title: Amygdala and dlPFC abnormalities, with aberrant connectivity and habituation in response to emotional stimuli in females with BPD.
abstract: Little is known about the frontolimbic abnormalities thought to underlie borderline personality disorder (BPD). We endeavoured to study regional responses, as well as their connectivity and habituation during emotion processing.
  
  
  
  14 BPD patients and 14 normal female controls (NC) controlled for menstrual phase underwent emotion-induction during an fMRI task using standardised images in a block design. We then performed psychophysiological interaction (PPI) analysis to investigate functional connectivity.
  
  
  
  BPD patients reported more disgust in questionnaires compared to controls. Relative to NC, they showed reduced left amygdala and increased dorsolateral prefrontal cortex (dlPFC) activation to all emotions collapsed versus neutral. Habituation of ventral striatal activity to repeated emotional stimuli was observed in controls but not in BPD. Finally, in the context of disgust (but not other emotions) versus neutral, BPD patients displayed enhanced left amygdala coupling with the dlPFC and ventral striatum.
  
  
  
  Strict inclusion criteria reduced the sample size.
  
  
  
  In summary, BPD showed abnormal patterns of activation, habituation and connectivity in regions linked to emotion regulation. Amygdala deactivation may be mediated by abnormal top-down regulatory control from the dorsolateral prefrontal cortex. Aberrant emotion processing may play a unique role in the pathophysiology of BPD.
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Complex Cases Service, Cambridge shire and Peterborough Foundation NHS Trust, UK; Behavioural and Clinical Neurosciences Institute, University of Cambridge, UK; Psychiatric Liaison Service, Ipswich Hospital, Norfolk and Suffolk NHS Foundation Trust, UK; Norwich Medical School, University of East Anglia, UK. Electronic address: rbd21@cam.ac.uk.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Dudas
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Mole
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Laurel S
authors.initials: LS
authors.lastname: Morris
authors.affiliation: Complex Cases Service, Cambridge shire and Peterborough Foundation NHS Trust, UK.
authors.forename: Chess
authors.initials: C
authors.lastname: Denman
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Complex Cases Service, Cambridge shire and Peterborough Foundation NHS Trust, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Hill
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Bence
authors.initials: B
authors.lastname: Szalma
authors.affiliation: School of Psychology, University of Birmingham, UK; Dudley and Walsall Mental Health Partnership NHS Trust, UK.
authors.forename: Davy
authors.initials: D
authors.lastname: Evans
authors.affiliation: Mood Disorders Centre, University of Exeter, UK.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Dunn
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, University of Cambridge, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Fletcher
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, University of Cambridge, UK.
authors.forename: Valerie
authors.initials: V
authors.lastname: Voon
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions; D005260:Female; D006185:Habituation, Psychophysiologic; D006801:Humans; D008279:Magnetic Resonance Imaging; D009434:Neural Pathways / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059906:Neuroimaging; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D066328:Ventral Striatum / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Amygdala; Borderline personality disorder; Disgust; Functional connectivity; Habituation; Imaging