Driessen M, Herrmann J, Stahl K, Zwaan M, Meier S, Hill A, Osterheider M, Petersen D
Department of Psychiatry, Gilead Hospital, Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany.
Arch Gen Psychiatry. 2000 Dec;57(12):1115-22. doi: 10.1001/archpsyc.57.12.1115.
Based on findings of stress-induced neural disturbances in animals and smaller hippocampal volumes in humans with posttraumatic stress disorder), we hypothesized that patients with borderline personality disorders (BPD), who often are victims of early traumatization, have smaller volumes of the hippocampus and the amygdala. We assumed that volumes of these brain regions are negatively correlated with traumatic experiences and with neuropsychological deficits.
We studied 21 female patients with BPD and a similar group of healthy controls. We performed clinical assessments, a modified version of the Childhood Trauma Questionnaire, and magnetic resonance imaging volumetric measurements of the hippocampus, amygdala, temporal lobes, and prosencephalon. Neuropsychological testing included scales on which disturbances in BPD were previously reported.
The patients with BPD had nearly 16% smaller volumes of the hippocampus (P<.001) and 8% smaller volumes of the amygdala (P<.05) than the healthy controls. The results for both hemispheres were nearly identical and were controlled for the volume of the prosencephalon and for head tilts. The volumes of the hippocampus were negatively correlated with the extent and the duration of self-reported early traumatization only when BPD and control subjects were considered together. Levels of neuropsychological functioning were associated with the severity of depression but not with the volumes of the hippocampus.
In female patients with BPD, we found reduction of the volumes of the hippocampus (and perhaps of the amygdala), but the association of volume reduction and traumatic experiences remains unclear. Arch Gen Psychiatry. 2000;57:1115-1122.
基于动物实验中应激诱导的神经紊乱以及创伤后应激障碍患者海马体积较小的研究结果，我们推测边缘型人格障碍（BPD）患者（他们常常是早期创伤的受害者）的海马体和杏仁核体积较小。我们假设这些脑区的体积与创伤经历及神经心理学缺陷呈负相关。
我们研究了21名患有BPD的女性患者以及一组与之相似的健康对照者。我们进行了临床评估、儿童创伤问卷的修订版调查，以及对海马体、杏仁核、颞叶和前脑的磁共振成像体积测量。神经心理学测试包括先前报道过BPD患者存在障碍的量表。
与健康对照者相比，BPD患者的海马体积小了近16%（P<.001），杏仁核体积小了8%（P<.05）。两个半球的结果几乎相同，并对前脑体积和头部倾斜进行了校正。仅当将BPD患者和对照者一起考虑时，海马体体积才与自我报告的早期创伤的程度和持续时间呈负相关。神经心理功能水平与抑郁严重程度相关，但与海马体体积无关。
在患有BPD的女性患者中，我们发现海马体（可能还有杏仁核）体积减小，但体积减小与创伤经历之间的关联仍不明确。《美国医学会杂志·精神病学卷》。2000年；57:1115 - 1122。
