Herpertz S C, Dietrich T M, Wenning B, Krings T, Erberich S G, Willmes K, Thron A, Sass H
Department of Psychiatry and Psychotherapy, Medical Faculty of Aachen Technical University-RWTH, Aachen, Germany.
Biol Psychiatry. 2001 Aug 15;50(4):292-8. doi: 10.1016/s0006-3223(01)01075-7.
Intense and rapidly changing mood states are a major feature of borderline personality disorder (BPD); however, there have only been a few studies investigating affective processing in BPD, and in particular no neurofunctional correlates of abnormal emotional processing have been identified so far.
Six female BPD patients without additional major psychiatric disorder and six age-matched female control subjects underwent functional magnetic resonance imaging (fMRI) to measure regional cerebral hemodynamic changes following brain activity when viewing 12 standardized emotionally aversive slides compared to 12 neutral slides, which were presented in random order.
Our main finding was that BPD subjects but not control subjects were characterized by an elevated blood oxygenation level dependent fMRI signal in the amygdala on both sides. In addition, activation of the medial and inferolateral prefrontal cortex was seen in BPD patients. Both groups showed activation in the temporo-occipital cortex including the fusiform gyrus in BPD subjects but not in control subjects.
Enhanced amygdala activation in BPD is suggested to reflect the intense and slowly subsiding emotions commonly observed in response to even low-level stressors. Borderline subjects' perceptual cortex may be modulated through the amygdala leading to increased attention to emotionally relevant environmental stimuli.
强烈且快速变化的情绪状态是边缘型人格障碍（BPD）的主要特征；然而，仅有少数研究调查了BPD中的情感加工，尤其是目前尚未确定异常情绪加工的神经功能相关性。
6名无其他重大精神疾病的女性BPD患者和6名年龄匹配的女性对照受试者接受了功能磁共振成像（fMRI），以测量在随机顺序呈现12张标准化情绪厌恶幻灯片与12张中性幻灯片时，观看幻灯片时大脑活动后区域脑血流动力学变化。
我们的主要发现是，BPD受试者而非对照受试者的特征是双侧杏仁核中血氧水平依赖性功能磁共振成像信号升高。此外，在BPD患者中观察到内侧和下外侧前额叶皮层的激活。两组在颞枕叶皮层均有激活，包括BPD受试者的梭状回，但对照受试者无此激活。
BPD中增强的杏仁核激活被认为反映了即使对低水平应激源作出反应时常见的强烈且逐渐消退的情绪。边缘型受试者的感觉皮层可能通过杏仁核进行调节，导致对与情绪相关的环境刺激的关注度增加。
