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Functional MRI correlates of the recall of unresolved life events in borderline personality disorder

Published online by Cambridge University Press:  30 March 2006

THOMAS BEBLO
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
MARTIN DRIESSEN
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany Luebeck School of Medicine, Luebeck, Germany Department of Psychology, University of Bielefeld, Germany
MARKUS MERTENS
Affiliation:
MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany
KATJA WINGENFELD
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
MARTINA PIEFKE
Affiliation:
Institute of Medicine, Research Center Juelich, Germany University Hospital of the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany
NINA RULLKOETTER
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany Department of Psychology, University of Bielefeld, Germany
ANAMARIA SILVA-SAAVEDRA
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
CHRISTOPH MENSEBACH
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany Department of Psychology, University of Bielefeld, Germany
LUISE REDDEMANN
Affiliation:
Clinic of Psychotherapy and Psychosomatic Medicine, Ev. Hospital Bielefeld, Germany
HARALD RAU
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany Department of Psychology, University of Bielefeld, Germany
HANS J. MARKOWITSCH
Affiliation:
Department of Psychology, University of Bielefeld, Germany
HELLA WULFF
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
WOLFGANG LANGE
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
CRISTINA BEREA
Affiliation:
Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
ISABELLA OLLECH
Affiliation:
MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany
FRIEDRICH G. WOERMANN
Affiliation:
MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany

Abstract

Background. Patients with borderline personality disorder (BPD) frequently report unresolved life events but it is still poorly understood, how these experiences are represented in the brain. Using functional magnetic resonance imaging (fMRI), the present study aimed at investigating the neural correlates of the recall of unresolved life events in patients with BPD and healthy controls.

Method. Twenty female BPD patients and 21 healthy control subjects underwent fMRI. During measurement subjects recalled unresolved and resolved negative life events. Individual cue words were used to stimulate autobiographical memory. After scanning, subjects rated their emotional states during the recall of both types of memories.

Results. When contrasting unresolved and resolved life events, patients showed significant bilateral activation of frontotemporal areas including the insula, amygdala, and the anterior cingulate cortex, the left posterior cingulate cortex, right occipital cortex, the bilateral cerebellum and the midbrain. In healthy subjects, no differential brain activation was related to these conditions. The 2×2 factorial analysis (ΔBPD−Δcontrols) revealed similar results with bilateral activation of the frontal cortex including parts of the insula and of the orbitofrontal cortex, temporal activation including the amygdala, activation of the right occipital cortex, and parts of the cerebellum. Patients but not controls reported higher levels of anxiety and helplessness during the unresolved versus resolved memory condition.

Conclusions. The activation of both, the amygdala and prefrontal areas, might reflect an increased effortful but insufficient attempt to control intensive emotions during the recall of unresolved life events in patients with BPD.

Type
Original Article
Copyright
© 2006 Cambridge University Press

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