Evidence map›Paper›PMID 29688873›Full record

ArticleJournal of psychiatry & neuroscience : JPN2018

Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder.

Falk Mancke, Ruth Schmitt, Dorina Winter, Inga Niedtfeld, Sabine C Herpertz, Christian Schmahl

Abstract readControlled Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of psychiatry & neuroscience : JPN, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Falk ManckeFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).
Ruth SchmittFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).
Dorina WinterFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).
Inga NiedtfeldFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).
Sabine C HerpertzFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).
Christian SchmahlFrom the Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Mancke, Herpertz); the Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany (Schmitt); the Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany (Winter, Niedtfeld, Schmahl); the Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany (Winter); and the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ont., Canada (Schmahl).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is increasing evidence that psychotherapy can alter the function of the brain of patients with borderline personality disorder (BPD). However, it is not known whether psychotherapy can also modify the brain structure of patients with BPD.

methodsWe used structural MRI data of female patients with BPD before and after participation in 12 weeks of residential dialectical behavioural therapy (DBT) and compared them to data from female patients with BPD who received treatment as usual (TAU). We applied voxel-based morphometry to study voxel-wise changes in grey matter volume over time.

resultsWe included 31 patients in the DBT group and 17 in the TAU group. Patients receiving DBT showed an increase of grey matter volume in the anterior cingulate cortex, inferior frontal gyrus and superior temporal gyrus together with an alteration of grey matter volume in the angular gyrus and supramarginal gyrus compared with patients receiving TAU. Furthermore, therapy response correlated with increase of grey matter volume in the angular gyrus. LIMITATIONS: Only women were investigated, and groups differed in size, medication (controlled for) and intensity of the treatment condition.

conclusionWe found that DBT increased grey matter volume of brain regions that are critically implicated in emotion regulation and higher-order functions, such as mentalizing. The role of the angular gyrus for treatment response may reside in its cross-modal integrative function. These findings enhance our understanding of psychotherapy mechanisms of change and may foster the development of neurobiologically informed therapeutic interventions.

Indexed as

Behavior TherapyAdultBorderline Personality DisorderCerebral CortexFemaleGray MatterHumansMagnetic Resonance ImagingNeuroimagingYoung Adult

Identifiers

PMID29688873
PMCPMC5915238

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.