학술논문

Emotion dysregulation, impulsivity and anger rumination in borderline personality disorder: the role of amygdala and insula.
Document Type
Article
Source
European Archives of Psychiatry & Clinical Neuroscience. Feb2024, Vol. 274 Issue 1, p109-116. 8p.
Subject
*BORDERLINE personality disorder
*INSULAR cortex
*AMYGDALOID body
*RUMINATION (Cognition)
*IMPULSIVE personality
*EMOTIONS
Language
ISSN
0940-1334
Abstract
Borderline Personality Disorder (BPD) is a severe mental disorder, characterized by deficits in emotion regulation, interpersonal dysfunctions, dissociation and impulsivity. Brain abnormalities have been generally explored; however, the specific contribution of different limbic structures to BPD symptomatology is not described. The aim of this study is to cover this gap, exploring functional and structural alterations of amygdala and insula and to highlight their contribution to neuropsychiatric symptoms. Twenty-eight BPD patients (23.7 ± 3.42 years; 6 M/22F) and twenty-eight matched healthy controls underwent a brain MR protocol (1.5 T, including a 3D T1-weighted sequence and resting-state fMRI) and a complete neuropsychiatric assessment. Volumetry, cortical thickness and functional connectivity of amygdala and insula were evaluated, along with correlations with the neuropsychiatric scales. BPD patients showed a lower cortical thickness of the left insula (p = 0.027) that negatively correlated with the Anger Rumination Scale (p = 0.019; r = − 0.450). A focused analysis on female patients showed a significant reduction of right amygdala volumes in BPD (p = 0.037), that correlate with Difficulties in Emotion Regulation Scale (p = 0.031; r = − 0.415), Beck Depression Inventory (p = 0.009; r = − 0.50) and Ruminative Response Scale (p = 0.045; r = − 0.389). Reduced functional connectivity was found in BPD between amygdala and frontal pole, precuneus and temporal pole. This functional connectivity alterations correlated with Anger Rumination Scale (p =.009; r = − 0.491) and Barratt Impulsiveness Scale (p = 0.020; r = − 0.447). Amygdala and insula are altered in BPD patients, and these two limbic structures are implicated in specific neuropsychiatric symptoms, such as difficulty in emotion regulation, depression, anger and depressive rumination. [ABSTRACT FROM AUTHOR]