Amygdala–Prefrontal Disconnection in Borderline Personality Disorder

Abstract

Abnormal fronto-amygdala circuitry has been implicated in impulsive aggression, a core symptom of borderline personality disorder (BPD). We examined relative glucose metabolic rate (rGMR) at rest and after m-CPP (meta-chloropiperazine) with 18 fluorodeoxyglucose (FDG) with positron emission tomography (PET) in 26 impulsive aggressive (IED)-BPD patients and 24 controls. Brain edges/amygdala were visually traced on MRI scans co-registered to PET scans; rGMR was obtained for ventral and dorsal regions of the amygdala and Brodmann areas within the prefrontal cortex (PFC). Correlation coefficients were calculated between rGMR for dorsal/ventral amygdala regions and PFC. Additionally, amygdala volumes and rGMR were examined in BPD and controls. Correlations PFC/amygdala Placebo: Controls showed significant positive correlations between right orbitofrontal (OFC) and ventral, but not dorsal, amygdala. Patients showed only weak correlations between amygdala and the anterior PFC, with no distinction between dorsal and ventral amygdala. Correlations PFC/amygdala: m-CPP response: Controls showed positive correlations between OFC and amygdala regions, whereas patients showed positive correlations between dorsolateral PFC and amygdala. Group differences between interregional correlational matrices were highly significant. Amygdala volume/metabolism: No group differences were found for amygdala volume, or metabolism in the placebo condition or in response to meta-chloropiperazine (m-CPP). We demonstrated a tight coupling of metabolic activity between right OFC and ventral amygdala in healthy subjects with dorsoventral differences in amygdala circuitry, not present in IED-BPD. We demonstrated no significant differences in amygdala volumes or metabolism between BPD patients and controls.

Mapping the brain correlates of borderline personality disorder: A functional neuroimaging meta-analysis of resting state studies

“…Reduced activity in the orbitofrontal cortex as identified in this meta-analysis was found not only in imaging studies (New et al, 2007;; Silbersweig et al, 2007) but also with magnetoelectroencephalography (Diaz-Marsa et al, 2011). In this latter study, decreased activity in this region was associated with affective dysregulation, and particularly predicted more severe depressive symptoms and lower global functioning in BPD.…”

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

“…The psychological profile of BPD, with disinhibition and emotional dysregulation as core symptoms, suggests the possible impairment of frontal and limbic structures and of their connections (4). This suggestion has prompted the search for abnormalities in specific brain locations, such as the hippocampal-amygdala complex, potentially involved in the prevalent negative emotions observed in the disorder.…”

Traumatic Experiences Disrupt Amygdala – Prefrontal Connectivity

“…BPD patients (n=26) had weak correlations between amygdala and the anterior PFC. This study demonstrated a tight coupling of metabolic activity between right OFC and ventral amygdala in healthy control subjects that was not present in BPD patients (New et al, 2007). Patients with MDD were characterized by decreased interaction between the amygdala and the prefrontal areas (dorsal ACC and dlPFC) during emotional processing compared with healthy subjects.…”