Neural correlates of the individual emotional Stroop in borderline personality disorder.
OBJECTIVE
Emotional dysregulation is a key feature of borderline personality disorder (BPD) with altered inhibitory functions having suggested as being crucial. The anterior cingulate cortex and further prefrontal brain regions are crucial for response inhibition. The regulation of emotions is ensured via inhibitory control over the amygdala. The present study aimed to investigate neural correlates of response inhibition in BPD by using an emotional Stroop paradigm extending the task to word stimuli which were related to stressful life events.


METHODS
Twenty BPD patients and 20 healthy controls underwent functional magnetic resonance imaging (fMRI) while performing the individual emotional Stroop task. A block design was used with the following word type conditions: neutral words, general negative words, and individual negative words. The individual negative words were recruited from a prior interview conducted with each participant.


RESULTS
While BPD patients had overall slower reaction times in the Stroop task compared to healthy controls, there was no increased slowing with emotional interference. Controls exhibited significant fMRI blood oxygenation level-dependent signal increases in the anterior cingulate cortex as well as in frontal cortex contrasting generally negative vs. neutral and individual negative vs. neutral conditions, respectively. BPD patients did not show equivalent signal changes.


CONCLUSIONS
These results provide further evidence for a dysfunctional network of brain areas in BPD, including the ACC and frontal brain regions. These areas are crucial for the regulation of stress and emotions, the core problems of BPD patients.
Wingenfeld
Katja
K
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. k.wingenfeld@uke.uni-hamburg.de
Rullkoetter
Nina
N
Mensebach
Christoph
C
Beblo
Thomas
T
Mertens
Markus
M
Kreisel
Stefan
S
Toepper
Max
M
Driessen
Martin
M
Woermann
Friedrich G
FG
D000328:Adult; D001883:Borderline Personality Disorder / Q000503:physiopathology / Q000523:psychology*; D001931:Brain Mapping; D016022:Case-Control Studies; D003220:Conflict, Psychological; D004644:Emotions / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000502:physiology*; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000502:physiology*; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D016555:Matched-Pair Analysis; D010364:Pattern Recognition, Visual / Q000502:physiology; D011930:Reaction Time / Q000502:physiology*; D012016:Reference Values; D055815:Young Adult