Identifying Disease-Specific Neural Reactivity to Psychosocial Stress in Borderline Personality Disorder

Ryan J. Murray, Kornelia Gentsch, Eléonore Pham, Zeynep Celen, Joana Castro, Nader Perroud, Dimitri Van De Ville, Patrik Vuilleumier, Camille Piguet

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7 Citas (Scopus)

Resumen

Background: Patients with borderline personality disorder (BPD) typically present emotion dysregulation (ED) when faced with adversity. However, it is argued that altered stress response may be more influenced by ED than BPD-specific traits. Here, we investigated this issue with functional magnetic resonance imaging using another ED condition as clinical control, i.e., bipolar disorder (BD), and controlling for ED traits. Methods: We recruited 17 patients with BD, 24 patients with BPD, and 32 healthy control (HC) subjects. We adapted a functional magnetic resonance imaging–compatible psychosocial stressor task (Montreal Imaging Stress Task) in which participants are placed under time pressure when performing mental calculations and then receive immediate performance feedback (positive, negative, and neutral). ED traits were measured via self-report questionnaires targeting cognitive emotion dysregulation, affective lability, and trait anger and anxiety. Results: Relative to patients with BD and HC subjects, patients with BPD exhibited overactive corticolimbic reactivity across all conditions, particularly in self-monitoring and emotion regulation regions such as the orbitofrontal cortex and anterior insula, even when controlling for ED. Conversely, patients with BD exhibited hypoactive corticolimbic reactivity to all feedback conditions compared with patients with BPD and HC subjects, even after controlling for ED. HC subjects exhibited significantly lower amygdala/hippocampus activity compared with both clinical groups, although this did not survive when controlling for ED. Conclusions: This study provides new insight into BPD-specific neural stress responding, suggesting hyperactive self- and emotion-regulatory neural psychosocial stress responding, independent of ED traits. The findings also highlight the importance of considering BPD as a diagnostic profile distinguishable from other ED disorder clinical groups.

Idioma originalEnglish
PublicaciónBiological Psychiatry: Cognitive Neuroscience and Neuroimaging
DOI
EstadoAccepted/In press - 2022
Publicado de forma externa

Nota bibliográfica

Funding Information:
The study is supported by the Swiss National Center of Competence in Research (“Synapsy: the Synaptic Basis of Mental Diseases,” Grant No. 51NF40-185897 [to CP] ) and the Swiss National Foundation (Grant No. 32003B_156914 [to CP] ) and by a Boninchi Foundation grant (to KG).

Publisher Copyright:
© 2022 Society of Biological Psychiatry

ASJC Scopus Subject Areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cognitive Neuroscience
  • Biological Psychiatry

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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