Abnormal prefrontal cortical response during affective processing in borderline personality disorder

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Science

Background:

• Emotion dysregulation is a core feature of borderline personality disorder (BPD).
• Dysfunction in prefrontal (PFC) and limbic systems is implicated in BPD's emotional instability.
• Understanding PFC function during emotional processing in BPD is crucial for targeted interventions.

Purpose of the Study:

• To investigate prefrontal cortex (PFC) function in females with BPD during the experience and suppression of sadness.
• To compare PFC activity between BPD patients and healthy controls using functional near-infrared spectroscopy (fNIRS).
• To explore the relationship between PFC activation patterns and emotion regulation difficulties in BPD.

Main Methods:

• Functional near-infrared spectroscopy (fNIRS) measured evoked hemodynamic oxygenated hemoglobin (oxy-Hb) in the PFC.
• Participants included females with BPD (N=9) and age-, gender-, and IQ-matched healthy controls (N=8).
• Subjects viewed neutral or sad images and were instructed to maintain or suppress emotional reactions.

Main Results:

• No significant group differences in behavioral sadness suppression or overall evoked oxy-Hb levels were found.
• Both BPD and control groups activated lateral PFC regions during emotional suppression.
• In BPD, right lateral PFC activation correlated with difficulty suppressing sadness, unlike the inverse relationship in controls' left lateral PFC.
• Medial PFC activation slopes differed: steep and positive in controls, shallow and negative in BPD, correlating with symptom severity.

Conclusions:

• BPD subjects exhibit abnormal medial PFC evoked oxy-Hb responses during transient sadness.
• Right lateral PFC recruitment in BPD is associated with self-reported emotion suppression difficulties.
• Altered cortical responses in BPD, potentially involving subcortical-limbic interactions, may underlie emotion dysregulation.