Borderline personality disorder, impulsivity, and the orbitofrontal cortex
Borderline personality disorder, impulsivity, and the orbitofrontal cortex
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DOI：
10.1176/appi.ajp.162.12.2360
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发表时间：
2005-12-01
影响因子：
17.7
通讯作者：
Iversen, SD
中科院分区：
文献类型：
--
作者：
Berlin, HA;Rolls, ET;Iversen, SD
目的：眶额皮质病变可导致不受抑制或社交不当的行为和情绪异常。边缘型人格障碍的特征包括冲动和情感不稳定。作者调查了边缘型人格障碍的各个方面，特别是冲动性，是否与眶额皮质功能障碍有关。方法：对边缘型人格障碍患者（N = 19），眶额皮质病变患者（N = 23），结果：眶额皮质病变组与边缘型人格障碍组在多项测量指标上无显著性差异，边缘型人格障碍组与眶额皮质病变组在多项测量指标上无显著性差异。与两个对照组相比，两组都更冲动，报告了更多不适当的行为，边缘型人格障碍特征，愤怒和更少的快乐，两组都不太开放的经验，并且比健康的对照组有更快的时间感知（生产不足的时间）。眶额皮质病变患者和边缘性人格障碍患者在其他测量上表现不同。边缘型人格障碍患者比其他组更不外向和认真，更神经质和情绪化。眶额皮质病变的患者有赤字，扭转刺激-神经传导协会和更快的感知时间（高估的时间）比健康的比较subjects.Conclusions：眶额皮质功能障碍可能有助于边缘性人格障碍的一些核心特征，特别是冲动。边缘型人格障碍的其他特征，如高水平的情绪化和人格不规则性，似乎与眶额皮质损伤产生的功能障碍类型无关。边缘型人格障碍患者与眶额皮质病变患者之间的异同有助于我们更好地理解边缘型人格障碍的病因和眶额皮质的功能。
Objective: Orbitofrontal cortex lesions produce disinhibited or socially inappropriate behavior and emotional irregularities. Characteristics of borderline personality disorder include impulsivity and affective instability. The authors investigated whether aspects of borderline personality disorder, in particular impulsivity, are associated with orbitofrontal cortex dysfunction.Method: Measures of personality, emotion, impulsivity, time perception, sensitivity to reinforcers, and spatial working memory were administered to patients with borderline personality disorder (N = 19), patients with orbitofrontal cortex lesions (N = 23), patients with lesions in the prefrontal cortex but not in the orbitofrontal cortex (N = 20), and healthy comparison subjects (N = 39).Results: The patients with orbitofrontal cortex lesions and the patients with borderline personality disorder performed similarly on several measures. Both groups were more impulsive and reported more inappropriate behaviors, borderline personality disorder characteristics, and anger and less happiness than the two comparison groups, and both groups were less open to experience and had a faster perception of time (underproduced time) than the healthy comparison subjects. The patients with orbitofrontal cortex lesions and the borderline personality disorder patients performed differently on other measures. The borderline personality disorder patients were less extraverted and conscientious and more neurotic and emotional than all other groups. Patients with orbitofrontal cortex lesions had deficits in reversing stimulus-reinforcer associations and a faster perception of time (overestimated time) than the healthy comparison subjects.Conclusions: Orbitofrontal cortex dysfunction may contribute to some core characteristics of borderline personality disorder, in particular impulsivity. Other characteristics of borderline personality disorder, such as high levels of emotionality and personality irregularities, do not appear to be related to the type of dysfunction produced by orbitofrontal cortex damage. The similarities and differences found between the borderline personality disorder patients and the patients with orbitofrontal cortex lesions may lead to a better understanding of the etiology of borderline personality disorder and the functions of the orbitofrontal cortex.