J Psychiatry Neurosci 2011;36(6):402-11
Robert Christian Wolf, MD; Fabio Sambataro, MD, PhD; Nenad Vasic, MD; Markus Schmid, MD; Philipp Arthur Thomann, MD; Sara Doris Bienentreu, MD; Nadine Donata Wolf, MD
R.C. Wolf, Thomann, Bienentreu — Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany; R.C. Wolf, Vasic, Schmid — Department of Psychiatry and Psychotherapy III, University of Ulm, Germany; Sambataro — Brain Center for Motor and Social Cognition, Italian Institute of Technology, Parma, Italy; N.D. Wolf — Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
Background: Several functional neuroimaging studies have reported regionally abnormal activation of the frontal cortex in individuals with borderline personality disorder (BPD) during cognitive and affective task performance. However, little is known about neural function in individuals with BPD during the resting state. Using functional magnetic resonance imaging (fMRI), this study investigated the functional connectivity of prefrontal and limbic networks in patients with BPD.
Methods: Between January 2009 and March 2010, we investigated patients with BPD according to DSM-IV criteria and healthy controls by means of resting-state fMRI. The data were analyzed using a spatial group independent component analysis, and random effects t tests were used to compare spatial components between groups (p < 0.005, uncorrected). Results: There were 17 women with BPD and 17 female healthy controls enrolled in this study. Within a network comprising cortical midline regions (“default mode network”), patients with BPD showed an increase in functional connectivity in the left frontopolar cortex (FPC) and the left insula, whereas decreased connectivity was found in the left cuneus. Within a network comprising predominantly right lateral prefrontal and bilateral parietal regions, patients with BPD showed decreased connectivity of the left inferior parietal lobule and the right middle temporal cortex compared with healthy controls. Two networks comprising lateral prefrontal and cingulate regions did not exhibit significant between-group differences. We found correlations between functional connectivity of the FPC and measures of impulsivity as well as between connectivity of the insula/cuneus and dissociation tension.
Limitations: Co-occurrent axis I disorders and medication use in this sample of patients with BPD have to be considered as potential limitations.
Conclusion: These data suggest that abnormal functional connectivity of temporally coherent resting-state networks may underlie certain symptom clusters in patients with BPD.
Submitted Oct. 11, 2010; Revised Dec. 23, 2010; Jan. 31, 2011; Accepted Feb. 1, 2011.
Acknowledgments: The authors thank all participants and their families for their time and interest in this study.
Competing interests: Dr. Bienentreu declared having received speaker fees/payment for service on speakers bureaus from Lilly, Boehringer Ingelheim, Janssen-Cilag, Pfizer, Lundbeck and Wyeth Pharma. None declared for Drs. R.C. Wolf, Sambataro, Vasic, Schmid, Thomann and N.D. Wolf.
Contributors: Drs. R.C. Wolf and N.D. Wolf designed the study and wrote the article. Drs. R.C. Wolf, Vasic and Schmid acquired the data, which Drs. R.C. Wolf, Sambataro, Thomann and Bienentreu analyzed. All authors reviewed the article and approved its publication.
Correspondence to: Dr. R.C. Wolf, Department of Psychiatry, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany; firstname.lastname@example.org