Research Study: Amygdala hyperreactivity in BPD (2003)

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Biol Psychiatry. 2003 Dec 1;54(11):1284-93.

" Amygdala hyperreactivity in borderline personality disorder:

implications for emotional dysregulation "

Donegan NH, Sanislow CA, Blumberg HP, Fulbright RK, Lacadie C,

Skudlarski P, Gore JC, Olson IR, McGlashan TH, Wexler BE.

Department of Psychiatry, Yale University School of Medicine, New Haven,

Connecticut 06520-8098, USA.

BACKGROUND: Disturbed interpersonal relations and emotional

dysregulation are fundamental aspects of borderline personality disorder

(BPD). The amygdala plays important roles in modulating vigilance and

generating negative emotional states and is often abnormally reactive in

disorders of mood and emotion. The aim of this study was to assess

amygdala reactivity in BPD patients relative to normal control subjects.

We hypothesized that amygdala hyperreactivity contributes to

hypervigilance, emotional dysregulation, and disturbed interpersonal

relations in BPD.

METHODS: Using functional magnetic resonance imaging, we examined neural

responses to 20-sec blocks of neutral, happy, sad, and fearful facial

expression (or a fixation point) in 15 BPD and 15 normal control

subjects. The DSM IV-diagnosed BPD patients and the normal control

subjects were assessed by a clinical research team in a medical school

psychiatry department.

RESULTS: Borderline patients showed significantly greater left amygdala

activation to the facial expressions of emotion (vs. a fixation point)

compared with normal control subjects. Post-scan debriefing revealed

that some borderline patients had difficulty disambiguating neutral

faces or found them threatening.

CONCLUSIONS: Pictures of human emotional expressions elicit robust

differences in amygdala activation levels in borderline patients,

compared with normal control subjects, and can be used as probes to

study the neuropathophysiologic basis of borderline personality disorder.

PMID: 14643096 [PubMed - indexed for MEDLINE]