Schmahl Christian G, Vermetten Eric, Elzinga Bernet M, Bremner J Douglas
Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, Germany.
Biol Psychiatry. 2004 Apr 1;55(7):759-65. doi: 10.1016/j.biopsych.2003.11.007.
Borderline personality disorder (BPD) is a common psychiatric disorder, which is linked to early stressors in many cases; however, the impact of traumatic events in the etiology of BPD is still unclear. This pilot study was conducted to measure the neural correlates of recall of traumatic memories in women with and without BPD.
Twenty women with a history of childhood physical or sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal traumatic abuse events. Brain blood flow during exposure to trauma and neutral scripts was compared between women with and without BPD.
Memories of trauma were associated with increases in blood flow in right dorsolateral prefrontal cortex (Brodmann's area [BA] 44 and 45) and with decreased blood flow in left dorsolateral prefrontal cortex (BA 44 and 45) in women without BPD. There was also increased blood flow in right anterior cingulate (BA 24) and left orbitofrontal cortex (BA 11) in women without BPD. Women with BPD failed to activate anterior cingulate gyrus and orbitofrontal cortex. Also, no blood flow changes were seen in dorsolateral prefrontal gyrus in women with BPD.
Dysfunction of dorsolateral and medial prefrontal cortex, including anterior cingulate, seems to be correlated with the recall of traumatic memories in women with BPD. These brain areas might mediate trauma-related symptoms, such as dissociation or affective instability, in patients with BPD.
边缘型人格障碍（BPD）是一种常见的精神疾病，在许多情况下与早期应激源有关；然而，创伤性事件在BPD病因学中的影响仍不清楚。本初步研究旨在测量有和没有BPD的女性回忆创伤性记忆时的神经关联。
20名有童年身体或性虐待史的女性在听描述中性和个人创伤性虐待事件的脚本时，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的女性在接触创伤性和中性脚本时的脑血流量。
在没有BPD的女性中，创伤性记忆与右侧背外侧前额叶皮质（布罗德曼区[BA]44和45）血流量增加以及左侧背外侧前额叶皮质（BA 44和45）血流量减少有关。没有BPD的女性右侧前扣带回（BA 24）和左侧眶额皮质（BA 11）的血流量也增加。患有BPD的女性未能激活前扣带回和眶额皮质。此外，患有BPD的女性背外侧前额叶回未见血流量变化。
包括前扣带回在内的背外侧和内侧前额叶皮质功能障碍似乎与患有BPD的女性回忆创伤性记忆有关。这些脑区可能介导BPD患者与创伤相关的症状，如解离或情感不稳定。
