Neural Substrates of Emotion in Borderline Patients

描述（由申请人提供）：边缘型人格障碍（BPD）是一种持续性和严重的精神障碍，具有高死亡率，发病率和痛苦程度。情绪失调或对环境事件的反应，特别是分离，挫折或损失等事件被认为是这种疾病的定义特征。这种疾病，很少接受调查审查和异常情绪处理的神经相关性尚不清楚。惊吓眨眼修正（SEM）方法为情绪加工的研究提供了一种非语言的定量工具。当在不愉快的刺激期间呈现短暂的惊吓刺激时，惊吓反应的幅度增强;愉快的刺激引起惊吓反应的相对抑制;并且中性刺激是中间的。本研究使用扫描电镜和功能性神经成像（事件相关的功能磁共振成像和FDG-PET），以探索强度，时间过程，习惯化和功能神经解剖学的情绪反应在三个严格筛选的群体：26例BPD患者（无共病轴I障碍或群集A或C人格障碍），26名非BPD患者（诊断为典型人格障碍，没有共病的B或C群人格障碍或轴I障碍）和26名健康对照。在fMRI扫描和PET的FDG摄取过程中，参与者将看到一系列混杂的不愉快（例如，讨厌），愉快（例如，快乐）和中性（例如，查看）的话。SEM幅度差分数（例如，不愉快-愉快）将提供对不愉快刺激的情绪处理的强度、时间过程和习惯化的测量，并与局部葡萄糖代谢相关。关键脑区的fMRI BOLD反应差异分数将提供脑激活的强度和时间过程的测量。我们关注三个被认为与情绪处理有关的大脑区域：杏仁核、前扣带回和前额叶皮层（眶额和背外侧）。这些区域是大脑回路的一部分，被认为介导情绪体验，并在BPD症状的表达中发挥重要作用。这种心理生理学和功能神经解剖学方法的结合，有可能提供急需的信息规范方面的情绪处理和洞察神经解剖学的基础上观察到的BPD的情绪失调。

DESCRIPTION (provided by applicant): Borderline personality disorder (BPD) is a persistent and severe mental disorder with high mortality, morbidity and levels of distress. Emotional dysregulation or reactivity to environmental events, particularly events such as separations, frustrations, or losses is considered a defining feature of this disorder. This disorder, has received little investigative scrutiny and the neural correlates of abnormal emotional processing are not understood. Startle eyeblink modification (SEM) methodology provides a non-verbal, quantitative tool for the study of emotional processing. When a brief startle stimulus is presented during an unpleasant stimulus, the amplitude of the startle response is potentiated; a pleasant stimulus occasions a relative inhibition of the startle response; and a neutral stimulus is intermediate. This study uses SEM and functional neuroimaging (event-related fMRI and FDG-PET) to explore the intensity, time course, habituation and functional neuroanatomy of emotional responses in three rigorously screened groups: 26 BPD patients (with no comorbid Axis I disorder or Cluster A or C personality disorders), 26 non-BPD patients (with a diagnosis of schizotypal personality disorder and no comorbid Cluster B or C personality disorders or Axis I disorder) and 26 healthy controls. During both the fMRI scan and FDG-uptake for PET, participants will view an intermixed series of unpleasant (e.g., hate), pleasant (e.g., happy) and neutral (e.g., view) words. SEM amplitude difference scores (e.g., unpleasant-pleasant) measured during simultaneous FDG uptake will provide a measure of the intensity, time course, and habituation of emotional processing of unpleasant stimuli and be correlated with regional glucose metabolism. fMRI BOLD response difference scores in key brain regions will provide measurement of the intensity and time course of brain activation. We focus on three brain regions thought to be involved in emotional processing: amygdala, anterior cingulate, and prefrontal cortex (orbitofrontal and dorsolateral). These regions are part of a brain circuit thought to mediate emotional experience and play a significant role in the expression of BPD symptoms. This proposed combination of a psychophysiological and functional neuroanatomy approach holds the potential to provide much-needed information on normative aspects of emotional processing and insights into the neuroanatomy underlying the emotional dysregulation observed in BPD.