[123I] ADAM and SPECT in patients with borderline personality disorder and healthy control subjects

Background: Impulsive behaviour, a key feature in borderline personality disorder (BPD), is associated with an impairment of the central serotonergic system. We hypothesized that the serotonin transporter availability is altered in patients with BPD and that there is an association between scores of impulsive aggression and serotonin transporter availability. Methods: In a group of eight female patients with BPD and nine healthy female controls, single photon emission computed tomography (SPECT) was conducted by using the serotonin specific radioligand [123I] ADAM. Using an occipital reference region, brain serotonin transporter availability was measured and ratios of specific to nonspecific [123I] ADAM binding for the brainstem and hypothalamus were calculated. Impulsiveness, anger and depressive symptoms were assessed using the Barratt Impulsiveness Scale, the State-Trait Anger Expression Inventory and the Beck Depression Inventory. Results: Mean specific-to-nonspecific ratios showed a 27% higher brainstem and a 29% higher hypothalamus [123I] ADAM binding in BPD patients compared to healthy controls. Significant correlations were found between ADAM binding and age, impulsiveness, and anger, but not depression. Conclusion: Our results are consistent with previous data suggesting a serotonergic dysfunction in the pathophysiology of BPD. Scores of impulsiveness and anger seemed to be associated with serotonin transporter availability in patients and in healthy controls.