Altered Patterns Of Amygdala Activation And Functional Connectivity In Individuals With Borderline Personality Disorder During Nonconscious And Conscious Emotion Processing

Abstract

Objective: Borderline personality disorder (BPD) is characterized by emotion dysregulation, which underlies symptoms such as suicidality and impulsivity. Neuroimaging provides a method for probing the biological basis of emotion dysregulation. We examined neural activation and connectivity in individuals with BPD and healthy controls (HCs) during nonconscious and conscious emotion processing. Methods: 21 unmedicated individuals with BPD and 10 healthy controls (HCs) completed an fMRI task viewing masked and unmasked happy and fearful faces. Whole brain and region of interest (ROI) analyses examined between group differences in activation. Differences in amygdala connectivity were assessed using psychophysiological interactions (PPI). Results: During unmasked emotion processing, whole-brain and ROI analyses reveal greater activation in the amygdala and hippocampus and PPI analyses show greater connectivity between the amygdala and subgenual anterior cingulate cortex (sgACC) in participants with BPD. In HCs, greater connectivity was found between the amygdala and areas of the prefrontal cortex. During masked emotion processing, HCs show greater activation in frontal and temporal regions and greater connectivity between the amygdala and temporal regions. Conclusion: Results find altered frontal-limbic activation and connectivity in individuals with BPD relative to HCs, varying depending on whether the emotional stimulus is consciously or nonconsciously perceived. This suggests that there may be more than one neural pathway underlying emotion dysregulation in BPD.