Reduced amygdala and hippocampus size in trauma-exposed women with borderline personality disorder and with outposttraumatic stress disorder

Reduced amygdala and hippocampus size in trauma-exposed women with borderline personality disorder and with outposttraumatic stress disorder

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J Psychiatry Neurosci 2009; 34(5): 383-388

Godehard Weniger, MD; Claudia Lange, PhD; Ulrich Sachsse, MD; Eva Irle, PhD

Weniger — Department of Social and General Psychiatry, University of Zürich, Switzerland; Lange, Irle — Department of Psychiatry and Psychotherapy, University of Göttingen; Sachsse — Asklepios Psychiatric Hospital, Göttingen, Germany

Abstract

Background: Individuals with posttraumatic stress disorder (PTSD) display reduced hippocampus size and impaired cognition. However, studies on individuals with borderline personality disorder (BPD) are rare, and studies on trauma-exposed patients with BPD but without PTSD are lacking.

Methods: Twenty-four trauma-exposed women with BPD (10 with PTSD and 14 without) and 25 healthy controls underwent 3-dimensional structural magnetic resonance imaging of the amygdala and hippocampus and a clinical and neuropsychological investigation.

Results: Compared with controls, patients with BPD and PTSD displayed significantly reduced amygdala (34%) and hippocampus (12%) size and significantly impaired cognition. Trauma-exposed patients with BPD but without PTSD also showed significantly reduced amygdala (22%) and hippocampus (11%) size but normal cognition. Amygdala and hippocampus size did not differ significantly between patients with and without PTSD.

Limitations: The sample sizes of trauma-exposed groups are relatively small. A larger sample size may have revealed statistically significant differences in amygdala size between those with and without PTSD.

Conclusions: Our results demonstrate strong amygdala size reduction in trauma-exposed patients with BPD with or without PTSD, much exceeding that reported for traumaexposed individuals without BPD. Our data suggest that BPD is associated with small amygdala size. Furthermore, evidence is increasing that amygdala and hippocampus size reduction is not only due to PTSD, but also to traumatic exposure.


Submitted Aug. 19, 2008; Revised Nov. 8, 2008, Jan. 25, 2009; Accepted Jan. 26, 2009

Acknowledgements: We express our appreciation to the participants of this study. We further wish to thank E. Kohlhase for assistance in participants’ assessments. Research was supported by grant IR 15/8 from the Deutsche Forschungsgemeinschaft.

Competing interests: None declared.

Contributors: Drs. Weniger, Sachsse and Irle designed the study. Drs. Weniger and Lange acquired the data, which Drs. Weniger, Lange and Irle analyzed. Dr. Irle wrote the article, and, together with all authors, revised it. All authors gave final approval for the article to be published.

Correspondence to: Dr. E. Irle, Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, D-37075 Göttingen, Germany; fax 551-3912712; eirle@gwdg.de