A science update from the National Institute of Mental Health explains that differences in the working tissue of the brain, called grey matter, have been linked to borderline personality disorder (BPD).
According to the experts, people with BPD had excess grey matter in a part of the brain termed a “fear hub”, which over-activated when they viewed scary faces. By contrast, the hub’s regulator near the front of the brain was deficient in grey matter and underactive, effectively taking the brakes off a runaway fear response.
The finding, facilitated by imaging studies, is the first to link structural brain differences with functional impairment in the same sample of BPD patients.
Similar changes in the same circuit have been implicated in mood and anxiety disorders, hinting that BPD might share common mechanisms with mental illnesses that have traditionally been viewed through the lens of biology.
Michael Minzenberg, M.D., of the University of California, Davis, and NIMH grantees Antonia S. New, M.D., and Larry J. Siever, M.D., of Mount Sinai School of Medicine, and colleagues, reported on their magnetic resonance imaging (MRI) findings in the Journal of Psychiatric Research.
Their functional imaging findings were reported in an earlier issue of Psychiatric Research Neuroimaging.
Accounting for up to 20 percent of psychiatric hospitalizations, BPD affects up to 1.4 percent of adults in a year. It is characterized by intense bouts of anger, depression, and anxiety that may last only hours, often in response to perceived rejection.
People with this difficult to treat disorder typically experience tumultuous work and family life and may engage in risky, impulsive behaviors. Cutting, burning and other forms of self-harm are common. The completed suicide rate in BPD approaches 10 percent, and at least 75 percent of afflicted individuals attempt suicide at least once.