Abstract
Borderline personality disorder (BPD) is characterized by “stable instability” of emotions and behavior and their regulation. This emotional and behavioral instability corresponds with a neurocognitive triple network model of psychopathology, which suggests that aberrant emotional saliency and cognitive control is associated with aberrant interaction across three intrinsic connectivity networks [i.e., the salience network (SN), default mode network (DMN), and central executive network (CEN)]. The objective of the current study was to investigate whether and how such triple network intrinsic functional connectivity (iFC) is changed in patients with BPD. We acquired resting-state functional magnetic resonance imaging (rs-fMRI) data from 14 patients with BPD and 16 healthy controls. High-model order independent component analysis was used to extract spatiotemporal patterns of ongoing, coherent blood-oxygen-level-dependent signal fluctuations from rs-fMRI data. Main outcome measures were iFC within networks (intra-iFC) and between networks (i.e., network time course correlation inter-iFC). Aberrant intra-iFC was found in patients’ DMN, SN, and CEN, consistent with previous findings. While patients’ inter-iFC of the CEN was decreased, inter-iFC of the SN was increased. In particular, a balance index reflecting the relationship of CEN- and SN-inter-iFC across networks was strongly shifted from CEN to SN connectivity in patients. Results provide first preliminary evidence for aberrant triple network iFC in BPD. Our data suggest a shift of inter-network iFC from networks involved in cognitive control to those of emotion-related activity in BPD, potentially reflecting the persistent instability of emotion regulation in patients.
Highlights
Borderline personality disorder (BPD) is characterized by “stable instability” (Schmideberg, 1959) of emotions, impulsivity, social relationships, and self-image
We suggest that the stability of fluctuating symptoms across time and different situations might be related to consistent and profound functional alterations in the patient’s brain intrinsic functional architecture, in brain regions involved in behavior/emotion regulation
INTRA-intrinsic functional connectivity (iFC) Automated component selection, which was based on spatial templates representing subsystems of the default mode network (DMN), salience network (SN), and central executive network (CEN), revealed six IC of interest from high-model-order analysis of fMRI data for each individual
Summary
Borderline personality disorder (BPD) is characterized by “stable instability” (Schmideberg, 1959) of emotions, impulsivity, social relationships, and self-image. We suggest that the stability of fluctuating symptoms across time and different situations might be related to consistent and profound functional alterations in the patient’s brain intrinsic functional architecture, in brain regions involved in behavior/emotion regulation. Previous functional neuroimaging studies revealed context specific patterns of altered brain activity in BPD patients during emotion- or self-related tasks. Memories of unresolved life events activate regions of the DMN in addition to amygdala, insula, and occipital cortices in patients (Beblo et al, 2006). Emotional and self-related context increasingly activates an aberrant distributed pattern of brain regions including the DMN, insula, amygdala, and occipital cortices in BPD patients
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