Structural brain features of borderline personality and bipolar disorders.

A potential overlap between bipolar disorder (BD) and borderline personality disorder (BPD) has been recently proposed. We aimed to assess similarities and differences of brain structural features in BD and BPD. Structural magnetic resonance imaging (MRI) was performed in 26 inpatients with BPD, 14 with BD, and 40 age-and sex-matched healthycontrols (HC). Voxel-based morphometry analysis with Statistical Parametric Mapping (SPM) was used to localize and quantify gray (GM) and white matter (WM) abnormalities in BD and BPD compared to HC and to identify those specifically affected in each patient group. Region of interest (ROI)-based analyses were also performed for confirmation. GM density changes in BD are significantly more diffuse and severe than in BPD, as demonstrated in both SPM- and ROI-based analyses. The topography of GM alterations showed some regions of overlap, but each disorder had specific regions of abnormality (involving both cortical and subcortical structures in BD, confined mainly to fronto-limbic regions in BPD). WM density changes were less pronounced in both conditions and involved completely different regions. Although BPD and BD show a considerable overlap of GM changes, the topography of alterations is more consistent with the separate conditions hypothesis and with the vulnerability of separate neural systems.

Regional atrophy of transcallosal prefrontal connections in cognitively normal APOE epsilon4 carriers.

PURPOSE: To investigate the possible effect of the APOE epsilon4 allele on age-related regional volume loss within the corpus callosum (CC) in healthy epsilon4 allele carriers compared with noncarriers. MATERIALS AND METHODS: A total of 211 subjects, ages 27 to 83 years, 51 epsilon4 carriers and 160 noncarriers underwent T1-weighted MRI scan. All subjects had normal MRI scan and performed within normal range on a neuropsychological battery of tests. CC was segmented into seven functionally relevant regions using a previously published probabilistic map of the CC connectivity. We measured the volumes of the CC and its subregions. We used a regression model (with volumes as dependent and age as independent variables) and compared the slopes between carriers and noncarriers using an analysis of covariance model. We also carried out voxel-based-morphometry analysis to investigate the possible effect of the APOE epsilon4 gene on the gray matter. RESULTS: We found that the volume of the CC and all subregions decreased with increasing age in both groups. The slope was steeper in the APOE epsilon4 carriers compared withthe noncarriers particularly in the prefrontal region (P = 0.02). No gray matter differences were observed between the two groups. CONCLUSION: APOE epsilon4 polymorphism is associated with accelerated age-related volume loss in the prefrontal callosal tracts without gray matter loss. This result suggests the role of APOE epsilon4 in the brain aging by primarily affecting white matter structures particularly in the frontal lobe.

Alexithymia in healthy women: a brain morphology study.

BACKGROUND: Alexithymia relates to difficulty recognizing and describing own feelings. Recent literature shows that specific structures process emotions. Aim of this study was to investigate whether alexithymia is associated with a specific cerebral morphology of candidate structures in healthy adults. METHODS: Fifty-four female volunteers were enrolled in the study and the 20-item Toronto Alexithymia Scale (TAS-20) was self-administered. Gray matter (GM) volume was assessed with an optimized voxel-based morphometry (VBM) protocol on high-resolution 3D magnetic resonance images. The following three experiments were carried out: 1) contrast between the 14 volunteers with TAS-20 scores > or = 61 (alexithymic) and the 30 with scores < 51 (non-alexithymic), 2) correlation of TAS-20 scores on the whole sample and 3) contrast between the 14 alexithymic and 14 non-alexithymic matched by age. The significant threshold for VBM comparisons and correlation was set at p<0.005 uncorrected. RESULTS: The alexithymic group showed smaller GM volume in the anterior cingulate cortex (cluster size: 735 voxel no.; z=3.26; stereotaxic coordinates: -12, 22, 30) and middle temporal gyrus (256; 3.21; -60, 2, -20). Of specific biological relevance, smaller clusters were located in the anterior insula, orbitofrontal cortex and superior temporal sulcus. The opposite comparison was negative. The correlation analysis confirmed the pattern of results mainly in the left hemisphere. CONCLUSIONS: Our findings suggest that the ability to process emotional aspects of the self correlates with morphology of a specific set of cerebral structures known to be involved in decision making and self awareness and rich in neurons subserving social competence.

Association of blood pressure and genetic background with white matter lesions in patients with mild cognitive impairment.

Background. White matter lesions (WMLs) may contribute to cognitive deficits in patients with mild cognitive impairment (MCI), but their pathogenesis is complex. Fluctuations of blood pressure (BP) over 24 hours and genetic predisposition to develop vascular damage have been implicated. Methods. In 63 MCI patients 65 years old or older, BP was measured both clinically and with ambulatory BP monitoring. Patients were classified in two groups: no/very mild (n = 34) and mild to severe (n = 29) WMLs, based on a visual scale on magnetic resonance (mean age 71.8 +/- 4.7 vs 74.6 +/- 5.1, and female gender 53% vs 66%, respectively). The volume of WMLs was measured by a semi-automatic method, separately for periventricular caps and rim, periventricular confluent, subcortical punctate, and subcortical confluent. Polymorphisms of cystatin C (CST3) and cholesterol 24-hydroxylase (CYP46) genes, putative risk factors for cerebrovascular disease, were determined. Results. The prevalence of cerebrovascular risk factors was similar in the two MCI groups of different WML severity, as well as clinic and ambulatory BP. In patients with mild to severe, but not in those with no/very mild WMLs, the volume of periventricular confluent WMLs increased with increasing daytime systolic BP (regression coefficient.47, 95% confidence interval [CI],.13 to.71 vs.02, 95% CI, -.32 to.36, p =.003 for the difference between slopes). The volume of other WML subtypes was not associated with ambulatory BP. Participants carrying both CST3*B and CYP46*T alleles were overrepresented in the MCI group with mild to severe WMLs (43% vs 17%, p.03). Conclusions. BP and gene putative risk factors for cerebrovascular disease are differentially associated with WMLs in two MCI groups of different WML severity. WMLs might develop for the convergence of innate with acquired factors.