title: Increased Prevalence of Intermittent Rhythmic Delta or Theta Activity (IRDA/IRTA) in the Electroencephalograms (EEGs) of Patients with Borderline Personality Disorder.
abstract: BACKGROUND
  An increased prevalence of pathological electroencephalography (EEG) signals has been reported in patients with borderline personality disorder (BPD). In an elaborative case description of such a patient with intermittent rhythmic delta and theta activity (IRDA/IRTA), the BPD symptoms where linked to the frequency of the IRDAs/IRTAs and vanished with the IRDAs/IRTAs following anticonvulsive therapy. This observation raised a question regarding the prevalence of such EEG abnormalities in BPD patients. The aim of this retrospective study was to identify the frequency of EEG abnormalities in a carefully analyzed psychiatric collective. Following earlier reports, we hypothesized an increased prevalence of EEG abnormalities in BPD patients.
  
  
  METHODS
  We recruited 96 consecutive patients with BPD from the archive of a university clinic for psychiatry and psychotherapy, and compared the prevalence of EEG abnormalities to those of 76 healthy controls subjects. The EEGs were rated by three different blinded clinicians, including a consultant specializing in epilepsy from the local epilepsy center.
  
  
  RESULTS
  We found a significant increase in the prevalence of IRDAs and IRTAs in BPD patients (14.6%) compared to the control subjects (3.9%; p = 0.020).
  
  
  CONCLUSIONS
  In this blinded retrospective case-control study, we were able to confirm an increased prevalence of pathological EEG findings (IRDAs/IRTAs only) in BPD patients. The major limitation of this study is that the control group was not matched on age and gender. Therefore, the results should be regarded as preliminary findings of an open uncontrolled, retrospective study. Future research performing prospective, controlled studies is needed to verify our findings and answer the question of whether such EEG findings might predict a positive response to anticonvulsive pharmacological treatment.
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Ludger
authors.initials: L
authors.lastname: Tebartz van Elst
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Fleck
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bartels
authors.affiliation: Department of Neurosurgery, Freiburg Epilepsy Center, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Dirk-Matthias
authors.initials: DM
authors.lastname: Altenmüller
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Riedel
authors.affiliation: Department for Psychiatry and Psychotherapy, Saarland University Medical Center Homburg, Germany.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Bubl
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Swantje
authors.initials: S
authors.lastname: Matthies
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Feige
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Evgeniy
authors.initials: E
authors.lastname: Perlov
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany.
authors.forename: Dominique
authors.initials: D
authors.lastname: Endres
keywords: EEG; IRDA; IRTA; borderline personality disorder; local area network inhibition