Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Germany.
Neuroimage. 2012 Jan 16;59(2):1727-34. doi: 10.1016/j.neuroimage.2011.08.061. Epub 2011 Aug 31.
Borderline personality disorder (BPD) is characterized by emotional dysregulation and a high prevalence of traumatic stress. Recent estimates suggest that 2-6% of non-clinical populations suffer from BPD. Despite this relevance, this is the first study considering the neural mechanisms underlying trauma-history and temporal features of cognitive reappraisal in non-clinical BPD patients using script-driven stimuli. Using functional magnetic resonance imaging (fMRI), we examined subjective ratings of negative emotional experience and brain activity following up- and down-regulation of emotional responses to standardized negative scripts in 43 women: 14 trauma-exposed BPD patients (BPD), 14 trauma-exposed healthy subjects without posttraumatic stress disorder (non-PTSD), and 15 non-traumatized healthy subjects (HC). Behaviorally, all groups were able to use cognitive reappraisal to up- and down-regulate negative emotions. HC subjects showed increased early activation in the prefrontal cortex (PFC) and the amygdala following up-regulation of emotions to negative scripts, whereas BPD and non-PTSD subjects showed early deactivation in the PFC. Additionally, the anterior cingulate cortex was more activated in HC subjects than in BPD and non-PTSD subjects during up- and down-regulation. No significant group differences were found between BPD patients and non-PTSD. BPD patients and healthy individuals with trauma history do not engage the cognitive control regions to the extent than HC subjects do when employing down-regulation of negative emotions. They also do not activate the brain regions associated with emotional up-regulation. These findings may reflect compensatory changes associated with trauma-exposure.
边缘型人格障碍（BPD）的特征是情绪调节障碍和创伤后应激的高患病率。最近的估计表明，2-6%的非临床人群患有 BPD。尽管相关性很高，但这是第一项研究，考虑了使用脚本驱动刺激的非临床 BPD 患者中创伤史和认知重评的时间特征的神经机制。使用功能磁共振成像（fMRI），我们检查了 43 名女性在对标准化负面脚本的情绪反应进行向上和向下调节后的负面情绪体验的主观评分和大脑活动：14 名创伤暴露的 BPD 患者（BPD），14 名创伤暴露的非创伤后应激障碍健康受试者（非 PTSD）和 15 名非创伤健康受试者（HC）。行为上，所有组都能够使用认知重评来向上和向下调节负面情绪。HC 组在对负面脚本的情绪进行向上调节后，前额叶皮层（PFC）和杏仁核的早期激活增加，而 BPD 和非 PTSD 组的 PFC 早期失活。此外，在向上和向下调节期间，前扣带皮层在 HC 组中的激活程度高于 BPD 和非 PTSD 组。BPD 患者和非 PTSD 患者与非 PTSD 患者之间没有发现组间差异。与 HC 相比，患有创伤史的 BPD 患者和健康个体在使用负性情绪向下调节时不会激活认知控制区域。他们也不会激活与情绪上调相关的大脑区域。这些发现可能反映了与创伤暴露相关的代偿性变化。
