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One-year functional magnetic resonance imaging follow-up study of neural activation during the recall of unresolved negative life events in borderline personality disorder

Published online by Cambridge University Press:  09 May 2008

M. Driessen ,
K. Wingenfeld ,
N. Rullkoetter ,
C. Mensebach ,
F. G. Woermann ,
M. Mertens  and
T. Beblo
M. Driessen*
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany Lübeck School of Medicine, Lübeck, Germany Department of Psychology, University of Bielefeld, Bielefeld, Germany
K. Wingenfeld
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
N. Rullkoetter
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
C. Mensebach
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
F. G. Woermann
Affiliation:
MRI-Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany
M. Mertens
Affiliation:
MRI-Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany
T. Beblo
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
*
*Address for correspondence: M. Driessen, M.D., Ph.D., Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69–71, D-33617 Bielefeld, Germany. (Email: martin.driessen@evkb.de)
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Abstract

Background

Recall of adverse life events under brain imaging conditions has been shown to coincide with activation of limbic and prefrontal brain areas in borderline personality disorder (BPD). We investigate changes of functional magnetic resonance imaging (fMRI) activation patterns during the recall of unresolved adverse life events (ULE) over 1 year.

Method

Thirteen female BPD patients participated in the study. During fMRI measurement subjects recalled ULE and negative but resolved life events (RLE) after individual cue words to stimulate autobiographical memory retrieval. Subjective intensity of emotional and sensoric experiences during recall was assessed as well as standardized measures of psychopathology.

Results

A 2×2 factorial analysis of fMRI data (Δt1/t2×ΔULE/RLE) revealed major right more than left differences of activation (i.e. t1>t2) of the posterior more than anterior cingulate, superior temporal lobes, insula, and right middle and superior frontal lobes (second-level analysis, t=3.0, puncorrected=0.003). The opposite contrast (Δt2/t1×ΔULE/RLE) did not reveal any differences. We did not find changes of emotional or sensoric qualities during recall (ULE versus RLE) or of psychopathology measures over the 1-year period.

Conclusions

Although subjective and clinical data did not change within 1 year, we observed a substantial decrease of temporo-frontal activation during the recall of ULE from t1 to t2. If future research confirms these findings, the question arises whether the decrease of neural activation precedes clinical improvement in BPD.

Keywords

BPDfMRInegative life eventsrecall
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 3 , March 2009 , pp. 507 - 516
Copyright
Copyright © 2008 Cambridge University Press

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