title: Brain structural anomalies in borderline and avoidant personality disorder patients and their associations with disorder-specific symptoms.
abstract: Borderline personality disorder (BPD) and avoidant personality disorder (AvPD) are characterized by hyper-reactivity to negatively-perceived interpersonal cues, yet they differ in degree of affective instability. Recent work has begun to elucidate the neural (structural and functional) and cognitive-behavioral underpinnings of BPD, although some initial studies of brain structure have reached divergent conclusions. AvPD, however, has been almost unexamined in the cognitive neuroscience literature.
  
  
  
  In the present study we investigated group differences among 29 BPD patients, 27 AvPD patients, and 29 healthy controls (HC) in structural brain volumes using voxel-based morphometry (VBM) in five anatomically-defined regions of interest: amygdala, hippocampus, medial prefrontal cortex (MPFC), dorsolateral prefrontal cortex (DLPFC), and anterior cingulate cortex (ACC). We also examined the relationship between individual differences in brain structure and self-reported anxiety and affective instability in each group.
  
  
  
  We observed reductions in MPFC and ACC volume in BPD relative to HC, with no significant difference among patient groups. No group differences in amygdala volume were found. However, BPD and AvPD patients each showed a positive relationship between right amygdala volume and state-related anxiety. By contrast, in HC there was an inverse relationship between MPFC volume and state and trait-related anxiety as well as between bilateral DLPFC volume and affective instability.
  
  
  
  Current sample sizes did not permit examination of gender effects upon structure-symptom correlations.
  
  
  
  These results shed light on potentially protective, or compensatory, aspects of brain structure in these populations-namely, relatively reduced amygdala volume or relatively enhanced MPFC and DLPFC volume.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Denny
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Psychology, Queens College, City University of New York, New York, NY 11367, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Fan
authors.affiliation: Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Guerreri
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Sarah Jo
authors.initials: SJ
authors.lastname: Mayson
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Liza
authors.initials: L
authors.lastname: Rimsky
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Antonia
authors.initials: A
authors.lastname: McMaster
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Alexander
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; James J Peters VA Medical Center, Bronx, NY 10468, USA.
authors.forename: Antonia S
authors.initials: AS
authors.lastname: New
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; James J Peters VA Medical Center, Bronx, NY 10468, USA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Goodman
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Perez-Rodriguez
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; James J Peters VA Medical Center, Bronx, NY 10468, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Siever
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; James J Peters VA Medical Center, Bronx, NY 10468, USA. Electronic address: HWarrenK@nyc.rr.com.
authors.forename: Harold W
authors.initials: HW
authors.lastname: Koenigsberg
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D001007:Anxiety / Q000000981:diagnostic imaging / Q000523:psychology; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping / Q000379:methods; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size / Q000502:physiology; D010554:Personality Disorders / Q000000981:diagnostic imaging* / Q000523:psychology; D012938:Social Perception; D055815:Young Adult
keywords: Affective instability; Anxiety; Avoidant personality disorder; Borderline personality disorder; Voxel-based morphometry