Dysregulation between emotion and theory of mind networks in borderline personality disorder

Abstract

a b s t r a c tIndividuals with borderline personality disorder (BPD) commonly display deficits in emotion regulation, but findings in the area of social cognitive (e.g., theory of mind, ToM) capacities have been heterogeneous. The aims of the current study were to investigate differences between patients with BPD and controls in functional connectivity (1) between the emotion and ToM network and (2) in the default mode network (DMN). Functional magnetic resonance imaging was used to investigate 19 healthy controls and 17 patients with BPD at rest and during ToM processing. Functional coupling was analysed. Significantly decreased functional connectivity was found for patients compared with controls between anterior cingulate cortex and three brain areas involved in ToM processes: the left superior temporal lobe, right supramarginal/inferior parietal lobes, and right middle cingulate cortex. Increased functional connectivity was found in patients compared with controls between the precuneus as the DMN seed and the left inferior frontal lobe, left precentral/middle frontal, and left middle occipital/ superior parietal lobes during rest. Reduced functional coupling between the emotional and the ToM network during ToM processing is in line with emotion-regulation dysfunctions in BPD. The increased connectivity between precuneus and frontal regions during rest might be related to extensive processing of internal thoughts and self-referential information in BPD.

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

“…It is expected that post-therapy neuronal activations are lower in a EP network involving areas in the PFC, the striatum and the insula-basal ganglia [57,58], when compared with pre-therapy. For post-therapy SCP, we expect lower CCRT pervasiveness, when compared with pre-therapy and we expect that post-therapy neurofunctional activations are lower in regions associated with the theory of mind (i.e., anterior cingulate, precuneus, inferior and middle frontal gyri and inferior parietal lobes) [69][70][71], compared with pre-therapy.…”

“…Decrease in CCRT pervasiveness is an indicator of productive change. The fMRI task involves the appreciation of humoristic stimuli measuring the patient's theory of mind; this task has previously been validated for BPD [69] (for the validation of the stimuli see [80,81]). It involves the processing and understanding of three sets of stimuli, presented in a pseudo-random order: (1) The remaining assessments concern secondary outcomes and include the Outcome Questionnaire-45 [82], which is a self-report questionnaire comprising 45 items aiming at assessing psychotherapeutic results, including a global score and three sub-scale scores: symptomatic level, interpersonal relationships and social role.…”

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

“…O'Neill and colleagues [72] examined neural functional connectivity during a ToM task in a sample of 17 individuals with BPD and 19 HCs. In the task, participants had to rate whether or not they understood or did not understand humorous cartoons and non-humorous pictures (consisting of an incongruity that could not be meaningfully interpreted).…”

“…As we argue in this project, a networkbased approach, focusing on the broader circuits at play such as the DMN, SN, and CEN is an important direction for BPD neuroimaging research and may help overcome the limitations of such a piecemeal literature. A few studies have already begun this work and find compelling evidence for the role that altered activation in these networks (measured using rs-fMRI, while the brain is not performing a specific task and is therefore considered at rest) plays in BPD pathology [72,92,185]. Additionally, we know that these neural regions and networks interplay in complex patterns in order to execute the processes associated with affect, cognition, and behavior and altered interactions between networks and regions likely underlies pathology.…”

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“…Moreover, studies using event-related measures such as fMRI have observed discrepant patterns of neural activation in the cognitive (Mensebach et al, 2009;Niedtfeld et al, 2017;O'Neill et al, 2015;Reitz et al, 2015) , behavioural (Herbort et al, 2016), social (Bungert et al, 2015;Domsalla et al, 2014;King-Casas et al, 2008) and affective processing (Bertsch et al, 2013;Hazlett et al, 2012;Lischke et al, 2017;Scherpiet et al, 2014) of BPD samples compared to healthy controls. However, it must be noted that the neurocircuitry of the disorderthough more PeerJ Preprints | https://doi.org/10.7287/peerj.preprints.27414v1 | CC BY 4.0 Open Access | rec: 5 Dec 2018, publ: 5 Dec 2018…”