Cortical Representation of Afferent Bodily Signals in Borderline Personality Disorder

Abstract

The ability to perceive and regulate one's own emotions has been tightly linked to the processing of afferent bodily signals (interoception). Thus, disturbed interoception might contribute to the core feature of emotional dysregulation in borderline personality disorder (BPD), as increased levels of depersonalization, body image disturbances, and reduced sensitivity to physical pain suggest poor body awareness in BPD. OBJECTIVE To determine neural correlates of disturbed body awareness in BPD and its associations with emotional dysregulation and to explore improvements in body awareness with BPD symptom remission.

Feeling, learning from and being aware of inner states: interoceptive dimensions in neurodegeneration and stroke

“…This finding aligns with previous evidence that such alterations correlate with behavioural interoceptive deficits [5,18]. Also, it indicates that difficulties to allocate attention to visceral signals are not confined to psychiatric conditions [67] with diffuse brain abnormalities, and may actually result from relatively circumscribed brain damage. Second, the association of impaired performance with fronto-temporal-insular and fronto-insular damage (in bvFTD and FIS, respectively) corroborates the central role of the IC networks in sensing body states, and of the cingulate and frontal cortices in the integration of interoceptive information [1,2,12].…”

“…Thus, not only does this domain depend on the full integrity of a broad network cutting across anterior and posterior hubs, but it can also be similarly affected irrespective of the underlying physiopathology. This observation, together with evidence of interoceptive accuracy impairments in conditions without a specific locus of brain damage [5,67], confirms the widely distributed and multidimensional nature of its putative mechanisms. In sum, interoceptive accuracy seems to rely on complex interactions among hubs, which span the overall interoceptive network and participate in other functional domains.…”

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

“…Emotion dysregulation may be further improved by interventions that focus on body awareness, such as mindfulness-based therapy, mindfulness-based interventions such as those included in DBT, or dance and movement therapy, the more interoception seems to be impaired in BPD [34]. One might also think of biofeedback interventions that have been shown to promote interoception and emotional state recognition [35] and continue research on neurofeedback as an amendment to psychotherapy.…”

Attention, in and Out: Scalp-Level and Intracranial EEG Correlates of Interoception and Exteroception

“…HEP modulations reflect not only heartbeat perception (Pollatos and Schandry, 2004), but also other processes related to body-brain communication, such as body awareness (Muller et al, 2015), emotional experience (Couto et al, 2015b), motivation (Weitkunat, 1990), attention (Montoya et al, 1993), pain perception (Shao et al, 2011), and stress (Gray et al, 2007). Given these properties, measurements of the HEP may afford critical insights into the cortical monitoring of internal signals, potentially shedding light on two relevant yet underexplored issues: (i) the specificity of internally driven (relative to externally driven) attentional processes; and (ii) its susceptibility to interoceptive training.…”

“…Given these properties, measurements of the HEP may afford critical insights into the cortical monitoring of internal signals, potentially shedding light on two relevant yet underexplored issues: (i) the specificity of internally driven (relative to externally driven) attentional processes; and (ii) its susceptibility to interoceptive training. A systematic assessment of such matters could afford valuable normative or reference parameters for clinical research, given that the HEP alterations during interoceptive tasks have been reported in patients with various psychiatric and neurological conditions (Terhaar et al, 2012; Muller et al, 2015; Schulz et al, 2015; García-Cordero et al, 2016). To foster progress in this direction, here we report the first joint assessment of the two abovementioned issues through a combination of behavioral measures, high-density electroencephalography (hd-EEG), and intracranial recordings.…”