Functional MRI correlates of the recall of unresolved life events in borderline personality disorder.
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.
Beblo
Thomas
T
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany. thomas.beblo@evkb.de
Driessen
Martin
M
Mertens
Markus
M
Wingenfeld
Katja
K
Piefke
Martina
M
Rullkoetter
Nina
N
Silva-Saavedra
Anamaria
A
Mensebach
Christoph
C
Reddemann
Luise
L
Rau
Harald
H
Markowitsch
Hans J
HJ
Wulff
Hella
H
Lange
Wolfgang
W
Berea
Cristina
C
Ollech
Isabella
I
Woermann
Friedrich G
FG
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