The Latest Neuroimaging Findings in Borderline Personality Disorder
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This review provides an overview of the most recent neuroimaging findings in borderline personality disorder. The contributions of the structural and functional imaging studies of the past 3 years are presented to help us better understand this severe psychiatric disorder. There are three domains of functional imaging findings: 1) affective dysregulation; 2) the complex of dissociation, self-injurious behavior, and pain processing; and 3) social interaction. Knowledge of the neurobiological basis of borderline personality disorder has grown considerably. Therefore, these findings convey a good impression of the current findings from neuroimaging research in this disorder and also of the necessary next steps with regard to content and methodology.
KeywordsBPD Imaging studies Affective dysregulation Dissociation Social interaction
Dr. Mauchnik has received a travel grant from GlaxoSmithKline.
Dr. Schmahl has received speakers’ honoraria from AstraZeneca and served on an advisory board for Lundbeck.
Papers of particular interest, published recently, have been highlighted as:• Of importance•• Of major importance
- 1.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 2000.Google Scholar
- 2.American Psychiatric Association: Practice guideline for the treatment of patients with borderline personality disorder—introduction. Am J Psychiatry 2001, 158:2.Google Scholar
- 12.Tebartz van Elst L, Hesslinger B, Thiel T, et al.: Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study. Biol Psychiatry 2003, 54:163–171.Google Scholar
- 20.• New AS, Hazlett EA, Buchsbaum MS, et al.: Amygdala-prefrontal disconnection in borderline personality disorder. Neuropsychopharmacology 2007, 32:1629–1640. This functional connectivity study showed a disturbed connection between the amygdala and prefrontal brain regions.CrossRefPubMedGoogle Scholar
- 22.Ruesch N, Luders E, Lieb K, et al.: Corpus callosum abnormalities in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder. J Psychiatry Neurosci 2007, 32:417–422.Google Scholar
- 34.Linehan MM, Kehrer CA: Borderline personality disorder. In Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, edn 2. Edited by Barlow DH. New York: Guilford Press; 1993:396–441.Google Scholar
- 36.Lynch TR, Rosenthal MZ, Kosson, DS, et al.: Heightened sensitivity to facial expressions of emotion in borderline personality disorder. Emotion 2006, 6:647–655.Google Scholar
- 45.•• Koenigsberg HW, Fan J, Ochsner KN, et al.: Neural correlates of the use of psychological distancing to regulate responses to negative social cues: a study of patients with borderline personality disorder. Biol Psychiatry 2009, 66:854–863. This was the first study to directly investigate emotion regulation mechanisms that can be assumed to be key to the understanding of BPD.CrossRefPubMedGoogle Scholar
- 46.Driessen M, Wingenfeld K, Rullkoetter N, Mensebach C, Woermann FG, Mertens M, Beblo T: One-year functional magnetic resonance imaging follow-up study of neural activation during the recall of unresolved negative life events in borderline personality disorder. Psychol Med 2008, 39:507–516.CrossRefPubMedGoogle Scholar
- 47.• Schnell K, Herpertz S: Effects of dialectic-behavioral-therapy on the neural correlates of affective hyperarousal in borderline personality disorder. J Psychiatr Res 2007, 41:837–847. This was the first pilot study to look at the influence of DBT on neural correlates of affective arousal.CrossRefPubMedGoogle Scholar
- 50.Schmahl C, Bohus M: Translational research issues in dissociation. In Traumatic Dissociation. Edited by Vermetten E, Dorahy M, Spiegel D. Washington, DC: American Psychiatric Publishing; 2007:121–138.Google Scholar
- 52.Ludaescher P, Valerius G, Stiglmayr C, et al.: Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid PTSD—a pilot study. J Psychiatry Neurosci 2010 (in press).Google Scholar