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

Abstract

ANOVA to test whether BPD patients exhibited weaker posttask 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 posttask 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 Abstract Emotion instability in borderline personality disorder (BPD) has been associated with an impaired frontolimbic 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 Blazej M. Baczkowski and Linda van Zutphen have contributed equally to this work. common for personality disorders; (c) avoidance of selfrelated appraisals induced by social emotional stimuli. Electronic supplementary material

Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity

“…Moreover, it has been reported that amygdala functional activations are lateralized to the left in emotional task-fMRI studies ( 52 ). In the BPD+CD− group, our results agree with previous studies that did not find differences in amygdala—mPFC functional connectivity compared with BPD−CD− ( 53 , 54 ). In the BPD−CD+ group we did not find a significant effect on functional connectivity, although it has been reported to be lower in CD compared to controls ( 20 ).…”

Borderline personality disorder with cocaine dependence: impulsivity, emotional dysregulation and amygdala functional connectivity

“…The functional connection between these structures has also been suggested to facilitate the urgency to consume the substance of interest during abstinence in individuals with dependence, sending to a so-called "impulsive system", consisting of the amygdala and nucleus accumbens, signals that magnify the value of somatic marker representations (49). In the BPD+CD-group, our results agree with previous studies that did not find differences in amygdala -mPFC FC compared with BPD-CD- (50,51). Amigdala -mPFC FC has been reported to be lower in CD compared to controls (20), while we found it non-significantly higher.…”

Emotion dysregulation in attention-deficit/hyperactivity disorder and borderline personality disorder

“…Resting-state fMRI, contrasting intrinsic functional connectivity before and after an emotion regulation task in patients with BPD, further supports disrupted regulation of emotional circuits. Emotional hypersensitivity in BPD was associated with increased intrinsic connectivity between the amygdala and bilateral insula together with dorsal anterior cingulate cortex, while their impaired control over emotional reactions was associated with diminished intrinsic connectivity between the central executive fronto-parietal regions and salience network [ 68 ]. Overall the pattern of findings in relation to emotion regulation was similar to that reported for ADHD by Hulvershorn and colleagues [ 65 ].…”