Amygdala Functional Connectivity in Young Women with Borderline Personality Disorder

Abstract

Borderline personality disorder (BPD) is a complex psychiatric disorder that involves the core feature of affect dysregulation. Prior neuroimaging studies have indicated that BPD patients have (1) excessive amygdala activation to negative emotion and (2) diminished frontal regulation. This study examined amygdala functional connectivity in 12 women with BPD and 12 matched healthy comparison volunteers. We explored how connectivity patterns would change in the context of processing neutral, overt fear, or masked fear face expressions. Each participant underwent three 5-min fMRI scans in which they primarily viewed: (1) neutral, (2) overt fear, and (3) masked fear faces. In comparison to their healthy counterparts, young women with BPD showed (1) lower connectivity between bilateral amygdala and mid-cingulate cortex during the neutral scan; (2) higher connectivity between bilateral amygdala and rostral anterior cingulate cortex during the overt fear scan; and (3) higher right amygdala connectivity with bilateral thalamus and right caudate during the masked fear scan. Exploratory analyses revealed interesting correlations between amygdala connectivity in these conditions with multiple clinical measures. Results from the neutral scan add to the few prior connectivity studies in BPD that have been suggestive of lower fronto-limbic connectivity in BPD. However, the connectivity findings during fear processing are novel, and map onto basic research models for amygdala connectivity, that is, connections to frontal areas for overt fear processing versus connections to thalamus for automatic fear processing. Further, results suggest that BPD subjects tap into both pathways more strongly than healthy comparisons.

Converging Medial Frontal Resting State and Diffusion-Based Abnormalities in Borderline Personality Disorder

“…It also agrees with the ancillary analysis showing increased connectivity between the left hippocampus and amygdala cluster (derived by ALFF) and a single small frontomedial cluster. All of these findings agree with the study by Cullen et al (15), which observed increased connectivity between a priori selected amygdala regions of interest and perigenual cortex under overt fear stimuli. Increase in GBC in the anterior cingulate is also relevant because this area is a core node of the default mode network (63).…”

“…It has also been shown that the experimental disruption of these connections leads to behavioral patterns similar to those observed in individuals with BPD (14). This evidence has led to the performance of functional magnetic resonance imaging (MRI) studies of connectivity in BPD, which also have reported significant alterations (15,16). However, similar to volumetric studies, the scope of such connectivity results is restricted by the prior selection of brain areas of interest.…”

Using Functional Neuroimaging to Refine the Diagnostic Construct of Borderline Personality Disorder

“…In a similar set of studies, Cullen and colleagues [107,108] used a task in which participants saw emotional faces masked (that is, the emotion was displayed so quickly as to be imperceptible) and overt (where the participants could consciously perceive the emotional stimuli). They found increased amygdala activation during passive, overt emotional face viewing, but not when the faces were masked.…”

“…They found increased amygdala activation during passive, overt emotional face viewing, but not when the faces were masked. Cullen et al [108] used a method for assessing task-based functional connectivity called psychophysiological interactions (PPI), in order to determine whether there were group differences in amygdala patterns of co-activation with other brain regions over the course of the task. They found increased functional connectivity between the amygdala and the rostral ACC during overt fear processing and increased amygdalasubcortical connectivity during masked fear processing.…”

Disrupted socio-emotional neural circuitry in adolescents with borderline personality traits

“…During processing of emotional stimuli, Dudas et al (9) reported greater functional connectivity when viewing emotion-inducing images depicting disgust in adults with BPD between the left amygdala and left dorsolateral PFC, and left amygdala and ventral striatum. Cullen et al (10) examined functional connectivity of the amygdala to neutral, overt fearful, and masked fearful facial expressions, finding lower connectivity between bilateral amygdalae and midcingulate cortex to neutral faces in BPD. In contrast, BPD showed higher bilateral amygdalae and ACC coupling to overt fearful faces, and higher right amygdala and bilateral thalamus and caudate coupling to masked fear faces.…”