Personality disorder MRI

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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

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

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. 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. [5]. 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 [6].

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. [7]. [8]. 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. [7]

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 7.0 7.1 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.
  8. 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.

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