Associations of Child Amygdala Development with Borderline Personality Symptoms in Adolescence.

Anna Constantino-Pettit, Kirsten Gilbert, Kiran Boone, Katherine Luking, Benjamin Geselowitz, Rebecca Tillman, Diana Whalen, Joan Luby, Deanna M Barch, Alecia Vogel
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Abstract

Background: The understanding of the neural correlates of borderline personality disorder (BPD) is limited, but suggests alterations in limbic structures play a role in adult BPD. The developmental course of structural neural differences in BPD is unknown. Whether there is specificity for structural alterations in BPD compared with other psychiatric presentations, such as major depressive disorder (MDD), remains unexplored. The current study examined childhood trajectories of two limbic regions implicated in BPD, hippocampal and amygdala volume, as they relate to adolescent BPD symptoms as compared with MDD symptoms.

Methods: Participants (N =175; 85 [48.6%] female) were from a 17-year longitudinal study of preschool depression. Participants completed up to 5 MRI scans from late childhood through adolescence. General linear models assessed the relationship between gray matter volume intercepts/slopes and BPD symptoms to understand the influence of the developmental trajectory of brain regions on BPD. Separate models assessed the relationship between MDD symptoms and volume intercepts to assess diagnostic specificity.

Results: Lower childhood amygdala volume (intercept; age 13 centered) across scans was associated with higher adolescent BPD symptoms (β=-0.25, adj. p=.015). There was no relationship between the slope of amygdala volume and BPD symptoms. There was no relationship between hippocampal volume and BPD, nor any relationship between amygdala or hippocampal volume and MDD symptoms in adolescence.

Conclusions: Our findings add evidence for the role of alterations in amygdala structure in BPD development. Decreased amygdala volume as early as age 13 may be an early indicator for the development of BPD in adolescence.

背景:人们对边缘型人格障碍(BPD)的神经相关性了解有限,但边缘结构的改变在成人 BPD 中起着一定的作用。BPD 神经结构差异的发展过程尚不清楚。与重度抑郁障碍(MDD)等其他精神疾病相比,BPD 的结构改变是否具有特异性,目前仍未探明。本研究考察了与 BPD 有关的两个边缘区域--海马和杏仁核体积--的童年轨迹,因为与 MDD 症状相比,它们与青少年 BPD 症状有关:参与者(人数=175;85 [48.6%]为女性)来自一项为期17年的学龄前抑郁症纵向研究。参与者从童年晚期到青春期完成了多达 5 次磁共振成像扫描。一般线性模型评估了灰质体积截距/斜率与 BPD 症状之间的关系,以了解大脑区域的发育轨迹对 BPD 的影响。不同的模型评估了 MDD 症状与体积截距之间的关系,以评估诊断特异性:结果:扫描中儿童期杏仁核体积较小(截距;年龄以 13 岁为中心)与青少年期 BPD 症状较高有关(β=-0.25,adj. p=.015)。杏仁核体积斜率与 BPD 症状之间没有关系。海马体积与BPD之间没有关系,杏仁核或海马体积与青少年MDD症状之间也没有关系:我们的研究结果为杏仁核结构的改变在BPD发展中的作用提供了新的证据。13岁时杏仁核体积的减少可能是青春期BPD发展的早期指标。
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