Structural brain abnormalities and suicidal behavior in borderline personality disorder
Open accessAbstract
Background Structural brain abnormalities have been demonstrated in subjects with BPD in prefrontal and fronto-limbic regions involved in the regulation of emotion and impulsive behavior, executive cognitive function and episodic memory. Impairment in these cognitive functions is associated with increased vulnerability to suicidal behavior. We compared BPD suicide attempters and non-attempters, high and low lethality attempters to healthy controls to identify neural circuits associated with suicidal behavior in BPD. Methods Structural MRI scans were obtained on 68 BPD subjects (16 male, 52 female), defined by IPDE and DIB/R criteria, and 52 healthy controls (HC: 28 male, 24 female). Groups were compared by diagnosis, attempt status, and attempt lethality. ROIs were defined for areas reported to have structural or metabolic abnormalities in BPD, and included: mid-inf. orbitofrontal cortex, mid-sup temporal cortex, anterior cingulate, insula, hippocampus, amygdala, fusiform, lingual and parahippocampal gyri. Data were analyzed using optimized voxel-based morphometry implemented with DARTEL in SPM5, co-varied for age and gender, corrected for cluster extent (p < .001). Results Compared to HC, BPD attempters had significantly diminished gray matter concentrations in 8 of 9 ROIs, non-attempters in 5 of 9 ROIs. Within the BPD sample, attempters had diminished gray matter in Lt. insula compared to non-attempters. High lethality attempters had significant decreases in Rt. mid-sup. temporal gyrus, Rt. mid-inf. orbitofrontal gyrus, Rt. insular cortex, Lt. fusiform gyrus, Lt. lingual gyrus and Rt. parahippocampal gyrus compared to low lethality attempters. Conclusions Specific structural abnormalities discriminate BPD attempters from non-attempters and high from low lethality attempters.
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Two relatively well-powered volumetric studies of BPD found smaller gray matter volume in rACC and lOFC.
“Nevertheless, two relatively well-powered volumetric studies of BPD (Soloff et al., 2008, 2012) found smaller gray matter volume in rACC and lOFC (Figures 8A,B).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Soloff et al., 2012
The 2012 paper's Methods describe a volumetric study of 68 BPD subjects and 52 controls. Its Results (Structural analyses; page unavailable) report reduced gray matter concentration in the anterior cingulate for the full BPD group, but do not specify the right side. Orbitofrontal reduction is reported for BPD suicide attempters versus controls, not for the full BPD group, and the passage does not establish that it was left-sided. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSmaller lOFC volume was specifically observed in suicide attempters and even more so in high lethality suicide attempters.
“Smaller lOFC volume was specifically observed in suicide attempters and even more so in high lethality suicide attempters (Soloff et al., 2012).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Soloff et al., 2012
The Abstract Results and Results > Structural analyses (page unavailable) report lower right middle-inferior orbitofrontal gray-matter concentration in high-lethality than low-lethality BPD attempters. They do not report smaller orbitofrontal volume specifically in attempters versus non-attempters; for that comparison, the reported difference is in the left insula. The paper measures gray-matter concentration, not volume. (LLM, conf=0.88)
Experimental — accuracy not yet measuredWell-powered studies of BPD showed smaller gray matter volumes in rACC and lOFC.
“By contrast, well-powered studies of BPD (Soloff et al., 2008, 2012) showed smaller gray matter volumes in rACC and lOFC.”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Soloff et al., 2012
The Results (Structural analyses; page unavailable) report reduced gray-matter concentration in the anterior cingulate among all BPD subjects versus controls, and in the orbitofrontal cortex among BPD suicide attempters versus controls. They do not establish the claimed right-anterior-cingulate and left-orbitofrontal pattern for BPD as a whole; the reported measure is gray-matter concentration rather than volume. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Soloff, P. H., Pruitt, P., Sharma, M., Radwan, J., White, R., & Diwadkar, V. A.
- Affiliations
- University of Pittsburgh (US)
- Wayne State University (US)
- Corresponding author
- Soloff, Paul H.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2012-04
- Volume
- 46
- Issue
- 4
- Pages
- 516-525
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC3307855
- OpenAlex
- W2035685966
- Cited by
- 191
- References
- 13
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 9 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 16 · 2019: 10 · 2018: 31 · 2017: 11 · 2016: 16 · 2015: 12 · 2014: 22 · 2013: 9 · 2012: 4
- FWCI
- 17.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (048463)
- National Institute of Mental Health (R01MH048463)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- borderline personality disorder, suicidal behavior, suicide attempts, gray matter volume, structural brain abnormalities, orbitofrontal cortex, insula, temporal cortex, fusiform gyrus, parahippocampal gyrus, limbic system
- MeSH terms
- Adult, Borderline Personality Disorder, Brain, Brain Mapping, Female, Humans, Image Processing, Computer-Assisted, Functional Laterality, Magnetic Resonance Imaging, Male, Psychiatric Status Rating Scales, Suicide, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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