Neurologic Soft Signs in Borderline Personality Disorder
J Clin Psychiatry 2006;67(4):541-546
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Objective: Borderline personality disorder is
a disabling and dramatic psychiatric condition.
To date, its pathophysiology remains unclear.
Scientific evidence seems to have found underlying, nonfocal, central nervous system
dysfunction in borderline personality disorder. Neurologic
soft signs are anomalies only evidenced by specific motor, sensory, or integrative testing
when no other sign of a neurologic lesion is
present. Neurologic soft signs have been proposed to
be nonfocal in origin and to reflect central
nervous system failure. The assessment of neurologic
soft signs now appears reliable and stable.
Assuming that neurologic soft signs reflect nonfocal
central nervous system dysfunction, we hypothesized
that patients with borderline personality disorder should have an increased frequency of
neurologic soft signs, therefore enhancing the possibility
of the existence in borderline personality disorder
of a nonlocalized brain dysfunction.
Method: To test this hypothesis, we
compared 29 neurologic soft signs in 20 drug-free patients with DSM-III-R borderline personality
disorder and 20 controls, using an examination
adapted from the literature on neurologic soft signs.
The study was conducted from February 1991
to March 1993.
Results: Thirteen neurologic soft signs
were significantly more frequent in the borderline group. Patients with borderline personality
disorder showed more left side, right side,
and total neurologic soft signs than controls (p = .0001). All patients in the borderline
group exhibited at least 1 neurologic soft sign,
while only 7 controls did (p = .0001).
Conclusion: Our hypothesis was
confirmed. These results add evidence to the possibility
of the existence of a nonfocal central nervous system failure in borderline personality disorder.