Structural Brain Alterations in Borderline Personality Disorder

Borderline personality disorder (BPD) is one of three clusters of personality disorders characterized by a pattern of difficulty regulating emotion, impulse control, interpersonal relationships, and self-image. Emotional dysregulation, impulsive aggression, repetitive self-injury, and chronic suicidal tendencies make these individuals frequent users of mental health services. BPD has a variety of causes and involves several factors which interact in various ways with each other. Emotional dysregulation and impulsivity can be caused by genetic factors and traumatic childhood experiences and lead to dysfunctional behaviors, psychosocial conflicts, and deficits that may exacerbate emotional dysregulation and impulsivity. BPD has been linked to anatomical alterations in brain areas in the prefrontal cortex, cingulate cortex, hippocampus, amygdala, hypothalamus, corpus callosum, and frontolimbic network. These brain changes can lead to the manifestation of the inability to control behavior, feelings, and interpersonal relationships, which often leads to violence. These symptoms may begin at a young age or in early adulthood and tend to continue as the individual ages. The goal of this article is to review how structural changes in the brain can cause BPD. KEYWORDS Borderline personality disorder, MRI in BPD, BPD patients, personality disorders, structural imaging BPD, neurobiology BPD