Out of control? Acting out anger is associated with deficient prefrontal emotional action control in male patients with borderline personality disorder
Out of control? Acting out anger is associated with deficient prefrontal emotional action control in male patients with borderline personality disorder
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DOI：
10.1016/j.neuropharm.2018.12.010
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发表时间：
2019-09-15
影响因子：
4.7
通讯作者：
Volman, Inge
中科院分区：
文献类型：
--
作者：
Bertsch, Katja;Krauch, Marlene;Volman, Inge
边缘型人格障碍（BPD）患者经常报告愤怒控制困难和愤怒相关的攻击他人的爆发。虽然男性性别是一种已知的攻击性预测因素，但几乎没有任何研究涉及男性BPD患者愤怒控制不足的神经关联。在之前关于女性BPD的研究报告的基础上，我们研究了外侧前额叶和背侧前额叶皮层在控制快速情绪行为中的作用，以及它与自我报告的愤怒行为倾向的关系。15名无药物治疗的男性BPD患者和25名年龄和智力匹配的健康男性参加了核磁共振扫描仪上的社会接近-回避任务。这项任务允许测量神经相关的潜在控制快速行为倾向接近快乐和避免愤怒的脸。采用假设驱动的兴趣区和探索性全脑分析来测试男性BPD患者和健康志愿者在情绪行为控制过程中前额叶前部和背外侧前额叶区域的激活及其与杏仁核的关系，以及它们与自我报告的愤怒的关联。与健康志愿者相比，男性BPD患者在情绪行为控制过程中表现出前外侧前额叶激活减少。此外，在男性BPD患者中，愤怒发泄与前额叶前部和背外侧的激活呈负相关，而与杏仁核活动呈正相关。目前的结果表明，前额叶前部和背外侧区域参与控制和压倒快速情绪行为。侧前额叶情绪控制缺陷似乎是愤怒相关攻击的常见神经机制。这篇文章是题为“攻击和冲动的神经生物学现状”特刊的一部分。
Difficulty in anger control and anger-related aggressive outbursts against others are frequently reported by patients with borderline personality disorder (BPD). Although male sex is a known predictor for aggression, hardly any study has addressed the neural correlates of deficient anger control in male patients with BPD. Building on previous reports in female BPD, we investigated the involvement of lateral antero- and dorsal prefrontal cortex in the control of fast emotional actions and its relation to self-reported tendencies to act out anger. 15 medication-free male patients with BPD and 25 age- and intelligence-matched healthy men took part in a social Approach-Avoidance task in the MR-scanner. This task allows the measurement of neural correlates underlying the control of fast behavioral tendencies to approach happy and avoid angry faces. Hypothesis-driven region-of-interest and exploratory whole brain analyses were used to test for activations of antero- and dorsolateral prefrontal regions and their relation with the amygdala during emotional action control as well as their association with self-reported anger out in male patients with BPD and healthy volunteers. Male patients with BPD showed reduced anterolateral prefrontal activations during emotional action control compared to healthy volunteers. Furthermore, anger out was negatively related to antero- and dorsolateral prefrontal activations, while it was positively related to amygdala activity in male patients with BPD. The current results suggest the involvement of antero- and dorsolateral prefrontal regions in controlling and overriding fast emotional actions. Deficits in lateral prefrontal emotion control seem to be a common neural mechanism underlying anger-related aggression.This article is part of the Special Issue entitled 'Current status of the neurobiology of aggression and impulsivity'.