Volume of hippocampal substructures in borderline personality disorder
Volume of hippocampal substructures in borderline personality disorder
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DOI：
10.1016/j.pscychresns.2014.11.010
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发表时间：
2015-03-30
影响因子：
2.3
通讯作者：
Driessen, Martin
中科院分区：
文献类型：
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作者：
Kreisel, Stefan Henner;Labudda, Kirsten;Driessen, Martin
与对照组相比，交界性人格障碍(BPD)可能与较小的海马体有关。然而，海马亚结构(即头部、体部和尾部)的特异性病理还没有得到充分的研究。为了更详细地研究海马区结构，我们研究了39名患有DSM-IV诊断的BPD的精神科住院患者和门诊患者，以及39名健康对照。在磁共振成像扫描中，手动分割海马体及其亚结构。在BPD患者和对照组之间，海马亚结构的体积(和海马体总体积)没有差异。探索性分析表明，与没有合并创伤后应激障碍(PTSD)的BPD患者相比，有创伤后应激障碍(PTSD)终生病史的患者的海马区可能明显较小(影响海马头和海马体)(海马体总体积差异：-10.5%，95%CI-2.6至-18.5，显著)。同时，符合7个或7个以上DSM-IV BPD标准的患者也显示出海马头体积缩小，仅限于海马头(海马头体积差：-16.5%，95%CI-6.1至-26.8，显著)。例如，在症状严重程度和精神并存方面的疾病异质性可能会限制研究之间的直接可比性；这里提出的结果可能反映了受影响较小的患者的海马体体积，也可能只是一个偶然的发现。然而，也有可能BPD对海马体的全球影响之前被高估了。(C)2014爱思唯尔爱尔兰有限公司。保留所有权利。
Borderline personality disorder (BPD) may be associated with smaller hippocampi in comparison to hippocampal size in controls. However, specific pathology in hippocampal substructures (i.e., head, body and tail) has not been sufficiently investigated. To address hippocampal structure in greater detail, we studied 39 psychiatric inpatients and outpatients with a DSM-IV diagnosis of BPD and 39 healthy controls. The hippocampus and its substructures were segmented manually on magnetic resonance imaging scans. The volumes of hippocampal substructures (and total hippocampal volume) did not differ between BPD patients and controls. Exploratory analysis suggests that patients with a lifetime history of posttraumatic stress disorder (PTSD) may have a significantly smaller hippocampus - affecting both the hippocampal head and body - in comparison to BPD patients without comorbid PTSD (difference in total hippocampal volume: -10.5%, 95%CI -2.6 to -18.5, significant). Also patients fulfilling seven or more DSM-IV BPD criteria showed a hippocampal volume reduction, limited to the hippocampal head (difference in volume of the hippocampal head: -16.5%, 95%CI -6.1 to -26.8, significant). Disease heterogeneity in respect to, for example, symptom severity and psychiatric comorbidities may limit direct comparability between studies; the results presented here may reflect hippocampal volumes in patients who are "less" affected or they may simply be a chance finding. However, there is also the possibility that global effects of BPD on the hippocampus may have previously been overestimated. (C) 2014 Elsevier Ireland Ltd. All rights reserved.