An fMRI Study of Emotional Dysregulation in Borderline Patients

边缘性患者情绪失调的功能磁共振成像研究

• 批准号: 7264285
• 负责人: Harold W Koenigsberg
• 金额: $ 37.82万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7264285
• 关键词: Accounting; Adult; Affect; Affective; Amygdaloid structure; Amyotrophic Lateral Sclerosis; Anger; Anterior; Attention; Avoidant Personality Disorders; Awareness; Behavioral; Body Image; Borderline Personality Disorder; Brain; Brain region; Calculi; Cerebrum; Characteristics; Clinical; Cognitive; Condition; Conscious; Corpus striatum structure; Cues; Data; Depressed mood; Development; Disease; Dorsal; Emotional; Emotions; Exposure to; Face; Failure; Feeling; Female; Functional Magnetic Resonance Imaging; Fusiform gyrus; Future; Gender; Genetic; Genetic Markers; Gestures; Hand; Health Resources; High Prevalence; Hippocampus (Brain); Image; Impairment; Impulsivity; Individual; Inferior; Instruction; Insula of Reil; Judgment; Knowledge; Lateral; Lead; Left; Legal patent; Life; Light; Literature; Love; Maintenance; Measures; Medial; Mediating; Medical center; Memory; Mental disorders; Metals; Methods; Monitor; Moods; Neuroanatomy; Neurons; Outcome; Parietal Lobe; Pathology; Patients; Pattern; Perception; Personal Communication; Personality; Personality Disorders; Persons; Pharmacotherapy; Play; Population; Post-Traumatic Stress Disorders; Posture; Precentral gyrus; Predisposition; Prefrontal Cortex; Prevalence; Principal Investigator; Process; Public Health; RHOA gene; Reaction; Recovery; Recruitment Activity; Reporting; Research; Retrieval; Review Literature; Role; Sampling; Sampling Biases; Sex Characteristics; Site; Slide; Source; Specificity; Stimulus; Stream; Suicide; Superior temporal gyrus; Symptoms; System; Temperament; Temporal Lobe; Thinking; Time; Visual; Woman; Work; angular gyrus; base; behavior measurement; cingulate gyrus; cognitive control; comparison group; cost; design; emotion regulation; emotional reaction; emotional stimulus; endophenotype; experience; frontal lobe; functional disability; gray matter; healthy volunteer; hospital bed; intraparietal sulcus; male; men; neuroimaging; novel; programs; relating to nervous system; response; social; suicide rate; theories; trait

DESCRIPTION (provided by applicant): Borderline Personality Disorder (BPD) is a prevalent and enduring psychiatric disorder found in approximately 2% of the population and 20% of hospitalized psychiatric patients. It is characterized by great volatility, impulsivity, sucidality, and unstable interpersonal relationships, and has proved difficult to treat. Suicide rates of approximately 10% have been reported in borderline patients. A core underlying feature of BPD is extreme emotional instability and this has been shown to be associated with the suicide threats, gestures and acts, inappropriate anger, and identity disturbances which prove so dangerous and disruptive for these patients. Despite its central role in the pathology of BPD, emotional instability is not well understood. This study employs functional magnetic resonance imaging (fMRI) to identify the disturbances in brain emotion processing systems that may explain the impairments in emtional control in BPD. It looks in particular at regional brain activity when BPD patients are consciously trying to control their emotional reactions to disturbing images and as they are systematically re-exposed to these images. Identification of the patterns of brain activity that are associated with efforts at conscious emotional control or with habituation to repeated exposure can lead to the development of new pharmacological approaches to treatment, to the development of new and more appropriately targeted cognitive/behavoral psychotherapeutic strategies, and the identification of brain activity markers for BPD that may guide future genetic studies. To achieve these objectives, we will obtain fMRI images of 30 BPD patients, and of comparison groups of 30 non-borderline personality disorder patients (i.e. patients with Avoidant Personality Disorder) and 30 healthy volunteers 1) as they make efforts to control their emotional reactions to emotion- inducing pictures and 2) as they are exposed to repeated presentions of the same pictures. The findings of this study may help in the development of new treatment strategies for BPD, a disorder which has not only great emotional costs in terms of the suffering experienced by borderline patients and their loved ones, but also social costs since BPD patients typically function at a level substantially below that of individuals with comparable intellect and they consume a disproportionate share of metal health resources. A more effective treatment for this disorder would thus greatly benefit public health.

描述（由申请人提供）：边缘型人格障碍（BPD）是一种普遍存在且持久的精神疾病，约2%的人口和20%的住院精神病患者中发现。它的特点是非常不稳定，冲动，自杀，人际关系不稳定，并已被证明是难以治疗的。自杀率约为10%，据报道，在边缘患者。BPD的一个核心潜在特征是极端的情绪不稳定，这已被证明与自杀威胁，手势和行为，不适当的愤怒和身份障碍有关，这些患者被证明是如此危险和破坏性。尽管情绪不稳定在BPD的病理学中起着核心作用，但人们对情绪不稳定的理解并不充分。本研究采用功能性磁共振成像（fMRI）来识别大脑情绪处理系统的干扰，可能解释BPD的情绪控制障碍。当BPD患者有意识地试图控制他们对令人不安的图像的情绪反应时，以及当他们系统地重新暴露于这些图像时，它特别关注区域大脑活动。识别与有意识的情绪控制或习惯于重复暴露的努力相关的大脑活动模式，可以导致新的药理学治疗方法的发展，新的和更有针对性的认知/认知心理治疗策略的发展，以及识别BPD的大脑活动标志物，这可能会指导未来的遗传学研究。为了实现这些目标，我们将获得30名BPD患者的fMRI图像，以及30名非边缘型人格障碍患者（即回避型人格障碍患者）和30名健康志愿者的对照组的fMRI图像，1）当他们努力控制他们对情绪诱导图片的情绪反应时，和2）当他们暴露于重复呈现的相同图片时。这项研究的结果可能有助于开发BPD的新治疗策略，这种疾病不仅在边缘患者及其亲人所经历的痛苦方面具有巨大的情感成本，而且还具有社会成本，因为BPD患者通常在远低于具有可比智力的个人的水平上发挥作用，并且他们消耗了不成比例的金属健康资源。因此，对这种疾病进行更有效的治疗将极大地有益于公众健康。