Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder
Morphometric differences in central stress-regulating structures between women with and without borderline personality disorder
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DOI：
10.1503/jpn.120039
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发表时间：
2013-03-01
影响因子：
4.3
通讯作者：
Herpertz, Sabine C.
中科院分区：
文献类型：
--
作者：
Kuhlmann, Andrea;Bertsch, Katja;Herpertz, Sabine C.
背景：早期生活压力的经历、心理唤醒的增加和身体的生理应激反应似乎在边缘性人格障碍（BPD）的发病机制和维持中发挥着重要作用。在本研究中，我们研究了女性 BPD 患者中枢压力调节结构灰质的变化。方法：我们使用全自动 DARTEL 基于体素的形态测定法，检查了未接受药物治疗的右利手女性 BPD 患者（根据 DSM-IV 标准）和年龄、智力和教育程度匹配的健康对照的 T-1 加权结构磁共振成像扫描。我们感兴趣的分析区域包括海马体、杏仁核、前扣带皮层 (ACC) 和下丘脑。结果：我们的研究招募了 30 名患者和 33 名对照者。与健康参与者相比，边缘性人格障碍患者的海马体灰质减少，但下丘脑灰质增加。 BPD 患者的下丘脑体积与创伤史呈正相关。杏仁核和 ACC 未发现显着改变。局限性：本研究因缺乏促肾上腺皮质激素释放激素、促肾上腺皮质激素和皮质醇水平的测量而受到限制。此外，需要考虑中等样本量和合并症。结论：我们的研究结果为下丘脑灰质的改变提供了新的证据，并重复了之前报道的 BPD 患者海马体积的减少。了解下丘脑和其他中枢压力调节结构的作用可以帮助我们进一步了解这种复杂疾病的神经生物学基础。
Background: Experiences of early life stress, increased psychological arousal and the body's physiologic stress response seem to play an important role in the pathogenesis and maintenance of borderline personality disorder (BPD). In the present study, we investigated alterations in grey matter of central stress-regulating structures in female patients with BPD. Methods: We examined T-1-weighted structural magnetic resonance imaging scans of unmedicated, right-handed female patients with BPD (according to DSM-IV criteria) and healthy controls matched for age, intelligence and education using fully automated DARTEL voxel-based morphometry. Our regions of interest analyses included the hippocampus, amygdala, anterior cingulate cortex (ACC) and hypothalamus. Results: We enrolled 30 patients and 33 controls in our study. The grey matter of patients with BPD was reduced in the hippocampus, but increased in the hypothalamus compared with healthy participants. Hypothalamic volume correlated positively with the history of traumatization in patients with BPD. No significant alterations were found in the amygdala and ACC. Limitations: This study is limited by the lack of measures of corticotropin-releasing hormone, adrenocorticotropic hormone and cortisol levels. Furthermore, moderate sample size and comorbid disorders need to be considered. Conclusion: Our findings provide new evidence for grey matter alterations in the hypothalamus and replicate previously reported decrements in hippocampal volume in patients with BPD. Understanding the role of the hypothalamus and other central stress-regulating structures could help us to further understand the neurobiological underpinnings of this complex disorder.