Impulse control under emotion processing: an fMRI investigation in borderline personality disorder compared to non-patients and cluster-C personality disorder patients

Abstract Impulsivity is a characteristic syndromal and neurobehavioral feature of borderline personality disorder (BPD). Research suggests an important interaction between high negative emotions and low behavioral inhibition in BPD. However, knowledge about the generalizability across stimulus categories and diagnosis specificity is limited. We investigated neural correlates of hypothesized impaired response inhibition of BPD patients to negative, positive and erotic stimuli, by comparing them to non-patients and cluster-C personality disorder patients. During fMRI scanning, 53 BPD patients, 34 non-patients and 20 cluster-C personality disorder patients completed an affective go/no-go task, including social pictures. BPD patients showed more omission errors than non-patients, independent of the stimulus category. Furthermore, BPD patients showed higher activity in the inferior parietal lobule and frontal eye fields when inhibiting negative versus neutral stimuli. Activity of the inferior parietal lobule correlated positively with the BPD checklist subscale impulsivity. When inhibiting emotional stimuli, BPD patients showed an altered brain activity in the inferior parietal lobe and frontal eye fields, whereas previously shown dysfunctional prefrontal activity was not replicated. BPD patients showed a general responsivity across stimulus categories in the frontal eye fields, whereas effects in the inferior parietal lobe were specific for negative stimuli. Results of diagnosis specificity support a dimensional rather than a categorical differentiation between BPD and cluster-C patients during inhibition of social emotional stimuli. Supported by behavioral results, BPD patients showed no deficiencies in emotionally modulated response inhibition per se but the present findings rather hint at attentional difficulties for emotional information.

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Attentional salience and the neural substrates of response inhibition in borderline personality disorder

Psychological Medicine ◽

10.1017/s0033291721000118 ◽

2021 ◽

pp. 1-9

Author(s):

J. S. Wrege ◽

D. Carcone ◽

A. C. H. Lee ◽

C. Cane ◽

U. E. Lang ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Response Inhibition ◽

Parietal Lobe ◽

Brain Regions ◽

Borderline Personality ◽

Specific Response ◽

Neural Activation ◽

Frontal Pole ◽

Neural Basis

Abstract Background Impulsivity is a central symptom of borderline personality disorder (BPD) and its neural basis may be instantiated in a frontoparietal network involved in response inhibition. However, research has yet to determine whether neural activation differences in BPD associated with response inhibition are attributed to attentional saliency, which is subserved by a partially overlapping network of brain regions. Methods Patients with BPD (n = 45) and 29 healthy controls (HCs; n = 29) underwent functional magnetic resonance imaging while completing a novel go/no-go task with infrequent odd-ball trials to control for attentional saliency. Contrasts reflecting a combination of response inhibition and attentional saliency (no-go > go), saliency processing alone (oddball > go), and response inhibition controlling for attentional saliency (no-go > oddball) were compared between BPD and HC. Results Compared to HC, BPD showed less activation in the combined no-go > go contrast in the right posterior inferior and middle-frontal gyri, and less activation for oddball > go in left-hemispheric inferior frontal junction, frontal pole, superior parietal lobe, and supramarginal gyri. Crucially, BPD and HC showed no activation differences for the no-go > oddball contrast. In BPD, higher vlPFC activation for no-go > go was correlated with greater self-rated BPD symptoms, whereas lower vlPFC activation for oddball > go was associated with greater self-rated attentional impulsivity. Conclusions Patients with BPD show frontoparietal disruptions related to the combination of response inhibition and attentional saliency or saliency alone, but no specific response inhibition neural activation difference when attentional saliency is controlled. The findings suggest a neural dysfunction in BPD underlying attention to salient or infrequent stimuli, which is supported by a negative correlation with self-rated impulsiveness.

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Response inhibition in borderline personality disorder: Neural and behavioral correlates

Biological Psychology ◽

10.1016/j.biopsycho.2019.02.003 ◽

2019 ◽

Vol 143 ◽

pp. 32-40 ◽

Cited By ~ 4

Author(s):

Jacobo Albert ◽

Sara López-Martín ◽

Rocío Arza ◽

Nerea Palomares ◽

Sandra Hoyos ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Response Inhibition ◽

Borderline Personality ◽

Behavioral Correlates

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Neurophysiological biomarkers of response inhibition and the familial risk for borderline personality disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry ◽

10.1016/j.pnpbp.2020.110115 ◽

2020 ◽

pp. 110115

Author(s):

Anthony C. Ruocco ◽

Achala H. Rodrigo ◽

Jaeger Lam ◽

Justine Ledochowski ◽

Jie Chang ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Response Inhibition ◽

Familial Risk ◽

Borderline Personality

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The effects of social exclusion on response inhibition in borderline personality disorder and major depression

Psychiatry Research ◽

10.1016/j.psychres.2017.03.034 ◽

2018 ◽

Vol 262 ◽

pp. 333-339 ◽

Cited By ~ 7

Author(s):

Mareike Ernst ◽

Harald M. Mohr ◽

Margerete Schött ◽

Constanze Rickmeyer ◽

Tamara Fischmann ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Major Depression ◽

Personality Disorder ◽

Social Exclusion ◽

Response Inhibition ◽

Borderline Personality

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Neural and behavioral correlates of response inhibition in borderline personality disorder

International Journal of Psychophysiology ◽

10.1016/j.ijpsycho.2016.07.393 ◽

2016 ◽

Vol 108 ◽

pp. 134

Author(s):

Jacobo Albert ◽

Sara López-Martín ◽

Rocío Arzac ◽

Nerea Palomares ◽

Sandra Hoyos ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Response Inhibition ◽

Borderline Personality ◽

Behavioral Correlates

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Attention to emotional stimuli in borderline personality disorder – a review of the influence of dissociation, self-reference, and psychotherapeutic interventions

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-016-0047-z ◽

2016 ◽

Vol 3 (1) ◽

Cited By ~ 12

Author(s):

Dorina Winter

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Emotional Stimuli ◽

Psychotherapeutic Interventions ◽

Self Reference

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Similar or Different Neuropsychological Profiles? Only Set Shifting Differentiates Women With Bipolar vs. Borderline Personality Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.690808 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ioannis Michopoulos ◽

Kalliopi Tournikioti ◽

Antonios Paraschakis ◽

Anna Karavia ◽

Rossetos Gournellis ◽

...

Keyword(s):

Executive Function ◽

Borderline Personality Disorder ◽

Discriminant Analysis ◽

Personality Disorder ◽

Response Inhibition ◽

Borderline Personality ◽

Stepwise Discriminant Analysis ◽

Set Shifting ◽

Neuropsychological Profile ◽

Patient Groups

There is ongoing debate about the similarities and differences between bipolar disorder (BD) and borderline personality disorder (BPD). Very few studies have concurrently assessed their neuropsychological profile and only on a narrow array of neuropsychological tests. We aimed to investigate the differences of these two patient groups on visual memory, executive function, and response inhibition. Twenty-nine BD patients, 27 BPD patients and 22 controls (all female) were directly compared on paired associates learning (PAL), set shifting (ID/ED), problem solving (SOC), and response inhibition (SSRT) using Cambridge Neuropsychological Test Automated Battery (CANTAB). Rank-normalized outcomes were contrasted in one-way ANOVA tests. Discriminant analysis was finally performed to predict BD or BPD patient status. BD patients performed significantly worse than controls on all tasks. BPD patients performed significantly worse than HC on all tests except SST. Significant differences between the two patient groups were recorded only on ID/ED, where BPD patients performed worse (p = 0.044). A forward stepwise discriminant analysis model based on ID/ED and SOC predicted correctly patients' group at 67.9% of cases. In conclusion, BD and BPD female patients appear to be more similar than different as regards their neuropsychological functions. This study is the first to show that BPD patients display more deficits than BD patients when directly compared on the set shifting executive function test, a marker of cognitive flexibility. Discerning BD from BPD patients through neuropsychological performance is promising but would improve by using additional subtler tests and psychometric evaluation.

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Trait impulsivity in female patients with borderline personality disorder and matched controls

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2010.00468.x ◽

2010 ◽

Vol 22 (3) ◽

pp. 139-149 ◽

Cited By ~ 14

Author(s):

Jørgen Assar Mortensen ◽

Lnge Andre Rasmussen ◽

Asta Håberg

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Response Inhibition ◽

Brain Activity ◽

Block Design ◽

Borderline Personality ◽

Parahippocampal Gyrus ◽

Sensitivity To Reward ◽

Female Patients ◽

Trait Impulsivity

Mortensen JA, Rasmussen IA, Håberg A. Trait impulsivity in female patients with borderline personality disorder and matched controls.Objective:Impulsivity has been shown to load on two separate factors, rash impulsivity and sensitivity to reward (SR) in several factor analytic studies. The aims of the current study were to explore the nature of impulsivity in women with borderline personality disorder (BPD) and matched controls, and the underlying neuronal correlates for rash impulsivity and SR.Methods:Fifteen females diagnosed with BPD and 15 matched controls were recruited. All completed the impulsiveness-venturesomeness scale (I7), the sensitivity to punishment (SP) - sensitivity to reward (SR) questionnaire, and performed a Go-NoGo block-design functional magnetic resonance imaging (fMRI) paradigm at 3T. Correlation analyses were done with I7, SP and SR scores with the level of activation in different brain areas in the whole group. An independent group t-test was used to explore any differences between the BPD group and the matched controls.Results:I7 scores correlated negatively with activity in the left orbitofrontal cortex, amygdala and precuneus, and bilaterally in the cingulate cortices during response inhibition for the entire sample. SP yielded negative correlations in the right superior frontal gyrus and parahippocampal gyrus. No activity related to response inhibition correlated to SR. The Go-NoGo task gave similar brain activity in BPD and matched controls, but behaviourally the BPD group had significantly more commission errors in the NoGo blocks. The BPD group had increased I7 and SP scores indicating rash impulsiveness combined with heightened SP.Conclusion:These results imply that successful impulse inhibition involves interaction between the impulsive and the emotional systems. Furthermore, impulsivity in BPD is described as rash impulsivity, coexisting with increased SP.

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