Heart and brain: Cortical representation of cardiac signals is disturbed in borderline personality disorder, but unaffected by oxytocin administration

Schmitz, Marius; Müller, Laura E.; Schulz, André; Kleindienst, Nikolaus; Herpertz, Sabine C.; Bertsch, Katja

doi:10.1016/j.jad.2019.11.139

Cited by 19 publications

(24 citation statements)

References 24 publications

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“…Moreover, and in contrast to previous studies [35,36], the HEP amplitudes were higher in patients with BPD compared to healthy participants, particularly over frontal electrodes. Differences between studies may originate from different methods and electrodes used.…”

Section: Discussioncontrasting

confidence: 99%

“…Differences between studies may originate from different methods and electrodes used. The studies [35,36] analyzed HEP amplitudes of all recorded 60 scalp electrodes averaged. As it can be seen in Fig.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with previous studies (e.g. [35,36]), we extracted the mean amplitudes in the timeframe of 455-595 ms after the R-wave for all scalp electrodes. HEP amplitudes of an additional timeframe from 250 to 450 ms after the R wave were exported according to previous work [21].…”

Section: Analysis Of Heartbeat-evoked Potentials (Hep)mentioning

confidence: 99%

“…As regards HEP, two studies found significantly reduced HEP amplitudes in patients with BPD compared to a healthy control group in a resting state condition [35,36]. In particular, low HEP amplitudes were correlated with the severity of BPD symptoms, depressive symptoms, emotion dysregulation and emotional abuse during childhood [35,36]. Similarly, another previous study investigates the impact of childhood trauma on interceptive accuracy and the associations with cortisol and heartrate in response to a socially evaluated cold pressure test in unaffected individuals.…”

Section: Introductionmentioning

confidence: 96%

“…Behaviorally, Hart and colleagues (2013) did not find differences between patients with BPD and healthy control participants in a heartbeat detection task [33], whereas another study reported superior heartbeat detection in patients with personality disorders compared to patients with functional disorders and control participants [34]. As regards HEP, two studies found significantly reduced HEP amplitudes in patients with BPD compared to a healthy control group in a resting state condition [35,36]. In particular, low HEP amplitudes were correlated with the severity of BPD symptoms, depressive symptoms, emotion dysregulation and emotional abuse during childhood [35,36].…”

Section: Introductionmentioning

confidence: 99%

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Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

Flasbeck

Popkirov

Ebert

et al. 2020

bord personal disord emot dysregul

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Background Patients with borderline personality disorder (BPD) experience difficulties in emotional awareness (alexithymia), and often develop dissociative symptoms, which may reflect broader deficits in interoceptive awareness. Whether this is associated with alterations in cortical processing of interoception is currently unknown. Methods We utilized an electrophysiological marker of interoception, i.e. heartbeat-evoked potentials (HEP), and examined its relationship with electrocardiographic correlates of autonomic nervous system (ANS) functioning (heart rate variability), and with self-report measures of alexithymia, dissociation and borderline symptom severity in patients with BPD. Results Individuals with BPD had higher HEP amplitudes over frontal electrodes compared to healthy controls. Sympathetic ANS activity was greater in BPD patients than in controls. Across groups, HEP amplitudes were associated with parasympathetic activity over central electrodes and correlated with alexithymia over frontal electrodes. Conclusions These findings support the idea that difficulties in emotional awareness in BPD are reflected in altered frontal electrophysiological markers of interception. Therefore, emotional awareness can be understood as failures of modulation between interoceptive and exteroceptive attention. Future research may aim to investigate whether altered interoception and its electrophysiological correlates are malleable by therapeutic intervention.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%