Affective context interferes with brain responses during cognitive processing in borderline personality disorder: fMRI evidence

Abstract

Emotion dysregulation in borderline personality disorder (BPD) is associated with loss of cognitive control in the face of intense negative emotion. Negative emotional context may interfere with cognitive processing through the dysmodulation of brain regions involved in regulation of emotion, impulse control, executive function and memory. Structural and metabolic brain abnormalities have been reported in these regions in BPD. Using novel fMRI protocols, we investigated the neural basis of negative affective interference with cognitive processing targeting these regions. Attention-driven Go No-Go and X-CPT (continuous performance test) protocols, using positive, negative and neutral Ekman faces, targeted the orbital frontal cortex (OFC) and the anterior cingulate cortex (ACC), respectively. A stimulus-driven Episodic Memory task, using images from the International Affective Pictures System, targeted the hippocampus (HIP). Participants comprised 23 women with BPD, who were compared with 15 healthy controls. When Negative>Positive faces were compared in the Go No-Go task, BPD subjects had hyper-activation relative to controls in areas reflecting task-relevant processing: the superior parietal/precuneus and thebasal ganglia. Decreased activation was also noted in the OFC, and increased activation in the amygdala (AMY). In the X-CPT, BPD subjects again showed hyper-activation in task-relevant areas: the superior parietal/precuneus and the ACC. In the stimulus-driven Episodic Memory task, BPD subjects had decreased activation relative to controls in the HIP, ACC, superior parietal/precuneus, and dorsal prefrontal cortex (dPFC) (for encoding), and the ACC, dPFC, and HIP for retrieval of Negative>Positive pictures, reflecting impairment of task-relevant functions. Negative affective interference with cognitive processing in BPD differs from that in healthy controls and is associated with functional abnormalities in brain networks reported to have structural or metabolic abnormalities. Task demands exert a differential effect on the cognitive response to negative emotion in BPD compared with control subjects.

Brain Structure and Response to Emotional Stimuli as Related to Gut Microbial Profiles in Healthy Women

“…Reduced hippocampal engagement to negative imagery may be associated with increased emotional arousal. Such changes have been suggested to result in less specificity of encoding the contextual details of incoming stimuli, a deficit seen in the setting of several psychiatric disorders, including depression, post traumatic stress disorder, and borderline personality disorder (45–47). While the subjects in this study were healthy, it is possible that the patterns which emerge from the microbial clustering represent vulnerability factors.…”

Impulsivity and aggression mediate regional brain responses in Borderline Personality Disorder: An fMRI study

“…Negative affect interferes with brain responses sub-serving attention and impulse control in participants with BPD compared to healthy controls (Soloff et al, 2015). In a recent study, attention-driven fMRI tasks (Go No-Go, X-CPT) were modified to evoke affective interference by replacing the standard cognitive tokens with negative, positive and neutral Ekman faces (Ekman and Friesen, 1976).…”

“…In a recent study, attention-driven fMRI tasks (Go No-Go, X-CPT) were modified to evoke affective interference by replacing the standard cognitive tokens with negative, positive and neutral Ekman faces (Ekman and Friesen, 1976). Directing attention to negative affective stimuli resulted in increased modulation of fMRI responses in BPD subjects compared to controls in fronto-limbic pathways, including the orbital frontal cortex (OFC) and the anterior cingulate cortex (ACC), areas critically involved in control of emotion and impulsive behavior (Soloff et al, 2015). Negative affective interference during cognitive processing in these regulatory areas may contribute to emotion dysregulation, impulsive and aggressive behavior in patients with BPD (Siever, 2008).…”

“…The failure of “top down” cortical regulation in the face of “bottom up” limbic hyper-arousal has been proposed as a model for affective interference with cognitive function in BPD, and for the borderline patient’s emotion dysregulation, impulsivity and aggression (Silbersweig et al, 2007, Siever, 2008). fMRI studies which pair emotion with cognitive tasks, demonstrate affective interference with neural processing in brain networks previously reported to have structural, metabolic or functional abnormalities (Soloff et al, 2015). …”

Repetitive TMS on Left Cerebellum Affects Impulsivity in Borderline Personality Disorder: A Pilot Study

“…An increased attentional process in the domain of selective attention when negative stimuli are involved and thus a deficit of inhibition of irrelevant information of aversive nature has been demonstrated in various studies (Domes et al, 2006; Soloff et al, 2015). The inability of borderline patients to disengage attention from negative stimuli may explain the good performance in the block where lack of inhibition of negative stimuli is advantageous (i.e., the target category NEGATIVE) and a worse performance where inhibition of negative stimuli is required (i.e., the block with target category POSITIVE).…”