title: Converging Medial Frontal Resting State and Diffusion-Based Abnormalities in Borderline Personality Disorder.
abstract: BACKGROUND
  The psychological profile of patients with borderline personality disorder (BPD), with impulsivity and emotional dysregulation as core symptoms, has guided the search for abnormalities in specific brain areas such as the hippocampal-amygdala complex and the frontomedial cortex. However, whole-brain imaging studies so far have delivered highly heterogeneous results involving different brain locations.
  
  
  METHODS
  Functional resting-state and diffusion magnetic resonance imaging data were acquired in patients with BPD and in an equal number of matched control subjects (n = 60 for resting and n = 43 for diffusion). While mean diffusivity and fractional anisotropy brain images were generated from diffusion data, amplitude of low-frequency fluctuations and global brain connectivity images were used for the first time to evaluate BPD-related brain abnormalities from resting functional acquisitions.
  
  
  RESULTS
  Whole-brain analyses using a p = .05 corrected threshold showed a convergence of alterations in BPD patients in genual and perigenual structures, with frontal white matter fractional anisotropy abnormalities partially encircling areas of increased mean diffusivity and global brain connectivity. Additionally, a cluster of enlarged amplitude of low-frequency fluctuations (high resting activity) was found involving part of the left hippocampus and amygdala. In turn, this cluster showed increased resting functional connectivity with the anterior cingulate.
  
  
  CONCLUSIONS
  With a multimodal approach and without using a priori selected regions, we prove that structural and functional abnormality in BPD involves both temporolimbic and frontomedial structures as well as their connectivity. These structures have been previously related to behavioral and clinical symptoms in patients with BPD.
authors.affiliation: Fundació per a la Investigació i Docència María Angustias Giménez (RS, EJC-R, MA, EP-C), Germanes Hospitalaries, Barcelona.; Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona. Electronic address: rsalvador@fidmag.com.
authors.forename: Raymond
authors.initials: R
authors.lastname: Salvador
authors.affiliation: Servei de Psiquiatria i Salut Mental (DV, AS, JR), Consorci Sanitari de l'Anoia, Igualada.; Departament de Psiquiatria i Medicina Legal & Institut de Neurociències (DV), Universitat Autònoma de Barcelona.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vega
authors.affiliation: Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona; Department of Psychiatry (JCP, JS), Hospital de la Santa Creu i Sant Pau, Barcelona.; Institut d'Investigació Biomèdica-Sant Pau (JCP, JS), Universitat Autònoma de Barcelona, Barcelona.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Pascual
authors.affiliation: Faculty of Psychology (JM, AR-F), University of Barcelona, Bellvitge Hospital, Barcelona.
authors.forename: Josep
authors.initials: J
authors.lastname: Marco
authors.affiliation: Fundació per a la Investigació i Docència María Angustias Giménez (RS, EJC-R, MA, EP-C), Germanes Hospitalaries, Barcelona.; Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona.
authors.forename: Erick Jorge
authors.initials: EJ
authors.lastname: Canales-Rodríguez
authors.affiliation: Benito Menni-Centre Assistencial en Salut Mental (SA), Sant Boi de Llobregat.; Psychiatry and Clinical Psychology Programme (SA), Universitat Autònoma de Barcelona, Barcelona.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Aguilar
authors.affiliation: Fundació per a la Investigació i Docència María Angustias Giménez (RS, EJC-R, MA, EP-C), Germanes Hospitalaries, Barcelona.; Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona.
authors.forename: Maria
authors.initials: M
authors.lastname: Anguera
authors.affiliation: Servei de Psiquiatria i Salut Mental (DV, AS, JR), Consorci Sanitari de l'Anoia, Igualada.
authors.forename: Angel
authors.initials: A
authors.lastname: Soto
authors.affiliation: Servei de Psiquiatria i Salut Mental (DV, AS, JR), Consorci Sanitari de l'Anoia, Igualada.
authors.forename: Joan
authors.initials: J
authors.lastname: Ribas
authors.affiliation: Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona; Department of Psychiatry (JCP, JS), Hospital de la Santa Creu i Sant Pau, Barcelona.; Institut d'Investigació Biomèdica-Sant Pau (JCP, JS), Universitat Autònoma de Barcelona, Barcelona.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Soler
authors.affiliation: Hospital Sant Joan de Déu (TM), Esplugues de Llobregrat, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Maristany
authors.affiliation: Faculty of Psychology (JM, AR-F), University of Barcelona, Bellvitge Hospital, Barcelona.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rodríguez-Fornells
authors.affiliation: Fundació per a la Investigació i Docència María Angustias Giménez (RS, EJC-R, MA, EP-C), Germanes Hospitalaries, Barcelona.; Centro de Investigación Biomedica en Red de Salud Mental (RS, JCP, EJC-R, MA, JS, EP-C), Barcelona.
authors.forename: Edith
authors.initials: E
authors.lastname: Pomarol-Clotet
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D016880:Anisotropy; D001883:Borderline Personality Disorder / Q000503:physiopathology*; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007175:Impulsive Behavior; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D013030:Spain; D055815:Young Adult
keywords: ALFF; Amygdala; BPD; Brain connectivity; Diffusion MRI; Resting state