title: Deficient amygdala-prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.
abstract: Emotion instability in borderline personality disorder (BPD) has been associated with an impaired fronto-limbic inhibitory network. However, functional connectivity (FC) underlying altered emotion regulation in BPD has yet to be established. Here, we used resting-state fMRI to investigate enduring effects of effortful emotion regulation on the amygdala intrinsic FC in BPD. In this multicenter study, resting-state fMRI was acquired before and after an emotion regulation task in 48 BPD patients and 39 non-patient comparison individuals. The bilateral amygdalae were used as a seed in the whole-brain FC analysis and two-way mixed ANOVA to test whether BPD patients exhibited weaker post-task increase in the amygdala intrinsic FC with the prefrontal cortex (PFC), compared to non-patients. Subsequently, we explored whether the results are common for personality disorders characterized by emotional problems, using additional data of 21 cluster-C personality disorder patients. In contrast to non-patients, BPD patients failed to show increased post-task amygdala resting-state FC with the medial, dorsolateral, ventrolateral PFC, and superior temporal gyrus, but surprisingly exhibited decreased FC with the posterior cingulate cortex and increased FC with the superior parietal lobule. In BPD patients, the emotion regulation task failed to increase resting-state amygdala FC with brain regions essential for effortful emotion regulation, which suggests: (a) altered cognitive control typically used to indirectly alleviate distress by reinterpreting the meaning of emotional stimuli; (b) impaired direct regulation of emotional responses, which might be common for personality disorders;
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.|Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors.forename: Blazej M
authors.initials: BM
authors.lastname: Baczkowski
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. linda.vanzutphen@maastrichtuniversity.nl.
authors.forename: Linda
authors.initials: L
authors.lastname: van Zutphen
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Nicolette
authors.initials: N
authors.lastname: Siep
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany.
authors.forename: Gitta A
authors.initials: GA
authors.lastname: Jacob
authors.affiliation: Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany.|Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany.|Department of Biological and Clinical Psychology, University of Trier, Trier, Germany.
authors.forename: Gregor
authors.initials: G
authors.lastname: Domes
authors.affiliation: Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany.|Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Maier
authors.affiliation: Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sprenger
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
authors.forename: Alena
authors.initials: A
authors.lastname: Senft
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Willenborg
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany.|Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Tüscher
authors.affiliation: Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.|Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Arnoud
authors.initials: A
authors.lastname: Arntz
authors.affiliation: Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: van de Ven
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D063132:Connectome / Q000379:methods*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000068356:Self-Control; D055815:Young Adult
keywords: Amygdala; BPD; Emotion regulation; Functional connectivity; Resting-state fMRI