NEUROIMAGING OF ADOLESCENT BORDERLINE PERSONALITY DISORDER WITH AND WITHOUT POST-TRAUMATIC STRESS DISORDER
NEUROIMAGERIE DU TROUBLE DE LA PERSONNALITE BORDERLINE A L'ADOLESCENCE AVEC ET SANS TROUBLE DE STRESS POST-TRAUMATIQUE
University Hospital, Caen
99 participants
Mar 11, 2022
INTERVENTIONAL
Conditions
Summary
Borderline personality disorder (BPD) is a common mental disorder in adolescents with significant individual and societal repercussions, characterized over the long term by emotional hyperresponsiveness, relational instability, identity disturbances and self-aggressive behavior. The etiology of BPD is multifactorial and involves exposure to traumatic life events, which are present in the majority of cases. This explains the very common co-morbidity between BPD and post-traumatic stress disorder (PTSD), which involves emotionally painful memory relapses of one or more traumatic events, associated with an emotional trauma avoidance syndrome (s). ) and hypervigilance. Brain imaging studies in adolescents with BPD have shown decreases in the volume of gray matter within the frontolimbic network, as well as a decrease in frontolimbic white matter bundles. These brain changes are considered to be biological markers of TPB. However, the exact same brain changes are seen in PTSD. Although it represents more than a third of adolescents hospitalized in psychiatry, neuroscientific studies of BPD in adolescence are still scarce. The expertise we have acquired in U1077 in adolescents with PTSD offers us an exceptional opportunity to characterize in BPD with and without PTSD structural anomalies, including the hippocampus, and functional at rest, never used for hour in the teenager's BPD. Beyond that, carrying out an 18-month follow-up of the patients will allow us to assess the predictive value of these anomalies on the level of general psychopathology in all the patients studied and the intensity of the symptoms of traumatic relapse in the patients with PTSD. This modeling of disorders integrating psychopathological, neuropsychological and neuroanatomical approaches will provide the clinician with new knowledge necessary for therapeutic innovation.
Eligibility
Inclusion Criteria15
- For the 3 groups:
- female
- Age between 13 and 17 years inclusive
- Oral and written comprehension of the French language
- Affiliation to the social security scheme
- Informed consent signed by the legal representatives holding the exercise of parental authority and the adolescent herself
- For patients:
- Diagnosis of borderline personality disorder according to the criteria of the Diagnostic and Statistical Manual for mental disorders, fifth edition (DSM-5; American Psychiatric Association, 2013; SIDP-IV)
- Level of general psychopathology compatible with participation in the study (score\> 20 on the CGA-S)
- TB + / PTSD + group:
- \- Post-traumatic stress disorder according to DSM-5 criteria (American Psychiatric Association, 2013; K-SADS-PL)
- In the control group :
- Absence of mental disorder according to DSM-5 criteria (American Psychiatric Association, 2013; K-SADS-PL and SIDP-IV)
- Oral and written comprehension of the French language
- Informed consent signed by the legal representative, the holder (s) of the exercise of parental authority and the adolescent herself
Exclusion Criteria11
- \- Illiteracy / illiteracy
- Sensory disorder (visual, auditory)
- Severe chronic psychiatric comorbidity: autism spectrum disorder, intellectual disability, schizophrenia spectrum disorder and other psychotic disorders, bipolar disorder
- Severe or current brain pathology (chronic neurological disease, encephalitis, history of severe head trauma), alertness disorder
- History of anoxic coma
- Contraindication to MRI (magnetic foreign body, claustrophobia, contraindication to prolonged lying down)
- Severe physical pathology in progress
- Moving outside the Normandy region planned within 18 months
- The inclusion of the subject in another biomedical research protocol (during the present study)
- Intellectual deficit (IQ \<70)
- Pregnant or breastfeeding women
Interventions
Anatomical MRI The anatomical data will be acquired by means of a 3T Signa Premier General Electric Healthcare MRI, allowing the acquisition of classic anatomical sequences (T1, T2) and a high-resolution hippocampal sequence allowing to accurately apprehend its various sub-fields. (total acquisition time: 10 min). The hippocampal volume, the orbital-frontal cortex and the cingulate cortex will be measured by voxel-based morphometry (VBM; Ashburner \& Friston, 2000\]) using the SPM software (Statistical Parametric Mapping; Friston et al., 2006). The voxel-by-voxel morphometric analysis of T1 MRI images makes it possible to classify and segment the different brain tissues (gray matter versus white matter) and to analyze the focal differences in volume within these tissues between the different groups.
Locations(1)
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NCT04852744