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Eur Arch Psychiatry Clin Neurosci. 2017 Sep;267(6):551-565. doi: 10.1007/s00406-016-0760-z. Epub 2016 Dec 30.

Deficient amygdala-prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.

Author information

1
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
2
Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
3
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. linda.vanzutphen@maastrichtuniversity.nl.
4
Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany.
5
Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany.
6
Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany.
7
Department of Biological and Clinical Psychology, University of Trier, Trier, Germany.
8
Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany.
9
Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany.
10
Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
11
Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
12
Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
13
Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands.

Abstract

Emotion instability in borderline personality disorder (BPD) has been associated with an impaired fronto-limbic inhibitory network. However, functional connectivity (FC) underlying altered emotion regulation in BPD has yet to be established. Here, we used resting-state fMRI to investigate enduring effects of effortful emotion regulation on the amygdala intrinsic FC in BPD. In this multicenter study, resting-state fMRI was acquired before and after an emotion regulation task in 48 BPD patients and 39 non-patient comparison individuals. The bilateral amygdalae were used as a seed in the whole-brain FC analysis and two-way mixed ANOVA to test whether BPD patients exhibited weaker post-task increase in the amygdala intrinsic FC with the prefrontal cortex (PFC), compared to non-patients. Subsequently, we explored whether the results are common for personality disorders characterized by emotional problems, using additional data of 21 cluster-C personality disorder patients. In contrast to non-patients, BPD patients failed to show increased post-task amygdala resting-state FC with the medial, dorsolateral, ventrolateral PFC, and superior temporal gyrus, but surprisingly exhibited decreased FC with the posterior cingulate cortex and increased FC with the superior parietal lobule. In BPD patients, the emotion regulation task failed to increase resting-state amygdala FC with brain regions essential for effortful emotion regulation, which suggests: (a) altered cognitive control typically used to indirectly alleviate distress by reinterpreting the meaning of emotional stimuli; (b) impaired direct regulation of emotional responses, which might be common for personality disorders.

KEYWORDS:

Amygdala; BPD; Emotion regulation; Functional connectivity; Resting-state fMRI

PMID:
28039553
PMCID:
PMC5561271
DOI:
10.1007/s00406-016-0760-z
[Indexed for MEDLINE]
Free PMC Article

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