title: Inferior frontal white matter microstructure and patterns of psychopathology in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder.
abstract: BACKGROUND
  Inferior frontal white matter circuits are likely to be relevant to dysfunctional affect regulation, aggression, dissociative symptoms, neuropsychological functioning and psychopathology in women with borderline personality disorder (BPD) and comorbid attention-deficit hyperactivity disorder (ADHD).
  
  
  METHODS
  20 women with BPD and comorbid ADHD and 20 healthy women were investigated, and groups were matched for age, education and premorbid intelligence. Mean diffusivity and fractional anisotropy were measured bilaterally in the inferior frontal white matter by diffusion tensor imaging (DTI). Conflict resolution was assessed by the Attention Network Test, sustained vigilance by the Degraded-Stimulus Continuous Performance Test.
  
  
  RESULTS
  Among women with BPD and comorbid ADHD, increased mean diffusivity in inferior frontal white matter was associated with higher levels of dysfunctional affect regulation, anger-hostility, dissociative symptoms, and general psychopathology (p<.05, uncorrected). Poor conflict resolution during the attention task was positively associated with anger-hostility, psychopathology, dissociation and the number of ADHD-symptoms, but not related to DTI variables. Both groups did not differ significantly with respect to DTI variables or neuropsychological performance. In the BPD group, a lifetime history of major depression or a current eating disorder were associated with impaired inferior frontal white matter integrity, while a history of sexual abuse or a current posttraumatic stress disorder were not.
  
  
  CONCLUSIONS
  Inferior frontal white matter microstructural abnormalities may be linked to key aspects of psychopathology in women with BPD and comorbid ADHD and add to alterations in orbitofrontal and limbic areas. The relationship between neuropsychological functioning and white matter structure remains unclear.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Freiburg, Germany. nicolas.ruesch@uniklinik-freiburg.de
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rüsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Weber
authors.forename: Kamil A
authors.initials: KA
authors.lastname: Il'yasov
authors.forename: Klaus
authors.initials: K
authors.lastname: Lieb
authors.forename: Dieter
authors.initials: D
authors.lastname: Ebert
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hennig
authors.forename: Ludger Tebartz
authors.initials: LT
authors.lastname: van Elst
mesh_terms: D000328:Adult; D016880:Anisotropy; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000473:pathology* / Q000523:psychology*; D001883:Borderline Personality Disorder / Q000150:complications / Q000473:pathology* / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging