title: White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder.
abstract: BACKGROUND
  Borderline personality disorder (BPD) is a severe psychiatric disorder involving a range of symptoms including marked affective instability and disturbances in interpersonal interactions. Neuroimaging studies are beginning to provide evidence of altered processing in fronto-limbic network deficits in the disorder, however, few studies directly examine structural connections within this circuitry together with their relation to proposed causative processes and clinical features.
  
  
  METHODS
  In the current study, we investigated whether individuals with BPD (n = 20) have deficits in white matter integrity compared to a matched group of healthy controls (n = 18) using diffusion tensor MRI (DTI). We hypothesized that the BPD group would have decreased fractional anisotropy (FA), a measure of white matter integrity, compared to the controls in white matter tracts connecting frontal and limbic regions, primarily the cingulum, fornix and uncinate fasciculus. We also investigated the extent to which any such deficits related to childhood adversity, as measured by the childhood trauma questionnaire, and symptom severity as measured by the Zanarini rating scale for BPD.
  
  
  RESULTS
  We report decreased white matter integrity in BPD versus controls in the cingulum and fornix. There were no significant relationships between FA and measures of childhood trauma. There were, however, significant associations between FA in the cingulum and clinical symptoms of anger, and in the fornix with affective instability, and measures of avoidance of abandonment from the Zanarini rating scale.
  
  
  CONCLUSIONS
  We report deficits within fronto-limbic connections in individuals with BPD. Abnormalities within the fornix and cingulum were related to severity of symptoms and highlight the importance of these tracts in the pathogenesis of the disorder.
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors: Heather C
authors: HC
authors: Whalley
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors: Thomas
authors: T
authors: Nickson
authors: Royal Edinburgh Hospital, Edinburgh, UK.
authors: Merrick
authors: M
authors: Pope
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors: Katie
authors: K
authors: Nicol
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors: Liana
authors: L
authors: Romaniuk
authors: Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, UK.
authors: Mark E
authors: ME
authors: Bastin
authors: Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK ; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors: Scott I
authors: SI
authors: Semple
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors: Andrew M
authors: AM
authors: McIntosh
authors: Division of Psychiatry, University of Edinburgh, Edinburgh, UK ; Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, UK.
authors: Jeremy
authors: J
authors: Hall
mesh_terms: D000328:Adult; D016880:Anisotropy; D001883:Borderline Personality Disorder / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D066127:White Matter / Q000473:pathology*
keywords: Abandonment; Anger; Borderline personality; Cingulum; Diffusion tensor imaging; Fornix