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J Affect Disord. 2015 Mar 15;174:650-7. doi: 10.1016/j.jad.2014.11.059. Epub 2014 Dec 9.

Specificity of abnormal brain volume in major depressive disorder: a comparison with borderline personality disorder.

Author information

1
Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.
2
Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany.
3
Department for Forensic Psychiatry and Psychotherapy at the District Hospital Günzburg, Ulm University, Ulm, Germany.
4
Brain Center for Motor and Social Cognition@UniPR, Istituto Italiano di Tecnologia, Parma, Italy.
5
Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany. Electronic address: christian.wolf@uks.eu.

Abstract

BACKGROUND:

Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups.

METHODS:

22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry.

RESULTS:

A significant (p<0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample.

LIMITATIONS:

Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment.

CONCLUSIONS:

ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders.

KEYWORDS:

Amygdala; Anterior cingulate; Borderline personality disorder; MRI; Major depressive disorder; Voxel-based morphometry

PMID:
25577159
DOI:
10.1016/j.jad.2014.11.059
[Indexed for MEDLINE]

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