Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
Department of Psychiatry and Psychotherapy, University of Leipzig, Germany.
Int J Psychophysiol. 2019 May;139:10-17. doi: 10.1016/j.ijpsycho.2019.02.007. Epub 2019 Feb 20.
Borderline Personality Disorder (BPD) is characterized by emotional instability, impulsivity, disturbed cognition, sleeplessness and states of high inner tension. Altered arousal regulation which is regarded as a higher domain of functioning according to the research domain criteria of the NIMH and which has previously been reported in several psychiatric disorders, such as mania or major depression could be involved in these features of BPD.
40 unmedicated patients with BPD and 42 matched healthy volunteers participated in a twenty minute resting-state EEG measurement with closed eyes. EEG-vigilance regulation was assessed with VIGALL2.0 (Vigilance Algorithm Leipzig), which allows a classification of consecutive 1-s segments in different vigilance stages ranging from high alertness/relaxed wakefulness (stages 0, A1, A2, A3) to drowsiness (B1, B2/3) and sleep onset (C).
Across 20 min, both groups showed a similar decline from higher to lower vigilance stages, but patients with BPD remained in higher stages of vigilance compared to healthy volunteers across the whole measurement (p = .013). Contrary to this, pre-experimental ratings indicated enhanced subjective sleepiness but no differences in self-reported sleep quantity in the previous night in patients with BPD compared to healthy volunteers.
The results of an elevated arousal regulation (in combination with increased subjective sleepiness) might reflect several symptoms, such as aversive inner tension and impoverished sense of self in patients with BPD. As arousal is linked to the noradrenergic system, further investigations in this field seem to be promising.
边缘型人格障碍（BPD）的特征是情绪不稳定、冲动、认知障碍、失眠和高度内在紧张状态。根据 NIMH 的研究领域标准，被认为是更高功能领域的唤醒调节异常，以前曾在几种精神疾病中报道过，例如躁狂或重度抑郁症，可能与 BPD 的这些特征有关。
40 名未经药物治疗的 BPD 患者和 42 名匹配的健康志愿者参加了一项持续 20 分钟的闭眼静息状态脑电图测量。使用 VIGALL2.0（莱比锡警觉算法）评估 EEG 警觉调节，该算法允许对连续 1 秒的警觉阶段进行分类，范围从高度警觉/放松清醒（阶段 0、A1、A2、A3）到困倦（B1、B2/3）和睡眠开始（C）。
在 20 分钟内，两组都表现出从较高警觉阶段到较低警觉阶段的相似下降，但与健康志愿者相比，BPD 患者在整个测量过程中仍处于较高的警觉阶段（p=0.013）。与此相反，实验前的评分表明 BPD 患者的主观困倦感增强，但与健康志愿者相比，前一天晚上的自我报告睡眠时间没有差异。
唤醒调节升高（结合主观困倦感增加）的结果可能反映了 BPD 患者的几种症状，例如厌恶的内在紧张和自我感缺失。由于唤醒与去甲肾上腺素能系统有关，因此进一步在该领域的研究似乎很有前途。
