Prefrontal glutamatergic emotion regulation is disturbed in cluster B and C personality disorders – A combined 1H/31P-MR spectroscopic study

Smesny, Stefan; Große, Johanna; Gussew, Alexander; Langbein, Kerstin; Schönfeld, Nils; Wagner, Gerd; Valente, Matias; Reichenbach, Jürgen R.

doi:10.1016/j.jad.2017.10.044

Cited by 11 publications

(7 citation statements)

References 44 publications

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“…Previously thought to be a “psychological” disorder with no organic basis, increasing evidence highlights abnormalities of prefrontal cortex glutamate activity. MRS studies show significant differences in NAA and Glu in the dorsolateral prefrontal cortex (DLPFC) between PD and healthy controls and across PD subtypes [ 191 ]. Interestingly, studies in PD have shown increased central pain suppression, pain adaptation, and dissociation from pain, especially in women and the borderline personality disorder subtype.…”

Section: Other Disordersmentioning

confidence: 99%

Emerging Evidence for the Widespread Role of Glutamatergic Dysfunction in Neuropsychiatric Diseases

et al. 2022

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The monoamine model of depression has long formed the basis of drug development but fails to explain treatment resistance or associations with stress or inflammation. Recent animal research, clinical trials of ketamine (a glutamate receptor antagonist), neuroimaging research, and microbiome studies provide increasing evidence of glutamatergic dysfunction in depression and other disorders. Glutamatergic involvement across diverse neuropathologies including psychoses, neurodevelopmental, neurodegenerative conditions, and brain injury forms the rationale for this review. Glutamate is the brain’s principal excitatory neurotransmitter (NT), a metabolic and synthesis substrate, and an immune mediator. These overlapping roles and multiple glutamate NT receptor types complicate research into glutamate neurotransmission. The glutamate microcircuit comprises excitatory glutamatergic neurons, astrocytes controlling synaptic space levels, through glutamate reuptake, and inhibitory GABA interneurons. Astroglia generate and respond to inflammatory mediators. Glutamatergic microcircuits also act at the brain/body interface via the microbiome, kynurenine pathway, and hypothalamus–pituitary–adrenal axis. Disruption of excitatory/inhibitory homeostasis causing neuro-excitotoxicity, with neuronal impairment, causes depression and cognition symptoms via limbic and prefrontal regions, respectively. Persistent dysfunction reduces neuronal plasticity and growth causing neuronal death and tissue atrophy in neurodegenerative diseases. A conceptual overview of brain glutamatergic activity and peripheral interfacing is presented, including the common mechanisms that diverse diseases share when glutamate homeostasis is disrupted.

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Section: Other Disordersmentioning

confidence: 99%

Emerging Evidence for the Widespread Role of Glutamatergic Dysfunction in Neuropsychiatric Diseases

et al. 2022

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“…Right DLPFC NAA concentrations correlated negatively with current psychological pain, which persisted when controlling for various clinical characteristics such as age, gender, and depression severity; additionally, psychological pain mediated the relationship between DLPFC NAA and current SI 32 . Smesny et al 75 examined metabolite concentrations in adults with cluster B and C personality disorders, conditions with increased suicide risk, and in healthy comparators. The investigators found increased right DLPFC Glu and decreased right dorsal ACC NAA in cluster B patients, while cluster C patients demonstrated decreased NAA in bilateral DLPFC, left dorsomedial prefrontal cortex, and left dorsal ACC voxels, as well as decreased bilateral DLPFC and left dorsomedial prefrontal Glu 75 .…”

Section: Discussionmentioning

confidence: 99%

“…Smesny et al 75 examined metabolite concentrations in adults with cluster B and C personality disorders, conditions with increased suicide risk, and in healthy comparators. The investigators found increased right DLPFC Glu and decreased right dorsal ACC NAA in cluster B patients, while cluster C patients demonstrated decreased NAA in bilateral DLPFC, left dorsomedial prefrontal cortex, and left dorsal ACC voxels, as well as decreased bilateral DLPFC and left dorsomedial prefrontal Glu 75 . By contrast, Rocha et al 31 found no difference in orbitofrontal cortical metabolite concentrations between healthy adults and groups of currently euthymic bipolar patients with and without historical suicide attempts.…”

Section: Discussionmentioning

confidence: 99%

“…First, less mature excitatory circuitry in our younger sample may contribute to the differences in metabolite measurements between groups that we observed compared with prior adult studies. Second, metabolite concentrations differ not only between brain regions but also between heterogeneous segments of a single structure; indeed, many studies that sampled ACC voxels [73][74][75] examined more dorsal aspects of the ACC than our pregenual voxel. The pregenual ACC is distinct in glutamatergic receptor density and microarchitecture compared to other ACC subregions, and prior 1 H-MRS work has found the pregenual ACC to have higher Glu and Gln concentrations than more caudal subregions 76 .…”

Section: Discussionmentioning

confidence: 99%

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Altered anterior cingulate glutamatergic metabolism in depressed adolescents with current suicidal ideation

et al. 2020

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The anterior cingulate cortex (ACC) is involved in emotion regulation and salience processing. Prior research has implicated ACC dysfunction in suicidal ideation (SI) and suicidal behavior. This study aimed to quantify ACC glutamatergic concentrations and to examine relationships with SI in a sample of healthy and depressed adolescents. Forty adolescents underwent clinical evaluation and proton magnetic resonance spectroscopy (1 H-MRS) at 3 T, utilizing a 2-dimensional J-averaged PRESS sequence sampling a medial pregenual ACC voxel. Cerebrospinal fluidcorrected ACC metabolite concentrations were compared between healthy control (HC, n = 16), depressed without SI (Dep/SI−, n = 13), and depressed with SI (Dep/SI+, n = 11) youth using general linear models covarying for age, sex, and psychotropic medication use. Relationships between ACC metabolites and continuous measures of SI were examined using multiple linear regressions. ROC analysis was used to determine the ability of glutamate+glutamine (Glx) and the N-acetylaspartate (NAA)/Glx ratio to discriminate Dep/SI− and Dep/SI+ adolescents. Dep/SI+ adolescents had higher Glx than Dep/SI− participants (p adj = 0.012) and had lower NAA/Glx than both Dep/SI− (p adj = 0.002) and HC adolescents (p adj = 0.039). There were significant relationships between SI intensity and Glx (p FDR = 0.026), SI severity and NAA/Glx (p FDR = 0.012), and SI intensity and NAA/Glx (p FDR = 0.004). ACC Glx and NAA/Glx discriminated Dep/SI− from Dep/SI+ participants. Uncoupled NAA−glutamatergic metabolism in the ACC may play a role in suicidal ideation and behavior. Longitudinal studies are needed to establish whether aberrant glutamatergic metabolism corresponds to acute or chronic suicide risk. Glutamatergic biomarkers may be promising targets for novel risk assessment and interventional strategies for suicidal ideation and behavior.

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“…Osoby borderline mają deficyty w rozpoznawaniu emocji zarówno swoich, jak i innych osób. Wyniki badań pokazują, że mają problem w rozumieniu kontekstu emocjonalnego [13]. Wykazują zwiększoną wrażliwość na emocje innych ludzi, a jednocześnie są mniej biegli w czytaniu ich motywów i powodów [13].…”

Section: Wstępunclassified

Zdrada w zaburzeniach osobowości borderline

Mosiołek,

Jakima

2022

Journal of Sexual and Mental Health

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Zaburzenie osobowości borderline (BPD) cechują się dużą chwiejnością emocjonalną, słabą kontrolą emocji oraz nastroju, impulsywnością, wysokim poziomem napięcia, niskim progiem tolerancji frustracji. U osób z zaburzeniami borderline występuje lęk przed odrzuceniem, lęk przed bliskością oraz trudności w nawiązaniu więzi. Często cechuje ich silne pragnienie bardzo bliskiej, wręcz symbiotycznej, wyłącznej relacji z partnerem. Osoby takie są skłonne podejmować nawet najbardziej ekstremalne ryzykowne zachowania seksualne w celu zadowolenia i przywiązania do siebie partnera. Przyczyny zdrady borderline wynikające z organizacji osobowości to przede wszystkim zaburzenia w badaniu i ocenie rzeczywistości. Chwiejność dotyczy emocji, postaw, bliskich związków międzyludzkich, poglądów, zainteresowań, co oznacza ogólną życiową, osobistą i zawodową niestabilność. U pacjentów z BPD występuje statystycznie istotnie większa liczba partnerów seksualnych. Cechy narcystyczne i socjopatyczne występujące w borderline powodują, że taka osoba zdradza, bo lubi wyzwania, chce sobie podnieść samoocenę bądź z powodu obawy przed monotonią i nudą. Osoby borderline mają często skrajnie impulsywne podejście do własnej seksualności, zdarza się, że decydują się na ryzykowne zachowania z wieloma partnerami. Współżycie z licznymi partnerami może być formą samoleczenia z poczucia samotności lub znudzenia czy odrętwienia. Niekiedy zdrada jest formą zemsty na bliskiej osobie bądź na sobie, może być formą karania się. Behawioralna funkcja zdrady wiąże się przede wszystkim z potrzebą dostymulowania się, sposobem na redukcję napięcia. Może wynikać z konieczności poddania się kompulsjom oraz potrzeby ucieczki przed nudą i pustką.

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Prefrontal glutamatergic emotion regulation is disturbed in cluster B and C personality disorders – A combined 1H/31P-MR spectroscopic study

Cited by 11 publications

References 44 publications

Emerging Evidence for the Widespread Role of Glutamatergic Dysfunction in Neuropsychiatric Diseases

Emerging Evidence for the Widespread Role of Glutamatergic Dysfunction in Neuropsychiatric Diseases

Altered anterior cingulate glutamatergic metabolism in depressed adolescents with current suicidal ideation

Zdrada w zaburzeniach osobowości borderline

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