A positron emission tomography study of memories of childhood abuse in borderline personality disorder.
BACKGROUND
Borderline personality disorder (BPD) is a common psychiatric disorder, which is linked to early stressors in many cases; however, the impact of traumatic events in the etiology of BPD is still unclear. This pilot study was conducted to measure the neural correlates of recall of traumatic memories in women with and without BPD.


METHODS
Twenty women with a history of childhood physical or sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal traumatic abuse events. Brain blood flow during exposure to trauma and neutral scripts was compared between women with and without BPD.


RESULTS
Memories of trauma were associated with increases in blood flow in right dorsolateral prefrontal cortex (Brodmann's area [BA] 44 and 45) and with decreased blood flow in left dorsolateral prefrontal cortex (BA 44 and 45) in women without BPD. There was also increased blood flow in right anterior cingulate (BA 24) and left orbitofrontal cortex (BA 11) in women without BPD. Women with BPD failed to activate anterior cingulate gyrus and orbitofrontal cortex. Also, no blood flow changes were seen in dorsolateral prefrontal gyrus in women with BPD.


CONCLUSIONS
Dysfunction of dorsolateral and medial prefrontal cortex, including anterior cingulate, seems to be correlated with the recall of traumatic memories in women with BPD. These brain areas might mediate trauma-related symptoms, such as dissociation or affective instability, in patients with BPD.
Schmahl
Christian G
CG
Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, Germany.
Vermetten
Eric
E
Elzinga
Bernet M
BM
Bremner
J Douglas
JD
D000328:Adult; D001143:Arousal / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D006179:Gyrus Cinguli / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D011939:Mental Recall / Q000502:physiology*; D017397:Prefrontal Cortex / Q000098:blood supply / Q000000981:diagnostic imaging; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D014055:Tomography, Emission-Computed