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Neuroimage Clin. 2019 Dec 19;25:102126. doi: 10.1016/j.nicl.2019.102126. [Epub ahead of print]

Atypical processing of social anticipation and feedback in borderline personality disorder.

Author information

1
Department of Neuroscience, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland; Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland; Department of Psychology, FPSE, University of Geneva, Geneva, Switzerland. Electronic address: kimberly.doell@unige.ch.
2
Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier - Inserm U1061 - University of Montpellier, Montpellier, France.
3
Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland; Department of Psychology, FPSE, University of Geneva, Geneva, Switzerland.
4
Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland.
5
Department of Neuroscience, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland; Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland.

Abstract

BACKGROUND-:

Borderline personality disorder (BPD) is characterized by maladaptive social functioning, and widespread negativity biases. The neural underpinnings of these impairments remain elusive. We thus tested whether BPD patients show atypical neural activity when processing social (compared to non-social) anticipation, feedback, and particularly, how they relate to each other.

METHODS-:

We acquired functional MRI data from 21 BPD women and 24 matched healthy controls (HCs) while they performed a task in which cues and feedbacks were either social (neutral faces for cues; happy or angry faces for positive and negative feedbacks, respectively) or non-social (dollar sign; winning or losing money for positive and negative feedbacks, respectively). This task allowed for the analysis of social anticipatory cues, performance-based feedback, and their interaction.

RESULTS-:

Compared to HCs, BPD patients expressed increased activation in the superior temporal sulcus during the processing of social cues, consistent with elevated salience associated with an upcoming social event. BPD patients also showed reduced activation in the amygdala while processing evaluative social feedback. Importantly, perigenual anterior cingulate cortex (pgACC) activity during the presentation of the social cue correlated with reduced amygdala activity during the presentation of the negative social feedback in the BPD patients.

CONCLUSIONS-:

These neuroimaging results clarify how BPD patients express altered responses to different types of social stimuli (i.e. social anticipatory cues and evaluative feedback) and uncover an atypical relationship between frontolimbic regions (pgACC-amygdala) over the time span of a social interaction. These findings may help to explain why BPD patients suffer from pervasive difficulties adapting their behavior in the context of interpersonal relationships and should be considered while designing better-targeted interventions.

KEYWORDS:

Borderline personality disorder; FMRI; Reward; Social cognition

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