is found. BPD is one of the most prevalent and commonly studied personality disorder and data regarding other types in lacking. Moreover, due to the co-occurence of other mental health conditions with PDs, it becomes difficult to ascertain the specific findings present in neuroimaging in PD. However, most of the studies reveals that changes in BPD is apparent in [[amygdala]] and [[limbic system]] in the brain. The findings in BPD on neuroimaging represent difference in volume and activity in brain structures.The first study was conducted by Lyoo et al. which compared 25 patients with BPD with age and gender-matched healthy subjects and demonstrated that individuals with BPD have smaller [[frontal lobe]] volume on brain MRI. <ref name="pmid9858082">{{cite journal| author=Lyoo IK, Han MH, Cho DY| title=A brain MRI study in subjects with borderline personality disorder. | journal=J Affect Disord | year= 1998 | volume= 50 | issue= 2-3 | pages= 235-43 | pmid=9858082 | doi=10.1016/s0165-0327(98)00104-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9858082 }} </ref>. More studies conducted by Driessen et al. and Terbartz van Elst et al. found that MRI scans in BPD were associated with smaller volumes of the [[hippocampus]] and [[amygdala]] than healthier controls (16% and 8% by Driessen et al.) and (20.5% and 24% by Terbartz van Elst et al.). The latter also revealed 24% reduction of the left [[orbitofrontal]] and a 26% reduction of the right [[anterior cingulate cortex]] in borderline personality disorder. <ref name="pmid11115325">{{cite journal| author=Driessen M, Herrmann J, Stahl K, Zwaan M, Meier S, Hill A | display-authors=etal| title=Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization. | journal=Arch Gen Psychiatry | year= 2000 | volume= 57 | issue= 12 | pages= 1115-22 | pmid=11115325 | doi=10.1001/archpsyc.57.12.1115 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11115325 }} </ref>. <ref name="pmid12873806">{{cite journal| author=Tebartz van Elst L, Hesslinger B, Thiel T, Geiger E, Haegele K, Lemieux L | display-authors=etal| title=Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study. | journal=Biol Psychiatry | year= 2003 | volume= 54 | issue= 2 | pages= 163-71 | pmid=12873806 | doi=10.1016/s0006-3223(02)01743-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12873806 }} </ref>. Another study by Brambilla et al. in 2003 replicated the [[hippocampus]] changes in BPD but failed to endorse changes in amygdala. However, it showed the relation of hippocampal changes in BPD with the presence of childhood abuse or trauma. It also demonstrated the increase in [[putamen]] in case of concomitant substance abuse in BPD. <ref name="pmid15313519">{{cite journal| author=Brambilla P, Soloff PH, Sala M, Nicoletti MA, Keshavan MS, Soares JC| title=Anatomical MRI study of borderline personality disorder patients. | journal=Psychiatry Res | year= 2004 | volume= 131 | issue= 2 | pages= 125-33 | pmid=15313519 | doi=10.1016/j.pscychresns.2004.04.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15313519 }} </ref>. Hence, studies throughout the time have endorsed the findings in hippocampus mostly and in amygdala in some cases. This is the cause of BPD or results due to symptoms of [[affective dysregualtion]] in them, remains unclear. Impulsivity in PD is associated with changes in [[frontal]] structures and aggression with changes in [[hippocampal]] and [[frontal]] structures <ref name="pmid32163818">{{cite journal| author=Davies G, Hayward M, Evans S, Mason O| title=A systematic review of structural MRI investigations within borderline personality disorder: Identification of key psychological variables of interest going forward. | journal=Psychiatry Res | year= 2020 | volume= 286 | issue= | pages= 112864 | pmid=32163818 | doi=10.1016/j.psychres.2020.112864 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32163818 }} </ref>. Irle et al. in 2005 showed a new finding of reduced right [[parietal cortex]] in individuals with BPD, which may be due to neurodevelopmental deficit of [[right hemisphere]]. <ref name="pmid15652877">{{cite journal| author=Irle E, Lange C, Sachsse U| title=Reduced size and abnormal asymmetry of parietal cortex in women with borderline personality disorder. | journal=Biol Psychiatry | year= 2005 | volume= 57 | issue= 2 | pages= 173-82 | pmid=15652877 | doi=10.1016/j.biopsych.2004.10.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15652877 }} </ref>. [[Functional MRI]] (fMRI) is another technique being used to ascertain the changes in BPD. It is a modality that measures and maps brain activity by detecting minute changes in blood flow in those regions. Lei et al. in 2017 established that fMRI in BPD manifests decreased [[amplitude of low frequency fluctuations]] (ALFF) and [[regional homogeneity]] (ReHo) in the right posterior [[cingulate cortex]] (PCC) and adjacent [[precuneus]] <ref name="pmid28478359">{{cite journal| author=Lei X, Zhong M, Liu Y, Jin X, Zhou Q, Xi C | display-authors=etal| title=A resting-state fMRI study in borderline personality disorder combining amplitude of low frequency fluctuation, regional homogeneity and seed based functional connectivity. | journal=J Affect Disord | year= 2017 | volume= 218 | issue= | pages= 299-305 | pmid=28478359 | doi=10.1016/j.jad.2017.04.067 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28478359 }} </ref>. | |||
[ | MRI imaging in antisocial PD is associated with [[cortical thinning]] in most cases. Jiang et al. study indicated that antisocial PD was associated with higher [[gray matter]] volumes in the [[inferior parietal lobule]] and [[white matter]] volumes in [[precuneus]] as compared to healthy individuals. <ref name="pmid25769320">{{cite journal| author=Jiang W, Liao J, Liu H, Huang R, Li Y, Wang W| title=[Brain structure analysis for patients with antisocial personality disorder by MRI]. | journal=Zhong Nan Da Xue Xue Bao Yi Xue Ban | year= 2015 | volume= 40 | issue= 2 | pages= 123-8 | pmid=25769320 | doi=10.11817/j.issn.1672-7347.2015.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25769320 }} </ref>. <ref name="pmid23593272">{{cite journal| author=Tang Y, Jiang W, Liao J, Wang W, Luo A| title=Identifying individuals with antisocial personality disorder using resting-state FMRI. | journal=PLoS One | year= 2013 | volume= 8 | issue= 4 | pages= e60652 | pmid=23593272 | doi=10.1371/journal.pone.0060652 | pmc=3625191 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23593272 }} </ref>. fMRI is also useful and results in higher degree of [[fractional anisotropy]] in left [[lingual gyrus]], bilateral [[precuneus]], right [[superior frontal gyrus]] and right [[middle temporal gyrus]]. <ref name="pmid25769320">{{cite journal| author=Jiang W, Liao J, Liu H, Huang R, Li Y, Wang W| title=[Brain structure analysis for patients with antisocial personality disorder by MRI]. | journal=Zhong Nan Da Xue Xue Bao Yi Xue Ban | year= 2015 | volume= 40 | issue= 2 | pages= 123-8 | pmid=25769320 | doi=10.11817/j.issn.1672-7347.2015.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25769320 }} </ref> | ||
Schulze et al. found that MRI in individuals with narcissistic personality disorder shows small [[gray matter]] volume in left [[anterior insula]] and [[fronto-paralimbic brain]] regions. <ref name="pmid23777939">{{cite journal| author=Schulze L, Dziobek I, Vater A, Heekeren HR, Bajbouj M, Renneberg B | display-authors=etal| title=Gray matter abnormalities in patients with narcissistic personality disorder. | journal=J Psychiatr Res | year= 2013 | volume= 47 | issue= 10 | pages= 1363-9 | pmid=23777939 | doi=10.1016/j.jpsychires.2013.05.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23777939 }} </ref>. No specific [[subcortical]] volumetric changes have been observed through studies in avoidant personality disorder. <ref name="pmid32663932">{{cite journal| author=Gosnell SN, Crooks KE, Robinson M, Oldham J, Patriquin MA, Fowler JC | display-authors=etal| title=Subcortical brain morphometry of avoidant personality disorder. | journal=J Affect Disord | year= 2020 | volume= 274 | issue= | pages= 1057-1061 | pmid=32663932 | doi=10.1016/j.jad.2020.05.127 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32663932 }} </ref>. | |||
Volumetric MRI studies by Atmaca et al. shows that small left and right [[orbit-frontal cortex]] volumes is seen in obsessive compulsive personality as compared to healthy individuals.<ref name="pmid30962057">{{cite journal| author=Atmaca M, Korucu T, Tabara MF, Yildirim H, Kılıç MC| title=Volumetric MRI study of orbito-frontal cortex and thalamus in obsessive-compulsive personality disorder. | journal=J Clin Neurosci | year= 2019 | volume= 64 | issue= | pages= 89-93 | pmid=30962057 | doi=10.1016/j.jocn.2019.03.062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30962057 }} </ref> | |||
The MRI in schizotypal PD reveals a reduced gray matter volume in left [[superior temporal gyrus]] and reduced [[parahippocampal]] asymmetry as compared to healthy adults. This is similar to those seen in schizophrenia patients. However, in schizophrenics, MRI also has abnormalities in [[medial temporal lobe]]. <ref name="pmid10356620">{{cite journal| author=Dickey CC, McCarley RW, Voglmaier MM, Niznikiewicz MA, Seidman LJ, Hirayasu Y | display-authors=etal| title=Schizotypal personality disorder and MRI abnormalities of temporal lobe gray matter. | journal=Biol Psychiatry | year= 1999 | volume= 45 | issue= 11 | pages= 1393-402 | pmid=10356620 | doi=10.1016/s0006-3223(99)00030-x | pmc=2832794 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10356620 }} </ref> | |||
==References== | ==References== | ||
Latest revision as of 16:47, 30 June 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayesha Anwar, M.B.B.S[2]
Overview
The MRI changes observed in borderline PD are found in hypothalamus and limbic system. The volumetric changes in gray matter in various regions of brain are associated with rest of PDs.
MRI
Variable data regarding findings on MRI in PD is found. BPD is one of the most prevalent and commonly studied personality disorder and data regarding other types in lacking. Moreover, due to the co-occurence of other mental health conditions with PDs, it becomes difficult to ascertain the specific findings present in neuroimaging in PD. However, most of the studies reveals that changes in BPD is apparent in amygdala and limbic system in the brain. The findings in BPD on neuroimaging represent difference in volume and activity in brain structures.The first study was conducted by Lyoo et al. which compared 25 patients with BPD with age and gender-matched healthy subjects and demonstrated that individuals with BPD have smaller frontal lobe volume on brain MRI. [1]. More studies conducted by Driessen et al. and Terbartz van Elst et al. found that MRI scans in BPD were associated with smaller volumes of the hippocampus and amygdala than healthier controls (16% and 8% by Driessen et al.) and (20.5% and 24% by Terbartz van Elst et al.). The latter also revealed 24% reduction of the left orbitofrontal and a 26% reduction of the right anterior cingulate cortex in borderline personality disorder. [2]. [3]. Another study by Brambilla et al. in 2003 replicated the hippocampus changes in BPD but failed to endorse changes in amygdala. However, it showed the relation of hippocampal changes in BPD with the presence of childhood abuse or trauma. It also demonstrated the increase in putamen in case of concomitant substance abuse in BPD. [4]. Hence, studies throughout the time have endorsed the findings in hippocampus mostly and in amygdala in some cases. This is the cause of BPD or results due to symptoms of affective dysregualtion in them, remains unclear. Impulsivity in PD is associated with changes in frontal structures and aggression with changes in hippocampal and frontal structures [5]. Irle et al. in 2005 showed a new finding of reduced right parietal cortex in individuals with BPD, which may be due to neurodevelopmental deficit of right hemisphere. [6]. Functional MRI (fMRI) is another technique being used to ascertain the changes in BPD. It is a modality that measures and maps brain activity by detecting minute changes in blood flow in those regions. Lei et al. in 2017 established that fMRI in BPD manifests decreased amplitude of low frequency fluctuations (ALFF) and regional homogeneity (ReHo) in the right posterior cingulate cortex (PCC) and adjacent precuneus [7].
MRI imaging in antisocial PD is associated with cortical thinning in most cases. Jiang et al. study indicated that antisocial PD was associated with higher gray matter volumes in the inferior parietal lobule and white matter volumes in precuneus as compared to healthy individuals. [8]. [9]. fMRI is also useful and results in higher degree of fractional anisotropy in left lingual gyrus, bilateral precuneus, right superior frontal gyrus and right middle temporal gyrus. [8]
Schulze et al. found that MRI in individuals with narcissistic personality disorder shows small gray matter volume in left anterior insula and fronto-paralimbic brain regions. [10]. No specific subcortical volumetric changes have been observed through studies in avoidant personality disorder. [11].
Volumetric MRI studies by Atmaca et al. shows that small left and right orbit-frontal cortex volumes is seen in obsessive compulsive personality as compared to healthy individuals.[12]
The MRI in schizotypal PD reveals a reduced gray matter volume in left superior temporal gyrus and reduced parahippocampal asymmetry as compared to healthy adults. This is similar to those seen in schizophrenia patients. However, in schizophrenics, MRI also has abnormalities in medial temporal lobe. [13]
References
- ↑ Lyoo IK, Han MH, Cho DY (1998). "A brain MRI study in subjects with borderline personality disorder". J Affect Disord. 50 (2–3): 235–43. doi:10.1016/s0165-0327(98)00104-9. PMID 9858082.
- ↑ Driessen M, Herrmann J, Stahl K, Zwaan M, Meier S, Hill A; et al. (2000). "Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization". Arch Gen Psychiatry. 57 (12): 1115–22. doi:10.1001/archpsyc.57.12.1115. PMID 11115325.
- ↑ Tebartz van Elst L, Hesslinger B, Thiel T, Geiger E, Haegele K, Lemieux L; et al. (2003). "Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study". Biol Psychiatry. 54 (2): 163–71. doi:10.1016/s0006-3223(02)01743-2. PMID 12873806.
- ↑ Brambilla P, Soloff PH, Sala M, Nicoletti MA, Keshavan MS, Soares JC (2004). "Anatomical MRI study of borderline personality disorder patients". Psychiatry Res. 131 (2): 125–33. doi:10.1016/j.pscychresns.2004.04.003. PMID 15313519.
- ↑ Davies G, Hayward M, Evans S, Mason O (2020). "A systematic review of structural MRI investigations within borderline personality disorder: Identification of key psychological variables of interest going forward". Psychiatry Res. 286: 112864. doi:10.1016/j.psychres.2020.112864. PMID 32163818 Check
|pmid=value (help). - ↑ Irle E, Lange C, Sachsse U (2005). "Reduced size and abnormal asymmetry of parietal cortex in women with borderline personality disorder". Biol Psychiatry. 57 (2): 173–82. doi:10.1016/j.biopsych.2004.10.004. PMID 15652877.
- ↑ Lei X, Zhong M, Liu Y, Jin X, Zhou Q, Xi C; et al. (2017). "A resting-state fMRI study in borderline personality disorder combining amplitude of low frequency fluctuation, regional homogeneity and seed based functional connectivity". J Affect Disord. 218: 299–305. doi:10.1016/j.jad.2017.04.067. PMID 28478359.
- ↑ 8.0 8.1 Jiang W, Liao J, Liu H, Huang R, Li Y, Wang W (2015). "[Brain structure analysis for patients with antisocial personality disorder by MRI]". Zhong Nan Da Xue Xue Bao Yi Xue Ban. 40 (2): 123–8. doi:10.11817/j.issn.1672-7347.2015.02.002. PMID 25769320.
- ↑ Tang Y, Jiang W, Liao J, Wang W, Luo A (2013). "Identifying individuals with antisocial personality disorder using resting-state FMRI". PLoS One. 8 (4): e60652. doi:10.1371/journal.pone.0060652. PMC 3625191. PMID 23593272.
- ↑ Schulze L, Dziobek I, Vater A, Heekeren HR, Bajbouj M, Renneberg B; et al. (2013). "Gray matter abnormalities in patients with narcissistic personality disorder". J Psychiatr Res. 47 (10): 1363–9. doi:10.1016/j.jpsychires.2013.05.017. PMID 23777939.
- ↑ Gosnell SN, Crooks KE, Robinson M, Oldham J, Patriquin MA, Fowler JC; et al. (2020). "Subcortical brain morphometry of avoidant personality disorder". J Affect Disord. 274: 1057–1061. doi:10.1016/j.jad.2020.05.127. PMID 32663932 Check
|pmid=value (help). - ↑ Atmaca M, Korucu T, Tabara MF, Yildirim H, Kılıç MC (2019). "Volumetric MRI study of orbito-frontal cortex and thalamus in obsessive-compulsive personality disorder". J Clin Neurosci. 64: 89–93. doi:10.1016/j.jocn.2019.03.062. PMID 30962057.
- ↑ Dickey CC, McCarley RW, Voglmaier MM, Niznikiewicz MA, Seidman LJ, Hirayasu Y; et al. (1999). "Schizotypal personality disorder and MRI abnormalities of temporal lobe gray matter". Biol Psychiatry. 45 (11): 1393–402. doi:10.1016/s0006-3223(99)00030-x. PMC 2832794. PMID 10356620.