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Structural brain abnormalities in borderline personality disorder correlate with clinical severity and predict psychotherapy response. | LitMetric

AI Article Synopsis

  • - This study examined brain structure differences in people with borderline personality disorder (BPD) using advanced imaging techniques in a larger sample than previous research, focusing on how these differences relate to clinical severity and therapy outcomes.
  • - Findings showed that individuals with BPD had reduced gray matter volume and cortical thickness in the prefrontal region but increased gray matter in limbic areas, indicating a possible link between these brain changes and symptoms like impulsivity and emotional dysregulation.
  • - The study suggests that certain brain structural abnormalities could serve as potential biomarkers for predicting how well patients respond to psychotherapy, emphasizing the relationship between brain health and mental health treatment effectiveness.

Article Abstract

Although previous imaging studies in borderline personality disorder (BPD) have found brain abnormalities, the results have been inconsistent. This study aimed to investigate structural brain abnormalities using voxel-based morphometry (VBM) and cortical thickness (Cth) analyses in a large sample of patients with BPD. Additionally, we aimed to determine the correlation between structural abnormalities and clinical severity and to assess its potential value at predicting psychotherapeutic response. Sixty-one individuals with BPD and 19 healthy controls underwent magnetic resonance imaging. Participants with BPD completed several self-report clinical scales, received dialectical-behavioral therapy skills training and post-therapy changes in clinical scores were also recorded. Gray matter volume (GMV) and Cth differences between groups were compared. Within the BPD group, we further characterized the structural brain correlates of clinical severity and investigated the relationship between pre-therapy structural abnormalities and therapeutic response. As potential confounders we included age, sex, educational level, and total intracranial volume (the latter only in VBM analyses). Compared to controls, the BPD group showed a reduced GMV/Cth in prefrontal areas but increased GMV in the limbic structures (amygdala and parahippocampal regions). Prefrontal abnormalities correlated with higher baseline scores on impulsivity and general BPD severity. Increased GMV in the parahippocampal area correlated with a greater emotion dysregulation. Importantly, several baseline structural abnormalities correlated with worse response to psychotherapy. Patients with BPD showed a reduced GMV in the prefrontal areas but a greater GMV in the limbic structures. Several structural abnormalities (i.e. middle and inferior prefrontal areas, anterior insula, or parahippocampal area) correlated with clinical severity and could potentially be used as imaging biological correlates biomarkers to predict psychotherapy response.

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Source
http://dx.doi.org/10.1007/s11682-021-00451-6DOI Listing

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