FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain.
Psychol Med. 2020 Jul;50(10):1746-1754. doi: 10.1017/S0033291719001880. Epub 2019 Aug 28.
Although executive and other cognitive deficits have been found in patients with borderline personality disorder (BPD), whether these have brain functional correlates has been little studied. This study aimed to examine patterns of task-related activation and de-activation during the performance of a working memory task in patients with the disorder.
Sixty-seven DSM-IV BPD patients and 67 healthy controls underwent fMRI during the performance of the n-back task. Linear models were used to obtain maps of within-group activations and areas of differential activation between the groups.
On corrected whole-brain analysis, there were no activation differences between the BPD patients and the healthy controls during the main 2-back v. baseline contrast, but reduced activation was seen in the precentral cortex bilaterally and the left inferior parietal cortex in the 2-back v. 1-back contrast. The patients showed failure of de-activation affecting the medial frontal cortex and the precuneus, plus in other areas. The changes did not appear to be attributable to previous history of depression, which was present in nearly half the sample.
In this study, there was some, though limited, evidence for lateral frontal hypoactivation in BPD during the performance of an executive task. BPD also appears to be associated with failure of de-activation in key regions of the default mode network.
虽然边缘型人格障碍（BPD）患者存在执行和其他认知缺陷，但这些缺陷是否与大脑功能相关尚未得到充分研究。本研究旨在探讨执行工作记忆任务时该障碍患者的任务相关激活和去激活模式。
67 名 DSM-IV BPD 患者和 67 名健康对照者在执行 n-back 任务期间接受 fMRI 检查。使用线性模型获得组内激活图和组间差异激活区。
在经校正的全脑分析中，BPD 患者与健康对照组在主 2-back v. 基线对比时无激活差异，但在 2-back v. 1-back 对比时双侧中央前回和左顶下小叶的激活减少。患者存在内侧额皮质和楔前叶等区域的去激活失败，以及其他区域的去激活失败。这些变化似乎与近一半样本中存在的既往抑郁史无关。
在这项研究中，在执行执行任务时，BPD 患者的外侧额皮质存在一定程度的活动减少，尽管证据有限。BPD 似乎还与默认模式网络关键区域的去激活失败有关。
