Instituto de Psiquiatría y SaludMental, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
J Affect Disord. 2012 Jul;139(2):149-53. doi: 10.1016/j.jad.2011.12.019. Epub 2012 Apr 11.
Prefrontal cortex plays a major role in the modulation of behaviors and emotions through regulation of both information processing and impulse control. Low prefrontal function in borderline personality disorder (BPD) has been consistently reported by a number of studies using neuropsychological assessments and functional neuroimaging techniques. To further explore this findings, this study aimed to investigate microstructural damage of prefrontal white matter tracts in subjects with BPD by using the novel, voxel-based approach, tract-based spatial statistics (TBSS).
A Diffusion Tensor Image (DTI) study was performed in 28 patients with DSM-IV BPD (13 males and 15 females) and in 26 healthy control subjects. Voxel wise analysis was performed using TBSS (diffusion toolbox of FSL - functional MRI Software Library) to localize regions of white matter showing significant changes of fractional anisotropy (FA).
TBSS analysis revealed a statistically significant decrease of FA in the genu and rostral areas of the corpus callosum (p<0.005), as well as in left and right prefrontal white matter fasciculi (p<0.002) in BPD participants compared with controls. White matter abnormalities were not correlated with age, neurological symptoms or comorbid ADHD.
Despite the reduced sample size, the results are in line with previous findings on reduced orbitofrontal functions in BPD with prominent affective-depressive feature and suggest that emotional and behavioral symptoms of BPD patients might be associated to damage at the connectivity tracts in these brain areas.
前额皮质通过调节信息处理和冲动控制，在行为和情绪的调节中发挥主要作用。多项使用神经心理学评估和功能神经影像学技术的研究一致报告，边缘型人格障碍（BPD）患者的前额皮质功能较低。为了进一步探索这一发现，本研究旨在通过使用新的基于体素的方法，即基于束的空间统计学（TBSS），研究 BPD 患者前额白质束的微观结构损伤。
对 28 名符合 DSM-IV BPD 诊断标准的患者（13 名男性和 15 名女性）和 26 名健康对照者进行了弥散张量成像（DTI）研究。使用 TBSS（FSL-功能磁共振成像软件库中的弥散工具包）进行基于体素的分析，以定位显示分数各向异性（FA）有显著变化的白质区域。
TBSS 分析显示，与对照组相比，BPD 患者胼胝体膝部和额部（p<0.005）以及左右前额白质束（p<0.002）的 FA 值显著降低。白质异常与年龄、神经症状或共患 ADHD 无关。
尽管样本量较小，但结果与之前关于具有明显情感抑郁特征的 BPD 患者眶额功能降低的发现一致，并表明 BPD 患者的情感和行为症状可能与这些大脑区域的连接束损伤有关。
