Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder.
Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder.
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DOI：
10.1007/s00406-017-0806-x
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发表时间：
2018-06
影响因子：
4.7
通讯作者：
Elzinga BM
中科院分区：
文献类型：
--
作者：
Krause-Utz A;Winter D;Schriner F;Chiu CD;Lis S;Spinhoven P;Bohus M;Schmahl C;Elzinga BM
情感高反应性和对情感材料的认知控制受损是边缘型人格障碍（BPD）的核心特征。高比例的BPD患者会经历与压力相关的解离，包括情绪麻木和记忆中断。到目前为止，很少有人知道解离如何影响神经加工的情绪材料在工作记忆任务的背景下，在BPD。我们的目的是调查全脑活动和杏仁核功能连接（FC）在情绪工作记忆任务（EWMT）后，解离诱导在未用药的BPD患者与健康对照组（HC）相比。使用脚本驱动的图像，解离诱导17例（'BPD_D'），而12例（'BPD_N'）和18 HC暴露于中性脚本在功能磁共振成像。之后，参与者使用中性与负IAPS图片与无干扰物进行EWMT。主要结果测量是行为表现（反应时间，错误）和全脑活动在EWMT。心理生理交互作用分析被用来检查杏仁核连接在情绪分心。分离诱导后的BPD患者表现出整体WM损伤，双侧杏仁核失活，左侧楔回、舌回和后扣带回的活动低于BPD_N，沿着左侧额下回的活动高于HC。BPD_D患者杏仁核FC与梭状回减少，杏仁核FC与右侧颞中回/上级回和左侧顶下小叶增强。研究结果表明，解离影响反应情绪突出的材料和WM。与情绪处理、记忆和自我参照过程相关的区域的活动改变可能有助于BPD的分离状态。本文的在线版本（doi：10.1007/s 00406 -017-0806-x）包含补充材料，可供授权用户使用。
Affective hyper-reactivity and impaired cognitive control of emotional material are core features of borderline personality disorder (BPD). A high percentage of individuals with BPD experience stress-related dissociation, including emotional numbing and memory disruptions. So far little is known about how dissociation influences the neural processing of emotional material in the context of a working memory task in BPD. We aimed to investigate whole-brain activity and amygdala functional connectivity (FC) during an Emotional Working Memory Task (EWMT) after dissociation induction in un-medicated BPD patients compared to healthy controls (HC). Using script-driven imagery, dissociation was induced in 17 patients (‘BPD_D’), while 12 patients (‘BPD_N’) and 18 HC were exposed to neutral scripts during fMRI. Afterwards, participants performed the EWMT with neutral vs. negative IAPS pictures vs. no distractors. Main outcome measures were behavioral performance (reaction times, errors) and whole-brain activity during the EWMT. Psychophysiological interaction analysis was used to examine amygdala connectivity during emotional distraction. BPD patients after dissociation induction showed overall WM impairments, a deactivation in bilateral amygdala, and lower activity in left cuneus, lingual gyrus, and posterior cingulate than BPD_N, along with stronger left inferior frontal gyrus activity than HC. Furthermore, reduced amygdala FC with fusiform gyrus and stronger amygdala FC with right middle/superior temporal gyrus and left inferior parietal lobule was observed in BPD_D. Findings suggest that dissociation affects reactivity to emotionally salient material and WM. Altered activity in areas associated with emotion processing, memory, and self-referential processes may contribute to dissociative states in BPD. The online version of this article (doi:10.1007/s00406-017-0806-x) contains supplementary material, which is available to authorized users.
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