title: Orbitofrontal cortex and impulsivity in borderline personality disorder: an MRI study of baseline brain perfusion.
abstract: Behavioral and neuroimaging studies in patients with borderline personality disorder (BPD) have associated orbitofrontal cortex (OFC) dysfunction with distinct symptom clusters such as impulsivity. It is unclear, however, whether abnormal patterns of OFC activity are also present during resting-state conditions and whether OFC dysfunction is specifically associated with impulsivity in BPD. This study tested the hypothesis that BPD patients would exhibit changes of OFC baseline perfusion and explored the relationship between regional cerebral blood flow and distinct BPD symptom clusters, such as impulsivity, dissociation tension and depressive symptoms. Using continuous arterial spin labeling magnetic resonance imaging at 3 Tesla, we investigated 16 women with BPD according to DSM-IV criteria and 16 healthy female control participants during resting-state conditions. Between-group comparisons were conducted using an analysis of variance (p < 0.05 cluster corrected). Compared to controls, BPD patients exhibited decreased blood flow in the medial OFC, whereas increased blood flow was found in the left and right lateral OFC. Correlation analyses revealed a positive relationship between medial and lateral orbitofrontal blood flow and impulsivity scores, whereas measures of dissociation tension and depression did not exhibit a significant correlation with OFC perfusion. These data suggest that dysfunction of medial and lateral regions of the OFC could specifically mediate symptoms of impulsivity in BPD.
authors.affiliation: Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany. christian.wolf@med.uni-heidelberg.de
authors.forename: Robert Christian
authors.initials: RC
authors.lastname: Wolf
authors.forename: Philipp Arthur
authors.initials: PA
authors.lastname: Thomann
authors.forename: Fabio
authors.initials: F
authors.lastname: Sambataro
authors.forename: Nenad
authors.initials: N
authors.lastname: Vasic
authors.forename: Markus
authors.initials: M
authors.lastname: Schmid
authors.forename: Nadine Donata
authors.initials: ND
authors.lastname: Wolf
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007175:Impulsive Behavior / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D010100:Oxygen / Q000097:blood; D017397:Prefrontal Cortex / Q000098:blood supply / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D010100:Oxygen