Cited by 105Personality Disorders and PsychopathologyNeural and Behavioral Psychology StudiesPsychopathy, Forensic Psychiatry, Sexual Offending

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Anterior cingulate volume in adolescents with first-presentation borderline personality disorder

Whittle, Sarah, Chanen, Andrew M., Fornito, Alex, McGorry, Patrick D., Pantelis, Christos, Yücel, Murat·2009·Psychiatry Research Neuroimaging

DOI 10.1016/j.pscychresns.2008.12.004

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Abstract

Reports of volumetric abnormalities in the anterior cingulate cortex (ACC) in adults with established borderline personality disorder (BPD) are inconsistent, and it is not known whether such abnormalities are present early in the disorder. We aimed to investigate ACC volume in a first-presentation teenage BPD sample with minimal exposure to treatment. Fifteen female BPD patients and 15 healthy female control participants underwent magnetic resonance imaging (MRI) scanning. ACC volumes were estimated using a reliable method that accounts for inter-individual variation in sulcal morphology, and measurements were compared between the two groups. Analysis of variance revealed a decrease in volume of the left ACC in BPD patients compared with control participants. This volumetric change was correlated with parasuicidal behavior and impulsivity. A measure of ACC volume asymmetry was also correlated with fear of abandonment symptoms. Our results suggest that ACC volumetric abnormalities early in the course of BPD might be related to clinical correlates of the disorder. Longitudinal studies are needed to examine the nature of this abnormality over the course of the disorder.

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“In addition, neuroimaging studies have highlighted deviant emotion processing in BPD (e.g., Driessen et al., 2000;Whittle et al., 2009), while other research has focused on the role of neurotransmitters such as serotonin (e.g., Norra et al., 2003; Ni et al., 2006) or neuropeptides (Bertsch,…”
Background
Borderline personality disorder and polycystic ovary syndrome: A review of the literature
Tan, R., Grigg, J., & Kulkarni, J. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867417730650 · Cited by 16
“…BPD have been found to have reduced hippocampal volume (Brambilla et al., 2004; Schmahl et al., 2003), smaller amygdala volume (Schmahl et al., 2003), smaller anterior cingulate cortex volume and a unique, compromised frontolimbic network functioning (Goodman et al., 2011; Whittle et al., 2009).”
The Neurobiological Basis of Adolescent-onset Borderline Personality Disorder.
Goodman, M. S., Mascitelli, K. A., & Triebwasser, J. (2013) · Europe PMC (PubMed Central) · Cited by 15
Olfactory sulcus morphology in teenagers with first-presentation borderline personality disorder
Takahashi, T., Nishikawa, Y., Velakoulis, D., Suzuki, M., McGorry, P. D., Pantelis, C., & Chanen, A. M. (2019) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2019.08.006 · Cited by 12
Personality Disorders
Newlin, E., & Weinstein, B. L. (2015) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000466668.02477.0c · Cited by 12
Hemispheric asymmetry of the frontolimbic cortex in young adults with borderline personality disorder
Zhou, Q., Zhong, M., Yao, S., Jin, X., Liu, Y., Tan, C., Zhu, X., & Yi, J. (2017) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12823 · Cited by 11
“Nevertheless, given the preponderance of evidence indicating that ACC and AI contribute to BPD (4, 12, 14, 17), we decided to examine these two regions more closely.”
BackgroundResult
Disrupted emotional neural circuitry in adolescents with borderline personality traits
Safar, K., Sato, J., Ruocco, A. C., Korenblum, M. S., O'Halpin, H., & Dunkley, B. T. (2019) · Neuroscience Letters · doi:10.1016/j.neulet.2019.02.021 · Cited by 12
Borderline Personality Disorder
Hooley, J. M., & Masland, S. R. (2017) · Psychopathology · doi:10.1002/9781394258949.ch14 · Cited by 11
Mentalizing in Adolescents with Borderline Personality Disorder
Uzar, M., Dmitrzak‐Węglarz, M., & Słopień, A. (2023) · Brain Sciences · doi:10.3390/brainsci13101473 · Cited by 12
Dialectical Behavior Therapy
Miller, A. L., Carnesale, M. T., & Courtney, E. A. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0591-1_24 · Cited by 10
Adolescent suicide and self-injury: Deepening the understanding of the biosocial theory and applying dialectical behavior therapy.
Courtney‐Seidler, E. A., Burns, K. E. A., Zilber, I., & Miller, A. L. (2014) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0101638 · Cited by 10
The Neurobiology of Adolescent-Onset Borderline Personality Disorder
Goodman, M. S., Pérez-Rodríguez, M. M., & Siever, L. J. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0591-1_9 · Cited by 8
Frontal systems related symptoms in cocaine dependent patients with comorbid personality disorders
Albein‐Urios, N., Martínez-González, J. M., Lozano, O. M., & Verdejo‐García, A. (2013) · Psychopharmacology · doi:10.1007/s00213-013-3040-x · Cited by 8
“This notion is in agreement with evidence showing that adolescents with very first presentation of borderline personality disorder have reduced gray matter in the cingulate cortex, which is relevant for motivation, inhibition, and executive control (Whittle et al. 2009).”
Result
Variable Presence of an Evolutionarily New Brain Structure Is Related to Trait Impulsivity
Willbrand, E. H., Maboudian, S. A., Elliott, M., Kellerman, G. M., Johnson, S. L., & Weiner, K. S. (2024) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.11.015 · Cited by 8
Resting-state functional connectivity predicting clinical improvement following treatment in female adolescents with non-suicidal self-injury
Mürner-Lavanchy, I. M., Josi, J., Koenig, J., Reichl, C., Brunner, R. M., & Kaess, M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.01.117 · Cited by 7
If It Looks Like a Duck and Quacks Like a Duck: Evaluating the Validity of Borderline Personality Disorder in Adolescents
Sharp, C., & Kalpakci, A. H. (2014) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2015-005 · Cited by 7
Neurobiological Findings in Youth with Borderline Personality Disorder
Brunner, R. M., Henze, R., Richter, J., & Kaess, M. (2014) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2015-003 · Cited by 6
“In contrast with the well-replicated finding of volumetric alterations in the amygdala and the hippocampus among adults with BPD (21), volume differences in adolescent patients with BPD were thought to be restricted to the aforementioned neuroanatomical structures (6,7,26,29).”
BackgroundResult
Hemispheric asymmetries in borderline personality disorder: a systematic review
Mundorf, A., Deneke, L., & Ocklenburg, S. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01888-8 · Cited by 5
A systematic review of neurobiological aspects of borderline personality disorder among adolescent patients
Cruz-Ausejo, L., Rojas-Ortega, A., Valdivieso-Jiménez, G., Copez-Lonzoy, A. J. E., Matayoshi, A., Pacheco‐Mendoza, J., & Benites-Zapata, V. A. (2024) · Biomarkers in Neuropsychiatry · doi:10.1016/j.bionps.2024.100114 · Cited by 5
Dynamic brain activity and thyroid dysregulation in suicidal ideation of MDD
Zhao, S., Wang, A., Han, Y., Liu, Y., Fang, W., Cheng, X., Guan, J., Chen, J., Song, C., Yan, Y., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120195 · Cited by 4
The Psychiatric‐Metabolic Interface: Exploring the Interplay Between Mental Disorders and Metabolic Syndrome
Elias, L., Saroufine, K., Alagha, M., Beaini, C. E., Bekai, E. A., Semaan, S., Elkhoury, E., Harb, F., Azar, S. T., Khoury, N. B. E., et al. (2026) · Mental Illness · doi:10.1155/mij/4208707 · Cited by 4
Increased Right Dorsolateral Prefrontal Cortex Connectivity During Emotion Recognition Task in Adolescents With Self-Injurious Behavior: A Functional Near-Infrared Spectroscopy Study
Lee, S. M., Cha, J., & Hong, M. (2023) · Psychiatry Investigation · doi:10.30773/pi.2022.0152 · Cited by 4
Anterior cingulate folding pattern is altered in autism spectrum disorder
Willbrand, E. H., Martinez, E., Ludwig, J. J., Maboudian, S. A., & Weiner, K. S. (2026) · Cerebral Cortex · doi:10.1093/cercor/bhag012 · Cited by 5
Borderline personality: revisiting its classification as a neurodevelopmental disorder
Laurini, O., Strugarek, P., & Rahioui, H. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1587778 · Cited by 4
Neuroimaging in Personality Disorders
Chan, C. C., Vaccaro, D. H., Rose, N. L. J., Kessler, L. E., & Hazlett, E. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108333931.003 · Cited by 3
Borderline Personality Disorder and the Heart
Boldrini, A. (2020) · Springer eBooks · doi:10.1007/978-3-030-28008-6_25 · Cited by 3
Functional and Structural MRI Studies on Impulsiveness: Attention-Deficit/Hyperactive Disorder and Borderline Personality Disorders
Archer, T., & Bright, P. (2012) · InTech eBooks · doi:10.5772/22915 · Cited by 3
“Whittle et al. (2009) investigated anterior cingulate cortex volume in a first-presentation teenage BPD population with minimal exposure to treatment.”
Background
Borderline personality disorder and post-traumatic stress disorder in adolescents: protocol for a comparative study of borderline personality disorder with and without comorbid post-traumatic stress disorder (BORDERSTRESS-ADO)
Riou, M., Duclos, H., Leribillard, M., Parienti, J., Segobin, S. H., Viard, A., Apter, G., Gérardin, P., Guillery‐Girard, B., & Guenolé, F. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06093-4 · Cited by 3
Early structural brain abnormalities in borderline personality disorder
Salgado‐Pineda, P., Ferrer, M., Calvo, N., Costa, X., Ramos‐Quiroga, J. A., Tarragona, B., Duque-Yemail, J. D., Veciana-Verdaguer, C., Rué, À., Fuentes‐Claramonte, P., et al. (2025) · Psychological Medicine · doi:10.1017/s0033291725101645 · Cited by 2
“Examining the female patients in the same study ( N = 15 and 15), Whittle et al. (2009) found reduced volume in the patients in an ROI placed in the ACC.”
A Biopsychosocial Model of Female Criminality: Implications for Assessment and Evidence-Based Treatment Approaches
Peper, M., Krammer, S., & Klecha, D. (2016) · Springer eBooks · doi:10.1007/978-3-319-08398-8_22 · Cited by 2
Risk Factors of Early Onset of Borderline Personality Disorder: A Conceptual Model
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Maurex, L. (2009) · Figshare · Cited by 2
Structural alterations related to emotion dysregulation, anxiety and self-harm in adolescents borderline personality disorder. A source-based morphometry study
Yi, X., Wang, X., Zhang, J., Wu, F., Shen, L., Wang, L., Xiao, Q., & Grecucci, A. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.121035 · Cited by 2
Brain structural and functional alterations in adolescents with borderline personality disorder: A systematic review and a research agenda
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Authors: Whittle, S., Chanen, A. M., Fornito, A., McGorry, P. D., Pantelis, C., & Yücel, M.
Affiliations: The University of Melbourne (AU)
Corresponding author: Yücel, Murat
ORCID: Whittle, Sarah
Chanen, Andrew M.
Fornito, Alex
McGorry, Patrick D.
Pantelis, Christos
Yücel, Murat
Venue: Psychiatry Research Neuroimaging
Publisher: Elsevier BV
Published: 2009-05
Volume: 172
Issue: 2
Pages: 155-160
ISSN: 0925-4927 (ISSN-L)
DOI: 10.1016/j.pscychresns.2008.12.004
OpenAlex: W2023217661
Cited by: 105
References: 56
Citations by year: 2026: 5 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 11 · 2013: 10 · 2012: 11
FWCI: 10.26
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Psychiatry Research Neuroimaging (publishedVersion)
PubMed (publishedVersion)
Figshare (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords: borderline personality disorder, anterior cingulate cortex, brain volume, adolescents, initial presentation, parasuicide, impulsivity, fear of abandonment, hemispheric lateralization, sulcal morphology, neuroanatomical correlates
MeSH terms: Adolescent, Age Factors, Atrophy, Borderline Personality Disorder, Brain, Brain Mapping, Female, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Functional Laterality, Limbic System, Magnetic Resonance Imaging, Young Adult

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Anterior cingulate volume in adolescents with first-presentation borderline personality disorder

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