title: Developmental differences in diffusion tensor imaging parameters in borderline personality disorder.
abstract: BACKGROUND
  Borderline personality disorder (BPD) often presents during adolescence. Early detection and intervention decreases its subsequent severity. However, little is known about early predictors and biological underpinnings of BPD. The observed abnormal functional connectivity among brain regions in BPD led to studies of white matter, as the neural substrate of connectivity. However, diffusion tensor imaging (DTI) studies in adult BPD have been inconclusive, and, as yet, there are no published DTI studies in borderline adolescents.
  
  
  METHODS
  We conducted DTI tractography in 38 BPD patients (14-adolescents, 24-adults) and 32 healthy controls (13-adolescents, 19-adults).
  
  
  RESULTS
  We found bilateral tract-specific decreased fractional anisotropy (FA) in inferior longitudinal fasciculus (ILF) in BPD adolescents compared to adolescent controls. ILF FA was significantly higher in adolescent controls compared to BPD adolescents, BPD adults and adult controls (Wilks F(3,57) = 3.55, p < 0.02). Follow-up voxelwise TBSS analysis demonstrated lower FA in BPD adolescents compared to adolescent controls also in uncinate and occipitofrontal fasciculi.
  
  
  CONCLUSIONS
  FA generally develops along an inverted U-shape curve, increasing through adolescence, and slowly decreasing in adulthood. Our findings suggest that, in adolescent BPD, this normal developmental "peak" in FA, which is seen in healthy controls, is not achieved. This suggests a possible neural substrate for the previously reported OFC-amygdala disconnect in adults with BPD. It raises the possibility that a white matter tract abnormality in BPD present in adolescence may not be appreciable in adulthood, but a functional abnormality in the coordination among brain regions persists. Our finding represents a possible biological marker to identify those at risk for developing BPD.
authors.affiliation: The Mental Illness Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, NY 10029, USA. antonia.new@mssm.edu
authors.forename: Antonia S
authors.initials: AS
authors.lastname: New
authors.forename: David M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: M Mercedes
authors.initials: MM
authors.lastname: Perez-Rodriguez
authors.forename: Luis H
authors.initials: LH
authors.lastname: Ripoll
authors.forename: Jennifer
authors.initials: J
authors.lastname: Avedon
authors.forename: Uday
authors.initials: U
authors.lastname: Patil
authors.forename: Erin A
authors.initials: EA
authors.lastname: Hazlett
authors.forename: Marianne
authors.initials: M
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D015203:Reproducibility of Results; D057566:Self Report; D055815:Young Adult