Evidence of abnormal amygdala functioning in borderline personality disorder: a functional MRI study.

Department of Psychiatry and Psychotherapy, Medical Faculty of Aachen Technical University-RWTH, Aachen, Germany.
Biological Psychiatry (Impact Factor: 10.26). 09/2001; 50(4):292-8. DOI: 10.1016/S0006-3223(01)01075-7
Source: PubMed


Intense and rapidly changing mood states are a major feature of borderline personality disorder (BPD); however, there have only been a few studies investigating affective processing in BPD, and in particular no neurofunctional correlates of abnormal emotional processing have been identified so far.
Six female BPD patients without additional major psychiatric disorder and six age-matched female control subjects underwent functional magnetic resonance imaging (fMRI) to measure regional cerebral hemodynamic changes following brain activity when viewing 12 standardized emotionally aversive slides compared to 12 neutral slides, which were presented in random order.
Our main finding was that BPD subjects but not control subjects were characterized by an elevated blood oxygenation level dependent fMRI signal in the amygdala on both sides. In addition, activation of the medial and inferolateral prefrontal cortex was seen in BPD patients. Both groups showed activation in the temporo-occipital cortex including the fusiform gyrus in BPD subjects but not in control subjects.
Enhanced amygdala activation in BPD is suggested to reflect the intense and slowly subsiding emotions commonly observed in response to even low-level stressors. Borderline subjects' perceptual cortex may be modulated through the amygdala leading to increased attention to emotionally relevant environmental stimuli.

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    • "Of note, BPD patients often show abnormal activity (e.g. Herpertz et al. 2001; Koenigsberg et al. 2009a, b; Niedtfeld et al. 2010; Schulze et al. 2011; Hazlett et al. 2012) and abnormal connectivity (e.g. New et al. 2007; Silbersweig et al. 2007; Niedtfeld et al. 2012) in these regions, indicating a dysfunctional interplay between (para-)limbic and prefrontal brain regions in BPD (Mauchnik & Schmahl, 2010; Krause-Utz et al. 2014). "
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    ABSTRACT: A dysfunctional network of prefrontal and (para-)limbic brain region has been suggested to underlie emotional dysregulation in borderline personality disorder (BPD). Abnormal activity in this network may be due to structural alterations in white-matter tracts connecting prefrontal and (para-)limbic brain regions. To test this hypothesis, we investigated the structural integrity of major white-matter tracts connecting these regions in BPD. Using diffusion tensor imaging, we investigated fractional anisotropy (FA), axonal anisotropy (AD) and radial diffusivity (RD) in the uncinate fasciculus, the major white-matter tract connecting (para-)limbic and prefrontal brain regions, in 26 healthy controls (HC) and 26 BPD participants. To clarify the specificity of possible white-matter alterations among HC and BPD participants, FA, AD and RD were also investigated in the cingulum. We found distinct structural alterations in the uncinate fasciculus but not in the cingulum of BPD participants. Compared to HC participants, BPD participants showed lower FA and higher RD in the uncinate fasciculus. By contrast, AD did not differ in the uncinate fasciculus of HC and BPD participants. Our finding of abnormal FA and RD in the uncinate fasciculus indicates distinct white-matter alterations in BPD, presumably due to stress-induced myelin degeneration in the aftermath of stressful life events. Although these alterations may account for abnormal activity in brain regions implicated in emotion dysregulation, such as the amygdala, anterior cingulate cortex and prefrontal cortex, it remains to be determined whether these alterations are specific for BPD.
    Psychological Medicine 06/2015; -1(15):1-10. DOI:10.1017/S0033291715001142 · 5.94 Impact Factor
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    • "Contents lists available at ScienceDirect NeuroImage: Clinical Brambilla et al., 2004; Zetzsche et al., 2007; O3Neill and Frodl, 2012; Richter et al., 2014). Functional imaging studies have also reported altered activation of amygdala to emotional stimuli (Herpertz et al., 2001; Donegan et al., 2003; Minzenberg et al., 2007; Hazlett et al., 2012), along with abnormal activation of regulatory regions in the prefrontal cortex (Silbersweig et al., 2007; O3Neill and Frodl, 2012; Kamphausen et al., 2013; Koenigsberg et al., 2014). There have, however, been fewer neuroimaging studies directly examining the integrity of white matter tracts within fronto-limbic circuits in BPD (Rusch et al., 2010; Carrasco et al., 2012; Maier-Hein et al., 2014). "
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    ABSTRACT: Borderline personality disorder (BPD) is a severe psychiatric disorder involving a range of symptoms including marked affective instability and disturbances in interpersonal interactions. Neuroimaging studies are beginning to provide evidence of altered processing in fronto-limbic network deficits in the disorder, however, few studies directly examine structural connections within this circuitry together with their relation to proposed causative processes and clinical features. In the current study, we investigated whether individuals with BPD (n = 20) have deficits in white matter integrity compared to a matched group of healthy controls (n = 18) using diffusion tensor MRI (DTI). We hypothesized that the BPD group would have decreased fractional anisotropy (FA), a measure of white matter integrity, compared to the controls in white matter tracts connecting frontal and limbic regions, primarily the cingulum, fornix and uncinate fasciculus. We also investigated the extent to which any such deficits related to childhood adversity, as measured by the childhood trauma questionnaire, and symptom severity as measured by the Zanarini rating scale for BPD. We report decreased white matter integrity in BPD versus controls in the cingulum and fornix. There were no significant relationships between FA and measures of childhood trauma. There were, however, significant associations between FA in the cingulum and clinical symptoms of anger, and in the fornix with affective instability, and measures of avoidance of abandonment from the Zanarini rating scale. We report deficits within fronto-limbic connections in individuals with BPD. Abnormalities within the fornix and cingulum were related to severity of symptoms and highlight the importance of these tracts in the pathogenesis of the disorder.
    Clinical neuroimaging 02/2015; 7. DOI:10.1016/j.nicl.2015.01.016 · 2.53 Impact Factor
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    • "The findings of some studies were dependent on the stimuli and revealed effects for BPD-specific stimuli but not for neutral stimuli (Hazlett et al., 2007; Limberg, Barnow, Freyberger, & Hamm, 2011) or effects of specific emotions such as fear but not anger (Minzenberg, Fan, New, Tang, & Siever, 2007). Additionally, a dissociation between physiological measures and subjective reports has been reported (Hazlett et al., 2007; Herpertz et al., 2001; Koenigsberg et al., 2009; Limberg et al., 2011). The findings of psychophysiological studies that have used standardized film clips are also mixed; some of these studies have reported higher baseline values and unchanged reactivity (Kuo & Linehan, 2009), whereas other studies have reported the opposite pattern (Austin, Riniolo, & Porges, 2007). "
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    ABSTRACT: Although emotion dysregulation has consistently been conceptualized as a core problem of borderline personality disorder (BPD), a comprehensive, and empirically and ecologically validated model that captures the exact types of dysregulation remains absent. In the present article, we combine insights from basic affective science and the biosocial theory of BPD to present a theoretical model that captures the most fundamental affective dynamical processes that underlie BPD and stipulates that individuals with BPD are characterized by more negative affective homebases, higher levels of affective variability, and lower levels of attractor strength or return to baseline. Next, we empirically validate this proposal by statistically modeling data from three electronic diary studies on emotional responses to personally relevant stimuli in personally relevant environments that were collected both from patients with BPD (N = 50, 42, and 43) and from healthy subjects (N = 50, 24, and 28). The results regarding negative affective homebases and heightened affective variabilities consistently confirmed our hypotheses across all three datasets. The findings regarding attractor strengths (i.e., return to baseline) were less consistent and of smaller magnitude. The transdiagnostic nature of our approach may help to elucidate the common and distinctive mechanisms that underlie several different disorders that are characterized by affective dysregulation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Abnormal Psychology 01/2015; 124(1). DOI:10.1037/abn0000021 · 4.86 Impact Factor
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