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Research confirms emotional dysregulation behind borderline personality disorder

Recent findings showed dysfunctional dorsolateral prefrontal and limbic brain regions are a significant feature of borderline personality disorder, consistent with the concept that the disorder is an emotional dysregulation disorder.

“Taken together, neuroimaging studies suggest that dysfunctional frontolimbic brain regions underlie the ‘emotional turmoil’ in patients with [borderline personality disorder (BPD)]. To further advance the neuroanatomical basis of disturbed emotion processing in BPD, the present study utilized a coordinate- and image-based meta-analytic approach to summarize available neuroimaging findings,” the researchers wrote.

Researchers used anisotropic effect size and signed differential mapping to determine combined coordinate- and image-based meta-analyses. Analyses included 19 functional neuroimaging studies on processing of negative vs. neutral stimuli among 281 individuals with BPD and 10 studies on gray matter abnormalities in 263 individuals with BPD.

Individuals with BPD exhibited increased activation of the left amygdala and posterior cingulate cortex and decreased responses in the bilateral dorsolateral prefrontal cortex during negative emotional stimuli processing, compared with healthy controls.

Multimodal analysis indicated a combination of functional hyperactivity and lower gray matter volume in the left amygdala among individuals with BPD.

Amygdala hyperresponsivity was moderated by medication status, according to researchers. Medication-free individuals exhibited limbic hyperactivity, while no group differences occurred among individuals currently taking psychotropic medication.

“Our results indicate that abnormal functioning of dorsolateral prefrontal and limbic brain regions might underlie disturbed emotion processing in BPD. Although suggestive of a causal link, these findings need to be complemented by functional connectivity studies to more strongly determine whether altered activity in the amygdala and parts of the prefrontal cortex are functionally related,” the researchers wrote. “Second, the amygdala and hippocampus are two adjacent structures that are difficult to exactly demarcate with typical brain imaging field strengths. This might compromise the regional specificity of the abnormalities in the limbic system.” – by Amanda Oldt

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.