title: Functional imaging of emotion reactivity in opiate-dependent borderline personality disorder.
abstract: Opiate dependence (OD) and borderline personality disorder (BPD), separately and together, are significant public health problems with poor treatment outcomes. BPD is associated with difficulties in emotion regulation, and brain-imaging studies in BPD individuals indicate differential activation in prefrontal cingulate cortices and their interactions with limbic regions. Likewise, a similar network is implicated in drug cue responsivity in substance abusers. The present, preliminary study used functional MRI to examine activation of this network in comorbid OD/BPD participants when engaged in an "oddball" task that required attention to a target in the context of emotionally negative distractors. Twelve male OD/BPD participants and 12 male healthy controls participated. All OD/BPD participants were taking the opiate replacement medication Suboxone, and a subset of participants was positive for substances of abuse on scan day. Relative to controls, OD/BPD participants demonstrated reduced activation to negative stimuli in the amygdala and anterior cingulate. Unlike previous studies that demonstrated hyperresponsivity in neural regions associated with affective processing in individuals with BPD versus healthy controls, comorbid OD/BPD participants were hyporesponsive to emotional cues. Future studies that also include BPD-only and OD-only groups are necessary to help clarify the individual and potentially synergistic effects of these two conditions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. moria.smoski@duke.edu
authors.forename: Moria J
authors.initials: MJ
authors.lastname: Smoski
authors.forename: Nicholas
authors.initials: N
authors.lastname: Salsman
authors.forename: Lihong
authors.initials: L
authors.lastname: Wang
authors.forename: Veronica
authors.initials: V
authors.lastname: Smith
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Lynch
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Dager
authors.forename: Kevin S
authors.initials: KS
authors.lastname: LaBar
authors.forename: Marsha M
authors.initials: MM
authors.lastname: Linehan
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001143:Arousal / Q000502:physiology; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D001931:Brain Mapping / Q000379:methods; D002047:Buprenorphine / Q000627:therapeutic use; D000069479:Buprenorphine, Naloxone Drug Combination; D016022:Case-Control Studies; D015897:Comorbidity; D003463:Cues; D004338:Drug Combinations; D004644:Emotions / Q000502:physiology*; D007839:Functional Laterality; D006801:Humans; D008032:Limbic System / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D011930:Reaction Time; D057566:Self Report
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D004338:Drug Combinations; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine