Lange Claudia, Kracht Lutz, Herholz Karl, Sachsse Ulrich, Irle Eva
Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany.
Psychiatry Res. 2005 Jul 30;139(2):115-26. doi: 10.1016/j.pscychresns.2005.05.003.
Individuals with borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) often experience dissociative symptoms. Evidence is increasing that stress-related hyperglutamatergic states may contribute to dissociative symptoms and neurodegeneration in temporo-parietal cortical areas. Seventeen young women with BPD who had been exposed to severe childhood physical/sexual abuse and presented with pronounced dissociative symptoms underwent (18)fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Nine healthy, matched volunteers served as comparison subjects. Borderline subjects displayed reduced FDG uptake (as analyzed by SPM) in the right temporal pole/anterior fusiform gyrus and in the left precuneus and posterior cingulate cortex. Impaired memory performance among borderline subjects was significantly correlated with metabolic activity in ventromedial and lateral temporal cortices. Our results demonstrate regional hypometabolism in temporal and medial parietal cortical regions known to be involved in episodic memory consolidation and retrieval. Currently, the precuneus/posterior cingulate cortex is modeled as part of a network of tonically active brain regions that continuously gather information about the world around and within us. Decreased resting metabolic rate of these regions may reflect dissociative symptoms and possibly also identity disturbances and interpersonal difficulties of individuals with BPD.
边缘型人格障碍（BPD）和创伤后应激障碍（PTSD）患者常出现分离性症状。越来越多的证据表明，与压力相关的高谷氨酸能状态可能导致颞顶叶皮质区域的分离性症状和神经退行性变。17名曾遭受严重童年期身体/性虐待且有明显分离性症状的BPD年轻女性接受了（18）氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）。9名健康的匹配志愿者作为对照对象。边缘型人格障碍患者在右侧颞极/前梭状回、左侧楔前叶和后扣带回皮质显示FDG摄取减少（通过统计参数映射分析）。边缘型人格障碍患者的记忆表现受损与腹内侧和外侧颞叶皮质的代谢活动显著相关。我们的研究结果表明，在已知参与情景记忆巩固和提取的颞叶和顶叶内侧皮质区域存在局部代谢减低。目前，楔前叶/后扣带回皮质被建模为一个持续活跃的脑区网络的一部分，该网络不断收集我们周围和自身内部世界的信息。这些区域静息代谢率的降低可能反映了分离性症状，也可能反映了BPD患者的身份障碍和人际困难。
