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Orbitofrontal cortex and impulsivity in borderline personality disorder: an MRI study of baseline brain perfusion

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Abstract

Behavioral and neuroimaging studies in patients with borderline personality disorder (BPD) have associated orbitofrontal cortex (OFC) dysfunction with distinct symptom clusters such as impulsivity. It is unclear, however, whether abnormal patterns of OFC activity are also present during resting-state conditions and whether OFC dysfunction is specifically associated with impulsivity in BPD. This study tested the hypothesis that BPD patients would exhibit changes of OFC baseline perfusion and explored the relationship between regional cerebral blood flow and distinct BPD symptom clusters, such as impulsivity, dissociation tension and depressive symptoms. Using continuous arterial spin labeling magnetic resonance imaging at 3 Tesla, we investigated 16 women with BPD according to DSM-IV criteria and 16 healthy female control participants during resting-state conditions. Between-group comparisons were conducted using an analysis of variance (p < 0.05 cluster corrected). Compared to controls, BPD patients exhibited decreased blood flow in the medial OFC, whereas increased blood flow was found in the left and right lateral OFC. Correlation analyses revealed a positive relationship between medial and lateral orbitofrontal blood flow and impulsivity scores, whereas measures of dissociation tension and depression did not exhibit a significant correlation with OFC perfusion. These data suggest that dysfunction of medial and lateral regions of the OFC could specifically mediate symptoms of impulsivity in BPD.

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Acknowledgments

The authors would like to thank all participants and their families for their time and interest in this study.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany

    Robert Christian Wolf & Philipp Arthur Thomann

  2. Brain Center for Motor and Social Cognition, Italian Institute of Technology, Parma, Italy

    Fabio Sambataro

  3. Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany

    Nenad Vasic & Markus Schmid

  4. Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany

    Nadine Donata Wolf

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  1. Robert Christian Wolf
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Correspondence to Robert Christian Wolf.

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Wolf, R.C., Thomann, P.A., Sambataro, F. et al. Orbitofrontal cortex and impulsivity in borderline personality disorder: an MRI study of baseline brain perfusion. Eur Arch Psychiatry Clin Neurosci 262, 677–685 (2012). https://doi.org/10.1007/s00406-012-0303-1

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