title: Personality disorder symptomatology is associated with anomalies in striatal and prefrontal morphology.
abstract: Personality disorder symptomatology (PD-Sx) can result in personal distress and impaired interpersonal functioning, even in the absence of a clinical diagnosis, and is frequently comorbid with psychiatric disorders such as substance use, mood, and anxiety disorders; however, they often remain untreated, and are not taken into account in clinical studies. To investigate brain morphological correlates of PD-Sx, we measured subcortical volume and shape, and cortical thickness/surface area, based on structural magnetic resonance images. We investigated 37 subjects who reported PD-Sx exceeding DSM-IV Axis-II screening thresholds, and 35 age, sex, and smoking status-matched control subjects. Subjects reporting PD-Sx were then grouped into symptom-based clusters: N = 20 into Cluster B (reporting Antisocial, Borderline, Histrionic, or Narcissistic PD-Sx) and N = 28 into Cluster C (reporting Obsessive-Compulsive, Avoidant, or Dependent PD-Sx); N = 11 subjects reported PD-Sx from both clusters, and none reported Cluster A (Paranoid, Schizoid, or Schizotypal) PD-Sx. Compared to control, Cluster C PD-Sx was associated with greater striatal surface area localized to the caudate tail, smaller ventral striatum volumes, and greater cortical thickness in right prefrontal cortex. Both Cluster B and C PD-Sx groups also showed trends toward greater posterior caudate volumes and orbitofrontal surface area anomalies, but these findings did not survive correction for multiple comparisons. The results point to morphological abnormalities that could contribute to Cluster C PD-Sx. In addition, the observations parallel those in substance use disorders, pointing to the importance of considering PD-Sx when interpreting findings in often-comorbid psychiatric disorders.
authors.affiliation: Addictions Program, Centre for Addiction and Mental Health, Toronto ON, Canada ; Research Imaging Centre, Centre for Addiction and Mental Health, Toronto ON, Canada ; Department of Psychiatry, University of Toronto, Toronto ON, Canada.
authors.forename: Doris E
authors.initials: DE
authors.lastname: Payer
authors.affiliation: Research Imaging Centre, Centre for Addiction and Mental Health, Toronto ON, Canada ; Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun QC, Canada ; Schulich School of Medicine and Dentistry, Western University, London ON, Canada.
authors.forename: Min Tae M
authors.initials: MT
authors.lastname: Park
authors.affiliation: Research Imaging Centre, Centre for Addiction and Mental Health, Toronto ON, Canada ; Department of Psychiatry, University of Toronto, Toronto ON, Canada.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kish
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto ON, Canada ; Complex Mental Illness Program, Forensic Service, Centre for Addiction and Mental Health, Toronto ON, Canada.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Kolla
authors.affiliation: Department of Medical Biophysics, University of Toronto, Toronto ON, Canada ; Mouse Imaging Centre, Hospital for Sick Children, Toronto ON, Canada.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Lerch
authors.affiliation: Research Imaging Centre, Centre for Addiction and Mental Health, Toronto ON, Canada ; Department of Psychiatry, University of Toronto, Toronto ON, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Boileau
authors.affiliation: Research Imaging Centre, Centre for Addiction and Mental Health, Toronto ON, Canada ; Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun QC, Canada ; Department of Psychiatry and Biomedical Engineering, McGill University, Montreal QC, Canada.
authors.forename: M M
authors.initials: MM
authors.lastname: Chakravarty
keywords: DSM Axis-II; magnetic resonance imaging; morphology; personality; striatum