Structural and Functional Connectivity of the Anterior Cingulate Cortex in Patients With Borderline Personality Disorder.

Xiaoxia Lei,Changlian Tan,Shuqiao Yao,Jinyao Yi,Mingtian Zhong,Wanrong Peng,Qian Liu,Bowen Zhang,Huihui Yang,Yu Zhang

doi:10.3389/fnins.2019.00971

Abstract

BackgroundEmerging evidences supported the hypothesis that emotional dysregulation results from aberrant connectivity within the fronto-limbic neural networks in patients with borderline personality disorder (BPD). Considering its important role in emotional regulation, the anterior cingulate cortex (ACC) has not yet been fully explored in BPD patients. Therefore, using the seed-based resting state functional connectivity (rsFC) and probabilistic fiber tracking, we aimed to explore the alterations of functional and structural connectivity (SC) of the ACC in patients with BPD.MethodsA cohort of 50 unmedicated, young BPD patients and 54 sex-, age-, and education-matched healthy controls (HCs) completed psychological tests and underwent rs-fMRI and diffuse tensor imaging (DTI) scanning. Rs-FC analysis and probabilistic fiber tracking were used to plot SC and FC of the ACC.ResultsWith the left ACC selected as a seed, BPD patients exhibited increased rsFC and abnormal SC with the right middle frontal gyrus (MFG), and decreased rsFC with the left middle temporal gyrus (MTG), compared with HCs. Additionally, negative cognitive emotion regulation and depressive symptoms both correlated negatively with the rsFC of the left ACC in BPD patients.ConclusionAbnormal SC and FC of the ACC underlie the deficient emotional regulation circuitry in BPD patients. Such alterations may be important biomarkers of BPD and thus could point to potential BPD treatment targets.

Highlights

Borderline personality disorder is a common psychiatric disorder, characterized by a pervasive pattern of emotional lability, impulsivity, interpersonal difficulties, identity disturbances, and disturbed cognition (Leichsenring et al, 2011)
Borderline personality disorder patients exhibited significantly increased resting state functional connectivity (rsFC) of the anterior cingulate cortex (ACC) with the right middle frontal gyrus (MFG) and decreased rsFC with the left middle temporal gyrus (MTG) compared with healthy controls (HCs)
The tract probability of left ACC-to-right MFG and left ACC-to-left MTG tract did not differ between the two groups

Summary

Introduction

Borderline personality disorder is a common psychiatric disorder, characterized by a pervasive pattern of emotional lability, impulsivity, interpersonal difficulties, identity disturbances, and disturbed cognition (Leichsenring et al, 2011). Emotional dysregulation, which is considered a core pathological feature of BPD (Gratz and Roemer, 2004; Dsm-5, 2013), has been attributed to weakened inhibitory effects of the prefrontal cortex (PFC) on hyperactive limbic brain regions in response to emotional stimuli (Krause-Utz et al, 2014b; Schulze et al, 2016). Activation of the ACC and other prefrontal structures (e.g., dorsolateral PFC and medial or orbital PFC) has been found to be consistently decreased during emotional processing in BPD patients compared with HCs (Silbersweig et al, 2007; Kraus et al, 2010; Smoski et al, 2011). Using the seed-based resting state functional connectivity (rsFC) and probabilistic fiber tracking, we aimed to explore the alterations of functional and structural connectivity (SC) of the ACC in patients with BPD

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