Structural alterations of amygdala and hippocampus and HPA axis dysregulation in patients with borderline personality disorder

Borderline personality disorder (BPD) is characterized by clinical symptoms such as affective dysregulation, as well as disturbances of impulse control and interpersonal relationships. Structural alterations of temporolimbic structures (hippocampus, amygdala) and a disturbance of the HPA axis were described for BPD. In other psychiatric diseases a possible causal relationship between hippocampal atrophy and increased cortisol levels was discussed. In this study we want to examine a possible correlation between structural changes of the hippocampus and amygdala and HPA axis dysregulation in BPD. 15 female right handed patients with BPD were examined. Patients fulfilled diagnostic criteria according to DSM IV. MRT examination with a 1.5 Tesla Magnetom Vision and Dexamethason-CRH test were performed. Hippocampal borders were defined by using „region of interest“ method and volume was calculated by using software program BRAINS. Data will be analysed by ANCOVA and correlation coefficients between hippocampal and amygdala brain volume and cortisol levels will be determined. Preliminary results will be presented. Hippocampal volume reduction and an increase of amygdala volume in BPD patients with MDE are expected. A possible correlation between HPA axis dysregulation and hippocampal and amygdala volumes in patients with BPD will be analysed. The implications of a relationship between abnormal stress regulation and alterations of temporolimbic structures in BPD will be discussed.