title: Functional MRI correlates of the recall of unresolved life events in borderline personality disorder.
abstract: BACKGROUND
  Patients with borderline personality disorder (BPD) frequently report unresolved life events but it is still poorly understood, how these experiences are represented in the brain. Using functional magnetic resonance imaging (fMRI), the present study aimed at investigating the neural correlates of the recall of unresolved life events in patients with BPD and healthy controls.
  
  
  METHODS
  Twenty female BPD patients and 21 healthy control subjects underwent fMRI. During measurement subjects recalled unresolved and resolved negative life events. Individual cue words were used to stimulate autobiographical memory. After scanning, subjects rated their emotional states during the recall of both types of memories.
  
  
  RESULTS
  When contrasting unresolved and resolved life events, patients showed significant bilateral activation of frontotemporal areas including the insula, amygdala, and the anterior cingulate cortex, the left posterior cingulate cortex, right occipital cortex, the bilateral cerebellum and the midbrain. In healthy subjects, no differential brain activation was related to these conditions. The 2 x 2 factorial analysis (DeltaBPD - Deltacontrols) revealed similar results with bilateral activation of the frontal cortex including parts of the insula and of the orbitofrontal cortex, temporal activation including the amygdala, activation of the right occipital cortex, and parts of the cerebellum. Patients but not controls reported higher levels of anxiety and helplessness during the unresolved versus resolved memory condition.
  
  
  CONCLUSIONS
  The activation of both, the amygdala and prefrontal areas, might reflect an increased effortful but insufficient attempt to control intensive emotions during the recall of unresolved life events in patients with BPD.
authors.affiliation: Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany. thomas.beblo@evkb.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Beblo
authors.forename: Martin
authors.initials: M
authors.lastname: Driessen
authors.forename: Markus
authors.initials: M
authors.lastname: Mertens
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: Martina
authors.initials: M
authors.lastname: Piefke
authors.forename: Nina
authors.initials: N
authors.lastname: Rullkoetter
authors.forename: Anamaria
authors.initials: A
authors.lastname: Silva-Saavedra
authors.forename: Christoph
authors.initials: C
authors.lastname: Mensebach
authors.forename: Luise
authors.initials: L
authors.lastname: Reddemann
authors.forename: Harald
authors.initials: H
authors.lastname: Rau
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Markowitsch
authors.forename: Hella
authors.initials: H
authors.lastname: Wulff
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lange
authors.forename: Cristina
authors.initials: C
authors.lastname: Berea
authors.forename: Isabella
authors.initials: I
authors.lastname: Ollech
authors.forename: Friedrich G
authors.initials: FG
authors.lastname: Woermann
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001921:Brain / Q000033:anatomy & histology* / Q000503:physiopathology*; D003463:Cues; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D011939:Mental Recall; D011581:Psychological Tests; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires