Hippocampal volume reduction and history of aggressive behaviour in patients with borderline personality disorder

Disturbances of aggression and impulse control are important symptoms of borderline personality disorder (BPD). The hippocampus is part of the limbic system, which is involved in the control of these types of behaviour. The aim of our study was to investigate potential structural changes of the hippocampal formation in BPD and to evaluate if these are related to aggressive and impulsive behaviour. Twenty-five female and right-handed BPD patients (DSM-IV) and 25 healthy control subjects matched according to sex, age, handedness and educational status were examined. Magnetic resonance imaging (MRI) was performed using a 1.5-T Magnetom Vision system. The software program "BRAINS" was employed for segmentation and volumetry of the hippocampal formation. German versions of instruments were used to evaluate impulsive and aggressive behaviour. Hippocampal grey matter volume was significantly decreased in BPD patients: the reduction was more pronounced in patients with multiple hospitalizations. Hippocampal volume of the left hemisphere was inversely correlated with lifetime history of aggressive behaviour. However, no significant relationship was found between hippocampal volume and impulsive behaviour. Our study confirms previous results indicating a volume reduction of the hippocampal formation in BPD patients. Furthermore, this structural change might facilitate aggressive behaviour. Subsequent studies are required to clarify whether the reduction of hippocampal volume is a trait and risk factor for increased aggression.