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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: [email protected])
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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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References

Beblo, T, Driessen, M, Mertens, M, Wingenfeld, K, Piefke, M, Rullkoetter, N, Silva-Saavedra, A, Mensebach, C, Reddemann, L, Rau, H, Markowitsch, HJ, Wulff, H, Lange, W, Berea, C, Ollech, I, Woermann, FG (2006 a). Functional MRI correlates of the recall of unresolved life events in borderline personality disorder. Psychological Medicine 36, 845–856.CrossRefGoogle ScholarPubMed
Beblo, T, Saavedra, AS, Mensebach, C, Lange, W, Markowitsch, HJ, Rau, H, Woermann, FG, Driessen, M (2006 b). Deficits n visual functions and neuropsychological inconsistency in borderline personality disorder. Psychiatry Research 145, 127–135.CrossRefGoogle Scholar
Beck, AT, Steer, RA (1994). Beck-Depressions-Inventar (BDI): Testhandbuch [Beck Depression Inventory: Test Handbook]. Huber: Bern.Google Scholar
Beck, AT, Ward, C, Medelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Bernstein, EM, Putnam, FW (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease 174, 727–735.CrossRefGoogle ScholarPubMed
Bremner, JD, Narayan, M, Staib, LH, Southwick, SM, McGlashan, T, Charney, DS (1999). Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder. American Journal of Psychiatry 156, 1787–1795.CrossRefGoogle ScholarPubMed
Bush, G, Luu, P, Posner, MI (2000). Cognitive and emotional influences in anterior cingulate cortex. Trends in Cognitive Sciences 4, 215–222.CrossRefGoogle ScholarPubMed
Critchley, HD (2004). The human cortex responds to an interoceptive challenge. Proceedings of the National Academy of Sciences USA 101, 6333–6334.CrossRefGoogle Scholar
De Bellis, MD, Keshavan, MS, Shifflett, H, Iyengar, S, Beers, SR, Hall, J, Moritz, G (2002). Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study. Biological Psychiatry 52, 1066–1078.CrossRefGoogle ScholarPubMed
De La Fuente, JM, Goldman, S, Stanus, E, Vizuete, C, Morlan, I, Bobes, J, Mendlewicz, J (1997). Brain glucose metabolism in borderline personality disorder. Journal of Psychiatric Research 31, 531–541.CrossRefGoogle ScholarPubMed
Doronbekov, TK, Tokunaga, H, Ikejiri, Y, Kazui, H, Hatta, N, Masaki, Y, Ogino, A, Miyoshi, N, Oku, N, Nishikawa, T, Takeda, M (2005). Neural basis of fear conditioning induced by video clip: positron emission tomography study. Psychiatry and Clinical Neurosciences 59, 155–162.CrossRefGoogle ScholarPubMed
Driessen, M, Beblo, T, Mertens, M, Piefke, M, Rullkoetter, N, Silva-Saavedra, A, Reddemann, L, Rau, H, Markowitsch, HJ, Wulff, H, Lange, W, Woermann, FG (2004). Posttraumatic stress disorder and fMRI activation patterns of traumatic memory in patients with borderline personality disorder. Biological Psychiatry 55, 603–611.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW, Benjamin, L (1996). User's Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). American Psychiatric Press, Inc.: Washington, DC.Google Scholar
Franke, G (1995). Die Symptom-Checkliste von Derogatis – German version [Derogatis Symptom Checklist]. Beltz Test: Göttingen.Google Scholar
Freyberger, HJ, Spitzer, C, Stieglitz, R-D (1999). Fragebogen zu Dissoziativen Symptomen (FDS) [German version of the American Dissociative Experiences Scale]. Hogrefe: Göttingen.Google Scholar
Friston, KJ (1998). Imaging neuroscience: principles or maps? Proceedings of the National Academy of Sciences USA 95, 796–802.CrossRefGoogle ScholarPubMed
Gazzaniga, MS (1998). Brain and conscious experience. Advances in Neurology 77, 181–193.Google ScholarPubMed
Golier, JA, Yehuda, R, Bierer, LM, Mitropoulou, V, New, AS, Schmeidler, J, Silverman, JM, Siever, LJ (2003). The relationship of borderline personality disorder to posttraumatic stress disorder and traumatic events. American Journal of Psychiatry 160, 2018–2024.CrossRefGoogle ScholarPubMed
Goyer, PF, Andreason, PJ, Semple, WE, Clayton, AH, King, AC, Compton-Toth, BA, Schulz, SC, Cohen, RM (1994). Positron-emission tomography and personality disorders. Neuropsychopharmacology 10, 21–28.CrossRefGoogle ScholarPubMed
Gunderson, JG, Weinberg, I, Daversa, MT, Kueppenbender, KD, Zanarini, MC, Shea, MT, Skodol, AE, Sanislow, CA, Yen, S, Morey, LC, Grilo, CM, McGlashan, TH, Stout, RL, Dyck, I (2006). Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder. American Journal of Psychiatry 163, 1173–1178.CrossRefGoogle ScholarPubMed
Herpertz, SC, Dietrich, TM, Wenning, B, Krings, T, Erberich, SG, Willmes, K, Thron, A, Sass, H (2001). Evidence of abnormal amygdala functioning in borderline personality disorder: a functional MRI study. Biological Psychiatry 50, 292–298.CrossRefGoogle ScholarPubMed
Jatzko, A, Schmitt, A, Kordon, A, Braus, DF (2005). Neuroimaging findings in posttraumatic stress disorder: review of the literature [in German]. Fortschritte der Neurologie Psychiatrie 73, 377–391.CrossRefGoogle ScholarPubMed
Juengling, FD, Schmahl, C, Hesslinger, B, Ebert, D, Bremner, JD, Gostomzyk, J, Bohus, M, Lieb, K (2003). Positron emission tomography in female patients with borderline personality disorder. Journal of Psychiatric Research 37, 109–115.CrossRefGoogle ScholarPubMed
Lanius, RA, Bluhm, R, Lanius, U, Pain, C (2006). A review of neuroimaging studies in PTSD: heterogeneity of response to symptom provocation. Journal of Psychiatric Research 40, 709–729.CrossRefGoogle ScholarPubMed
Leyton, M, Okazawa, H, Diksic, M, Paris, J, Rosa, P, Mzengeza, S, Young, SN, Blier, P, Benkelfat, C (2001). Brain regional α-[11C]methyl-l-tryptophan trapping in impulsive subjects with borderline personality disorder. American Journal of Psychiatry 158, 775–782.CrossRefGoogle ScholarPubMed
Maercker, A, Schützwohl, M (1998). Collection of psychological load sequences: the Impact of Event scale – revised version (IES-R) [in German]. Diagnostica 3, 130–141.Google Scholar
McLean, LM, Gallop, R (2003). Implications of childhood sexual abuse for adult borderline personality disorder and complex posttraumatic stress disorder. American Journal of Psychiatry 160, 369–371.CrossRefGoogle ScholarPubMed
Pagano, ME, Skodol, AE, Stout, RL, Shea, MT, Yen, S, Grilo, CM, Sanislow, CA, Bender, DS, McGlashan, TH, Zanarini, MC, Gunderson, JG (2004). Stressful life events as predictors of functioning: findings from the collaborative longitudinal personality disorders study. Acta Psychiatrica Scandinavica 110, 421–429.CrossRefGoogle Scholar
Rey, A (1964). L'Examen Clinique en Psychologie [Psychological Clinical Examination]. Presses Universitaires de France: Paris.Google Scholar
Schmahl, CG, Vermetten, E, Elzinga, BM, Bremner, JD (2004). A positron emission tomography study of memories of childhood abuse in borderline personality disorder. Biological Psychiatry 55, 759–765.CrossRefGoogle ScholarPubMed
Schnell, K, Herpertz, SC (2006). Effects of dialectic-behavioral-therapy on the neural correlates of affective hyperarousal in borderline personality disorder. Journal of Psychiatric Research 41, 837–847.CrossRefGoogle ScholarPubMed
Shin, LM, Rauch, SL, Pitman, RK (2006). Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Annals of the New York Academy of Sciences 1071, 67–79.CrossRefGoogle ScholarPubMed
Shin, LM, Wright, CI, Cannistraro, PA, Wedig, MM, McMullin, K, Martis, B, Macklin, ML, Lasko, NB, Cavanagh, SR, Krangel, TS, Orr, SP, Pitman, RK, Whalen, PJ, Rauch, SL (2005). A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Archives of General Psychiatry 62, 273–281.CrossRefGoogle ScholarPubMed
Soloff, PH, Meltzer, CC, Becker, C, Greer, PJ, Kelly, TM, Constantine, D (2003). Impulsivity and prefrontal hypometabolism in borderline personality disorder. Psychiatry Research 123, 153–163.CrossRefGoogle ScholarPubMed
Soloff, PH, Meltzer, CC, Greer, PJ, Constantine, D, Kelly, TM (2000). A fenfluramine-activated FDG-PET study of borderline personality disorder. Biological Psychiatry 47, 540–547.CrossRefGoogle ScholarPubMed
Sugiura, M, Shah, NJ, Zilles, K, Fink, GR (2005). Cortical representations of personally familiar objects and places: functional organization of the human posterior cingulate cortex. Journal of Cognitive Neuroscience 17, 183–198.CrossRefGoogle ScholarPubMed
van Elst, LT, Thiel, T, Hesslinger, B, Lieb, K, Bohus, M, Hennig, J, Ebert, D (2001). Subtle prefrontal neuropathology in a pilot magnetic resonance spectroscopy study in patients with borderline personality disorder. Journal of Neuropsychiatry and Clinical Neurosciences 13, 511–514.CrossRefGoogle Scholar
Vogt, BA, Laureys, S (2005). Posterior cingulate, precuneal and retrosplenial cortices: cytology and components of the neural network correlates of consciousness. Progress in Brain Research 150, 205–217.CrossRefGoogle ScholarPubMed
Vogt, BA, Vogt, L, Laureys, S (2006). Cytology and functionally correlated circuits of human posterior cingulate areas. Neuroimage 29, 452–466.CrossRefGoogle ScholarPubMed
Vollm, B, Richardson, P, Stirling, J, Elliott, R, Dolan, M, Chaudhry, I, Del Ben, C, McKie, S, Anderson, I, Deakin, B (2004). Neurobiological substrates of antisocial and borderline personality disorder: preliminary results of a functional fMRI study. Criminal Behaviour and Mental Health 14, 39–54.CrossRefGoogle ScholarPubMed
Wittchen, H-U, Zaudig, M, Fydrich, T (1997). Strukturiertes Klinisches Interview für DSM-IV (SKID) [Structured Clinical Interview for DSM-IV]. Hogrefe: Göttingen.Google Scholar
Zanarini, MC, Frankenburg, FR, Hennen, J, Reich, DB, Silk, KR (2006). Prediction of the 10-year course of borderline personality disorder. American Journal of Psychiatry 163, 827–832.CrossRefGoogle ScholarPubMed