Hyper-modulation of brain networks by the amygdala among women with Borderline Personality Disorder: Network signatures of affective interference during cognitive processing

Abstract

Emotion dysregulation is a core characteristic of patients with Borderline Personality Disorder (BPD), and is often attributed to an imbalance in fronto-limbic network function. Hyperarousal of amygdala, especially in response to negative affective stimuli, results in affective interference with cognitive processing of executive functions. Clinical consequences include the impulsive-aggression, suicidal and self-injurious behaviors which characterize BPD. Dysfunctional interactions between amygdala and its network targets have not been well characterized during cognitive task performance. Using psychophysiological interaction analysis (PPI), we mapped network profiles of amygdala interaction with key regulatory regions during a Go No-Go task, modified to use negative, positive and neutral Ekman faces as targets. Fifty-six female subjects, 31 BPD and 25 healthy controls (HC), completed the affectively valenced Go No-Go task during fMRI scanning. In the negative affective condition, the amygdala exerted greater modulation of its targets in BPD compared to HC subjects in Rt. OFC, Rt. dACC, Rt. Parietal cortex, Rt. Basal Ganglia, and Rt. dlPFC. Across the spectrum of affective contrasts, hypermodulation in BPD subjects observed the following ordering: Negative > Neutral > Positive contrast. The amygdala seed exerted modulatory effects on specific target regions important in processing response inhibition and motor impulsiveness. The vulnerability of BPD subjects to affective interference with impulse control may be due to specific network dysfunction related to amygdala hyper-arousal and its effects on prefrontal regulatory regions such as the OFC and dACC.

Insomnia as a predictor of mental disorders: A systematic review and meta-analysis

“…In the present meta-analysis, we extended our previous finding [11], showing that the presence of insomnia at baseline also increased the odds of suffering from anxiety at follow-up. For the other investigated disorders (alcohol abuse, psychosis), the increase in risk was numerically slightly smaller (around factor 1. borderline personality disorder, posttraumatic stress disorder, and addiction [39][40][41]. Specific interactions of genetic and environmental risk factors contribute to a brain arousal profile that is associated with an increased risk for mental disorders [42].…”

Affective interference in borderline personality disorder: The lethality of suicidal behavior predicts functional brain profiles

“…Limbic hyperarousal and diminished fronto-limbic inhibitory function has been previously demonstrated in BPD subjects exposed to negative affective stimuli in diverse paradigms (Kraus et al, 2010;Kraus-Utz et al, 2014;Minzenberg et al, 2007;Schmahl et al, 2003a;Silbersweig et al, 2007). In addition, BPD subjects have been shown to have diminished or aberrant functional connectivity between amygdala and regions of the frontal cortex, including ACC (New et al 2007, Soloff et al, 2017a.…”

“…The dorsolateral PFC is one of the neural "anchors" of the CEN, which mediates high level cognitive functions (Menon, 2011). Diminished functional connectivity between amygdala and frontal regulatory structures in BPD varies with the emotional valence of stimuli (Banks et al 2007;Cullen et al 2011;New et al, 2007;Soloff et al, 2017a). Limbic ("bottom-up") hyperarousal in the face of diminished cortical ("top down") activation may contribute to affective interference with the neural processing of cognitive tasks such as response inhibition and impulse control at times of emotional stress.…”

Neurocognition and the Suicidal Process

“…Cognitive deficits in BPD associated with hyperarousal may relate to progression along the suicidal process. BPD is characterized by hypersensitivity to emotional stressors and emotion dysregulation (Soloff et al 2017). Negative life events have been shown to trigger episodes of affective instability and behavioral disinhibition that are often characterized by impulsive aggression and suicidal and/or selfinjurious behavior and are associated with high-lethality suicide attempts in individuals with BPD (Brodsky et al 1997;Cackowski et al 2014;Soloff et al 2017;Yen et al 2004).…”