Neural Correlates of Disturbed Emotion Processing in Borderline Personality Disorder: A Multimodal Meta-Analysis

Description: Disturbances in the processing and regulation of emotions are core symptoms of borderline personality disorder (BPD). To further elucidate neural underpinnings of BPD, the present meta-analysis summarizes functional neuroimaging findings of emotion processing tasks as well as structural neuroimaging findings, and investigates multi-modally affected brain regions.Combined coordinate- and image-based meta-analyses were calculated using Anisotropic Effect Size Signed Differential Mapping. Nineteen functional neuroimaging studies investigating the processing of negative compared to neutral stimuli in a total of 281 patients with BPD and 293 healthy controls were included. In addition, ten nine studies investigating gray matter abnormalities in 263 256 patients with BPD and 278 272 healthy (HC) controls were analyzed. Compared to HC, BPD patients showed relatively increased activation of the left amygdala and posterior cingulate cortex, along with blunted responses of the bilateral dorsolateral prefrontal cortex during the processing of negative emotional stimuli. The multi-modal analysis identified the left amygdala to be characterized by a combination of functional hyperactivity and smaller gray matter volume compared to HC. Hyperresponsivity of the amygdala was moderated by medication status of the patient samples. Medication-free samples were characterized by limbic hyperactivity, whereas no such group differences were found in patients currently taking psychotropic medication. Results strengthen the assumption that dysfunctional dorsolateral prefrontal and limbic brain regions are a hallmark feature of BPD, and therefore are consistent with the conceptualization of BPD as an emotion dysregulation disorder.

Related article: http://doi.org/10.1016/j.biopsych.2015.03.027