Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study.

Autor:	Geurts DEM; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands., Van den Heuvel TJ; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.; Department of Scelta, Expert Centre for Personality Disorders, GGNet, Nijmegen, Netherlands., Huys QJM; Mental Health Neuroscience Department, Division of Psychiatry and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Institute of Neurology, University College London, London, United Kingdom., Verkes RJ; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.; Kairos Center for Forensic Psychiatry, Pro Persona Mental Health, Nijmegen, Netherlands., Cools R; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in behavioral neuroscience [Front Behav Neurosci] 2022 Aug 30; Vol. 16, pp. 938403. Date of Electronic Publication: 2022 Aug 30 (Print Publication: 2022).
DOI:	10.3389/fnbeh.2022.938403
Abstrakt:	Borderline personality disorder (BPD) is a prevalent, devastating, and heterogeneous psychiatric disorder. Treatment success is highly variable within this patient group. A cognitive neuroscientific approach to BPD might contribute to precision psychiatry by identifying neurocognitive factors that predict who will benefit from a specific treatment. Here, we build on observations that BPD is accompanied by the enhanced impact of the aversive effect on behavior and abnormal neural signaling in the amygdala. We assessed whether BPD is accompanied by abnormal aversive regulation of instrumental behavior and associated neural signaling, in a manner that is predictive of symptom reduction after therapy. We tested a clinical sample of 15 female patients with BPD, awaiting dialectical behavior therapy (DBT), and 16 matched healthy controls using fMRI and an aversive Pavlovian-to-instrumental transfer (PIT) task that assesses how instrumental behaviors are influenced by aversive Pavlovian stimuli. Patients were assessed 1 year after the start of DBT to quantify changes in BPD symptom severity. At baseline, behavioral aversive PIT and associated neural signaling did not differ between groups. However, the BOLD signal in the amygdala measured during aversive PIT was associated with symptom reduction at 1-year follow-up: higher PIT-related aversive amygdala signaling before treatment was associated with reduced clinical improvement at follow-up. Thus, within the evaluated group of BPD patients, the BOLD signal in the amygdala before treatment was related to clinical symptom reduction 1 year after the start of treatment. The results suggest that less PIT-related responsiveness of the amygdala increases the chances of treatment success. We note that the relatively small sample size is a limitation of this study and that replication is warranted. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Geurts, Van den Heuvel, Huys, Verkes and Cools.)
Databáze:	MEDLINE
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