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Martin Driessen, MD, PhD; Jörg Herrmann, MS; Kerstin Stahl, MS; Martin Zwaan, MD, PhD; Szilvia Meier, MD; Andreas Hill, MD; Marita Osterheider, MD; Dirk Petersen, MD, PhD

Arch Gen Psychiatry. 2000;57:1115-1122.

Background  Based on findings of stress-induced neural disturbances in animals and smaller hippocampal volumes in humans with posttraumatic stress disorder), we hypothesized that patients with borderline personality disorders (BPD), who often are victims of early traumatization, have smaller volumes of the hippocampus and the amygdala. We assumed that volumes of these brain regions are negatively correlated with traumatic experiences and with neuropsychological deficits.

Methods  We studied 21 female patients with BPD and a similar group of healthy controls. We performed clinical assessments, a modified version of the Childhood Trauma Questionnaire, and magnetic resonance imaging volumetric measurements of the hippocampus, amygdala, temporal lobes, and prosencephalon. Neuropsychological testing included scales on which disturbances in BPD were previously reported.

Results  The patients with BPD had nearly 16% smaller volumes of the hippocampus (P<.001) and 8% smaller volumes of the amygdala (P<.05) than the healthy controls. The results for both hemispheres were nearly identical and were controlled for the volume of the prosencephalon and for head tilts. The volumes of the hippocampus were negatively correlated with the extent and the duration of self-reported early traumatization only when BPD and control subjects were considered together. Levels of neuropsychological functioning were associated with the severity of depression but not with the volumes of the hippocampus.

Conclusion  In female patients with BPD, we found reduction of the volumes of the hippocampus (and perhaps of the amygdala), but the association of volume reduction and traumatic experiences remains unclear.

From the Department of Psychiatry (Drs Driessen, Meier, and Hill, and Mr Herrmann, and Ms Stahl) and Institute of Radiology (Drs Osterheider and Petersen), Luebeck School of Medicine, Luebeck, Germany; Department of Psychiatry, Gilead Hospital, Bethel, Bielefeld, Germany (Dr Driessen); and Institute of Diagnostic and Interventional Radiology, Ammerland-Clinic, Westerstede, Germany (Dr Zwaan).

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