title: Elevated Monoamine Oxidase-A Distribution Volume in Borderline Personality Disorder Is Associated With Severity Across Mood Symptoms, Suicidality, and Cognition.
abstract: BACKGROUND
  Monoamine oxidase-A (MAO-A) is a treatment target in neurodegenerative illness and mood disorders that increases oxidative stress and predisposition toward apoptosis. Increased MAO-A levels in prefrontal cortex (PFC) and anterior cingulate cortex (ACC) occur in rodent models of depressive behavior and human studies of depressed moods. Extreme dysphoria is common in borderline personality disorder (BPD), especially when severe, and the molecular underpinnings of severe BPD are largely unknown. We hypothesized that MAO-A levels in PFC and ACC would be highest in severe BPD and would correlate with symptom magnitude.
  
  
  METHODS
  [(11)C] Harmine positron emission tomography measured MAO-A total distribution volume (MAO-A VT), an index of MAO-A density, in severe BPD subjects (n = 14), moderate BPD subjects (n = 14), subjects with a major depressive episode (MDE) only (n = 14), and healthy control subjects (n = 14). All subjects were female.
  
  
  RESULTS
  Severe BPD was associated with greater PFC and ACC MAO-A VT compared with moderate BPD, MDE, and healthy control subjects (multivariate analysis of variance group effect: F6,102 = 5.6, p < .001). In BPD, PFC and ACC MAO-A VT were positively correlated with mood symptoms (PFC: r = .52, p = .005; ACC: r = .53, p = .004) and suicidality (PFC: r = .40, p = .037; ACC: r = .38, p = .046), while hippocampus MAO-A VT was negatively correlated with verbal memory (r = -.44, p = .023).
  
  
  CONCLUSIONS
  These results suggest that elevated MAO-A VT is associated with multiple indicators of BPD severity, including BPD symptomatology, mood symptoms, suicidality, and neurocognitive impairment.
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto; Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Kolla
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Lina
authors.initials: L
authors.lastname: Chiuccariello
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Alan A
authors.initials: AA
authors.lastname: Wilson
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Houle
authors.affiliation: Department of Psychiatry, University of Western Ontario; Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Links
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto; Department of Psychology; Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Shelley
authors.initials: S
authors.lastname: McMain
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Charis
authors.initials: C
authors.lastname: Kellow
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Jalpa
authors.initials: J
authors.lastname: Patel
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Paraskevi V
authors.initials: PV
authors.lastname: Rekkas
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto.
authors.forename: Suvercha
authors.initials: S
authors.lastname: Pasricha
authors.affiliation: Centre for Addiction and Mental Health Research Imaging Centre, Campbell Family Mental Health Research Institute at Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto; Institute of Medical Science, University of Toronto, Toronto, Canada.. Electronic address: jeff.meyer@camhpet.ca.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000339:Affect; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging* / Q000523:psychology*; D002250:Carbon Radioisotopes / Q000528:radiation effects; D016022:Case-Control Studies; D003071:Cognition; D003863:Depression; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging*; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging*; D006247:Harmine / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000378:metabolism*; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D013405:Suicide; D055815:Young Adult
chemical_list: D002250:Carbon Radioisotopes; D008996:Monoamine Oxidase Inhibitors; D006247:Harmine; D008995:Monoamine Oxidase
keywords: Borderline personality disorder; Harmine; Imaging; Monoamine oxidase-A; Positron emission tomography; Suicidal behavior