Schmahl Christian G, Elzinga Bernet M, Vermetten Eric, Sanislow Charles, McGlashan Thomas H, Bremner J Douglas
Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Freiburg, Germany.
Biol Psychiatry. 2003 Jul 15;54(2):142-51. doi: 10.1016/s0006-3223(02)01720-1.
Borderline personality disorder (BPD) is a common psychiatric disorder that is often linked to early stressors. One particularly salient feature of the disorder is fear of abandonment. This pilot study was conducted to measure neural correlates of memories of abandonment in women with and without BPD.
Twenty women with a history of childhood sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal abandonment events. Brain blood flow during exposure to abandonment and neutral scripts was compared among women with and without BPD.
Memories of abandonment were associated with greater increases in blood flow in bilateral dorsolateral prefrontal cortex (middle frontal gyrus, Brodmann's areas 9 and 10) as well as right cuneus (area 19) in women with BPD than in women without BPD. Abandonment memories were associated with greater decreases in right anterior cingulate (areas 24 and 32) in women with BPD than in women without BPD.
These findings implicate dysfunction of dorsolateral and medial prefrontal cortex including anterior cingulate, left temporal cortex, and visual association cortex in memories of abandonment in women with BPD. These brain areas may mediate symptoms of BPD.
边缘型人格障碍（BPD）是一种常见的精神障碍，常与早期应激源相关。该障碍一个特别显著的特征是害怕被抛弃。本初步研究旨在测量有和没有BPD的女性中与被抛弃记忆相关的神经关联。
20名有童年性虐待史的女性在听描述中性和个人被抛弃事件的脚本时，接受正电子发射断层扫描成像测量脑血流量。比较有和没有BPD的女性在接触被抛弃和中性脚本时的脑血流量。
与没有BPD的女性相比，有BPD的女性中，被抛弃记忆与双侧背外侧前额叶皮质（额中回，布罗德曼9区和10区）以及右侧楔叶（19区）血流量的更大增加相关。与没有BPD的女性相比，有BPD的女性中，被抛弃记忆与右侧前扣带回（24区和32区）血流量的更大减少相关。
这些发现表明，在有BPD的女性的被抛弃记忆中，背外侧和内侧前额叶皮质（包括前扣带回）、左侧颞叶皮质和视觉联合皮质存在功能障碍。这些脑区可能介导BPD的症状。
