Functional Connectivity of Pain-Mediated Affect Regulation in Borderline Personality Disorder 英文参考文献.docVIP

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Functional Connectivity of Pain-Mediated Affect Regulation in Borderline Personality Disorder 英文参考文献.doc

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Functional Connectivity of Pain-Mediated Affect Regulation in Borderline Personality Disorder 英文参考文献

FunctionalConnectivityofPain-MediatedAffect RegulationinBorderlinePersonalityDisorder IngaNiedtfeld1*,PeterKirsch2,LarsSchulze3,SabineC.Herpertz4,MartinBohus1,ChristianSchmahl1 1Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany, 2Department of Clinical Psychology, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany, 3Clinical Psychology and Psychotherapy, Freie Universita¨t Berlin, Berlin, Germany, 4Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg,Germany Abstract Affective instability and self-injurious behavior are important features of Borderline Personality Disorder. Whereas affective instability may be caused by a pattern of limbic hyperreactivity paired with dysfunctional prefrontal regulation mechanisms, painfulstimulationwasfoundtoreduceaffectivearousalattheneurallevel,possiblyunderlyingthesoothingeffectofpaininBPD. Weusedpsychophysiologicalinteractionstoanalyzefunctionalconnectivityof(para-)limbicbrainstructures(i.e.amygdala, insula,anteriorcingulatecortex)inBorderlinePersonalityDisorderinresponsetopainfulstimulation.Therefore,were-analyzeda datasetfrom20patientswithBorderlinePersonalityDisorderand23healthycontrolswhotookpartinanfMRI-taskinducing negative(versusneutral)affectandsubsequentlyapplyingheatpain(versuswarmthperception). Resultssuggestanenhancednegativecouplingbetweenlimbicaswellasparalimbicregionsandprefrontalregions,specifically withthemedialanddorsolateralprefrontalcortex,whenpatientsexperiencedpaininadditiontoemotionalarousingpictures. When neutral pictures were combined with painful heat sensation, we found positive connectivity in Borderline Personality Disorderbetween(para-)limbicbrainareasandpartsofthebasalganglia(lentiformnucleus,putamen),aswellareasinvolvedin self-referentialprocessing(precuneusandposteriorcingulate). Wefound