White Matter Alterations in Borderline Personality Disorder

Borderline personality disorder (BorPD) is characterized by instability and impulsivity of mood, relationships and self-image. This disease is an important area of public health policy; compared to other psychiatric disorders, individuals with BorPD experience the most severe functional impairments. Nevertheless, for the patients that do recover, this recovery is stable and only few relapse back to psychopathology. Given its high rate of remission, the rewards of effective treatment options are clear. Identification of underlying anatomical and physiological changes is crucial to refine current treatments and develop new ones. In this perspective, previous magnetic resonance imaging studies have highlighted alterations associated with BorPD phenotype. In particular, diffusion weighted imaging (DWI) has identified many white matter structural alterations in individuals with this diagnosis. Although in its infancy, limiting this line of investigation is a lack of direction at the field level. Hence, the present paper aims to conduct a meta-analysis of DWI findings in individuals with a diagnosis of BorPD, testing the hypothesis that there are specific white matter alterations associated with BorPD. To this end, we performed a meta-analysis of the existing literature of DWI in BorPD representing a total of 123 individuals with BorPD and 117 Controls. Our results indicated that individuals with BorPD show regions of reduced fractional anisotropy in the corpus callosum and fornix. These results survived all jack-knife reshuffles and showed no publication bias. This suggest that alterations in these structures may contribute to psychopathology. Further, the present results lend support to extant psychological and biological models of BorPD.