[I-123] ADAM and SPECT in patients with borderline personality disorder and healthy control subjects.
OBJECTIVE
Serotonergic dysfunction is considered to be involved in the pathophysiology of borderline personality disorder (BPD). The aim of this study was to investigate serotonin transporter availability in patients with BPD as a marker of the central serotonergic system.


METHODS
Eight unmedicated patients with BPD and 9 healthy control subjects received single photon emission computed tomography (SPECT) 4 hours after injection of 185 MBq [I-123] ADAM (2-([2-([dimethylamino]methyl)phenyl]thio)). As a measure of brain serotonin transporter (SERT) availability, ratios of specific-to-nonspecific [I-123] ADAM binding for the brainstem and hypothalamus were calculated with an occipital reference. Levels of impulsiveness and depressive symptoms were assessed with the Barratt Impulsiveness Scale and the Beck Depression Inventory.


RESULTS
Mean specific-to-nonspecific ratios showed a 43% higher brainstem and a 12% higher hypothalamus ADAM binding in patients, compared with control subjects. We found significant correlations of ADAM binding with both age and impulsiveness but not depression. Associations of BIS scores with ADAM binding remained significant after controlling for age and depression (r = 0.69, p < 0.01).


CONCLUSIONS
The study provides evidence of a serotonergic dysfunction in patients with BPD and suggests a serotonergic component in the pathophysiology of the disorder. SERT binding reflected the level of impulsiveness as a common feature in BPD.
Koch
Walter
W
Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany.
Schaaff
Nadine
N
Pöpperl
Gabriele
G
Mulert
Christoph
C
Juckel
Georg
G
Reicherzer
Markus
M
Ehmer-von Geiso
Christoff
C
Möller
Hans-Jürgen
HJ
Hegerl
Ulrich
U
Tatsch
Klaus
K
Pogarell
Oliver
O
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging*; D001933:Brain Stem / Q000000981:diagnostic imaging; D002928:Cinanserin / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D011569:Psychiatric Status Rating Scales; D019275:Radiopharmaceuticals; D012701:Serotonin / Q000502:physiology; D050486:Serotonin Plasma Membrane Transport Proteins / Q000502:physiology; D011795:Surveys and Questionnaires; D015899:Tomography, Emission-Computed, Single-Photon
C413491:2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine; D019275:Radiopharmaceuticals; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin; D002928:Cinanserin