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Frontal White Matter Integrity in Borderline Personality Disorder With Self-Injurious Behavior

Received July 17, 2006; revised October 30, 2006; accepted November 20, 2006. Drs. Grant and Schulz are affiliated with the University of Minnesota, Minneapolis, Minnesota. Dr. Correia is affiliated with the Providence Veterans Affairs Medical Center, Brown Medical School, Providence, Rhode Island. Ms. Brennan-Krohn and Dr. Malloy are affiliated with Butler Hospital, Brown Medical School, Providence, Rhode Island. Dr. Laidlaw is affiliated with Brown University, Providence, Rhode Island. Address correspondence to Dr. Grant, Department of Psychiatry, University of Minnesota Medical Center, 2450 Riverside Avenue, Minneapolis, MN 55454; grant045{at}umn.edu (e-mail).

Self-injurious behavior in borderline personality disorder is a frequent cause of morbidity and mortality, but neurobiological studies examining this behavior are few. Nine women with borderline personality disorder self-injurious behavior and seven comparison subjects underwent diffusion tensor imaging (DTI). Trace and fractional anisotropy (FA) were calculated for frontal and posterior regions. Borderline personality disorder-self-injurious behavior subjects also underwent a battery of neuropsychological tests that emphasized executive functions. They had significantly higher trace and lower FA in inferior frontal but not posterior regions. Correlational analyses between DTI and cognitive variables showed a pattern of results that was contrary to expectations with posterior white matter integrity correlating with isolated measures of executive function and anterior white matter integrity correlating with a component of verbal memory test performance. Women with borderline personality disorder-self-injurious behavior exhibit decreased white matter microstructural integrity in inferior frontal brain regions that may include components of orbito-frontal circuitry.

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