FMRI AND EMOTION IN PERSONALITY DISORDER PATIENTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Affective instability is a core feature of borderline personality disorder (BPD). It may be associated with significant functional impairment, high rates of service utilization, and negative clinical outcomes. This symptom may be related to an underlying disturbance in the neural processing of emotional stimuli. A recent development in the study of neurobilogical aspects of emotion processing involves exposing a subject to emotional stimuli in functional magnetic resonance imaging. This type of paradigm is consistently associated with activation of subcortical and neocortical brain regions known to be involved in emotional experience and processing of emotional information. Patients with affective disorders exhibit altered responses in several of these brain regions, including amygdala, and anterior cingulate, orbitofrontal and dorsolateral prefrontal cortices. A particularly important functional relationship for emotion regulation may exist between the amygdala and anterior cingulate cortex in these disorders in these disorder. In contrast, the pattern of regional brain activation to emotional stimuli has not been well-investigated in BPD. This application proposes to use fMRI to initiate a pilot study of regional brain response to emotional stimuli, with the prediction that BPD patients will show differences in the activation of areas of the amygdala and cingulate cortex compared to normal controls. Results from this study will be utilized to later examine the clinical specificity of this hypothesized brain brain dysfunction for the symptoms (ie within diagnostic category) and for the diagnosis (ie across diagnostic category) of BPD, and to characterize the temporal and spatial dynamics of emotion processing disturbance in a frontolimbic model of affective instability.