Citation

Schmahl CG, Vermetten E, Elzinga BM, Bremner JD. Biol. Psychiatry 2004; 55(7): 759-765.

Affiliation

Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, Germany.

Comment In:

Curr Psychiatry Rep 2005;7(1):39.

Copyright

(Copyright © 2004, Elsevier Publishing)

DOI

10.1016/j.biopsych.2003.11.007

PMID

15039006

Abstract

BACKGROUND: Borderline personality disorder (BPD) is a common psychiatric disorder, which is linked to early stressors in many cases; however, the impact of traumatic events in the etiology of BPD is still unclear. This pilot study was conducted to measure the neural correlates of recall of traumatic memories in women with and without BPD. METHODS: Twenty women with a history of childhood physical or sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal traumatic abuse events. Brain blood flow during exposure to trauma and neutral scripts was compared between women with and without BPD. RESULTS: Memories of trauma were associated with increases in blood flow in right dorsolateral prefrontal cortex (Brodmann's area [BA] 44 and 45) and with decreased blood flow in left dorsolateral prefrontal cortex (BA 44 and 45) in women without BPD. There was also increased blood flow in right anterior cingulate (BA 24) and left orbitofrontal cortex (BA 11) in women without BPD. Women with BPD failed to activate anterior cingulate gyrus and orbitofrontal cortex. Also, no blood flow changes were seen in dorsolateral prefrontal gyrus in women with BPD. CONCLUSIONS: Dysfunction of dorsolateral and medial prefrontal cortex, including anterior cingulate, seems to be correlated with the recall of traumatic memories in women with BPD. These brain areas might mediate trauma-related symptoms, such as dissociation or affective instability, in patients with BPD.

Language: en