Preliminary in vivo investigation of the opioid system in borderline personality disorder

项目总结 本研究的目的是探讨kappa阿片受体(Kor)在症状学中的作用。 临界性人格障碍(BPD)，这是一种与自杀风险惊人地增加相关的疾病 自杀未遂(高达75%)和自杀(高达10%)。尽管BPD的患病率相对较低(1-5%)，但 流行病学研究报告称，最近超过三分之二的自杀企图发生在患有 每桶。不幸的是，大多数可用的治疗方法都不能解决整个bpd症状。 严重或迅速降低自杀风险。磁共振成像研究已经确定了结构和 BPD症状表现的网络改变以及与额叶-边缘回路失调相关的 BPD症状严重程度的增加。BPD症状的分子机制研究， 特别是自杀风险是促进新疗法开发和 促进BPD的风险防范。 新出现的证据表明，KOR与BPD和自杀行为有关。KOR在情绪中起着关键作用 调节、社会功能和疼痛感知--所有这些都是BPD的核心，并与自杀有关 风险。尸检研究表明，KOR与自杀死亡之间存在关联。此外，各种不同的 在动物和人类身上的研究表明，KOR靶向药物可以产生抗抑郁药， 抗焦虑，甚至有抗自杀的作用。重要的是，KOR特工对多巴胺的影响与 毒品滥用，减少了人们对滥用可能性的担忧。在这里，我们提出了一种新的关于KOR的调查 使用正电子发射断层扫描(PET)脑成像技术在BPD患者中的可用性， 和放射性配体[11C]EKAP，它选择性地与脑中的KOR结合(目标1)。鉴于艾滋病的高流行率 BPD的自杀相关行为，我们还将评估KOR可获得性、自杀之间的关联 在BPD中尝试历史和当前的自杀想法(目标2)。最后，我们将评估两者之间的关联 冲动、疼痛耐受和自我伤害--BPD的关键内表型，对治疗具有抵抗力-- 和KOR可获得性(目标3)。这项研究的结果将为两国关系提供潜在的关键洞察力 这种新的分子靶点、BPD症状表现和自杀行为之间的关系。根据我们的调查结果 将为一项更大的PET研究寻求资金，以测试潜在的非成瘾性KOR靶向药物 总体上减少BPD症状和自杀风险。

PROJECT SUMMARY The goal of this study is to investigate the role of the kappa opioid receptor (KOR) in the symptomatology of borderline personality disorder (BPD), a condition associated with alarmingly elevated risk for suicide attempt (up to 75%) and death by suicide (up to 10%). Despite BPD’s relatively low prevalence (1-5%), an epidemiological study reported that more than two thirds of recent suicide attempts occurred in individuals with BPD. Unfortunately, most of the available treatments are not capable of addressing overall BPD symptom severity or rapidly reducing suicide risk. Magnetic resonance imaging studies have identified structural and network alterations in BPD symptom presentation and have associated fronto-limbic circuit dysregulation with an increase in BPD symptom severity. Investigation of molecular mechanisms responsible for BPD symptoms, and suicide risk specifically is an essential next step to both promote development of novel treatments and facilitate risk prevention in BPD. Emerging evidence implicates KOR in BPD and suicidal behavior. KOR plays critical roles in emotion regulation, social functioning, and pain perception – all of which are both central to BPD and related to suicide risk. Postmortem studies have shown an association between KOR and death by suicide. Further, a variety of studies in both animals and humans have shown that KOR targeted medications can produce antidepressant, anxiolytic, and even anti-suicidal effects. Importantly, KOR agents’ effect on dopamine is modest relative to drugs of abuse, reducing concerns about abuse potential. Here, we propose a novel investigation of KOR availability of in individuals with BPD using positron emission tomography (PET), a brain imaging technique, and radioligand [11C]EKAP which binds selectively to KOR in the brain (Aim 1). Given the high prevalence of suicide-related behavior in BPD, we will also evaluate the association between KOR availability, suicide attempt history, and current suicidal thoughts in BPD (Aim 2). Lastly, we will evaluate the association between impulsivity, pain tolerance, and self-injury – key endophenotypes of BPD and which are resistant to treatment – and KOR availability (Aim 3). Results of this study will provide potentially critical insight into the relationship between this novel molecular target, BPD symptom presentation, and suicidal behavior. Based on findings we will pursue funding for a larger PET study to test potential non-addictive KOR targeted medications for both overall BPD symptom reduction, and suicide risk.