Microstructural white matter alterations in borderline personality disorder: A minireview

• Published in: Journal of affective disorders Vol. 264; pp. 249 - 255
• Main Authors: Grottaroli, M., Delvecchio, G., Bressi, C., Moltrasio, C., Soares, J.C., Brambilla, P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2020
• Subjects: Borderline personality disorder; Borderline Personality Disorder - diagnostic imaging; Connectivity; Corpus Callosum - diagnostic imaging; Diffusion Tensor Imaging; Humans; Limbic System - diagnostic imaging; White matter; White Matter - diagnostic imaging; Connectivity; White matter; Borderline personality disorder; Diffusion tensor imaging
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2019.12.033

•BPD is characterized by a complex symptomatology and selective functional deficits.•DTI studies quantitatively investigated the white matter integrity in BPD patients.•WM deficits in prefrontal, limbic and callosal areas were found in BPD patients.•Identifying specific biomarkers is paramount for understanding the etiology of BPD. Borderline personality disorder (BPD) affects 1–5% of the population and is characterized by a complex symptomatology and selective functional impairments. Although brain imaging studies have contributed to better characterizing the pathophysiological mechanisms underlying BPD, the white matter (WM) deficits associated with this disorder are still unclear. Therefore, the present review aims at providing an overview of the findings emerged from the available diffusion tensor imaging (DTI) studies on BPD. From a bibliographic research in PubMed until May 2019, we collected 12 studies that fulfilled our inclusion criteria, including a total sample of 291 BPD subjects and 293 healthy controls. Overall, the DTI studies reviewed showed impairments in selective WM tracts that are part of the prefronto-limbic system, including frontal WM (short and long tracts), anterior cingulate cortex, corpus callosum, corona radiata, hippocampal fornix and thalamic radiation, in BPD patients compared to healthy controls. Few DTI studies with heterogeneous findings. Overall these results reported that BPD is characterized by selective structural connectivity alterations in prefronto-limbic structures, further supporting the neurobiological model of BPD that suggests the presence of an abnormal modulation of frontal regions over limbic structures. Finally, the results also highlighted that the disrupted WM integrity in selective brain regions may also explain key-aspects of BPD symptomatology, including emotional dysregulation, ambivalence, contradictory behaviors and cognitive dysfunctions.