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Trait anxiety modulates fronto-limbic processing of emotional interference in borderline personality disorder.

Holtmann J, Herbort MC, Wüstenberg T, Soch J, Richter S, Walter H, Roepke S, Schott BH - Front Hum Neurosci (2013)

Bottom Line: Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results.Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance.As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin Berlin Berlin, Germany ; Campus Benjamin Franklin, Charité Universitätsmedizin Berlin Berlin, Germany ; Department of Education and Psychology, Freie Universität Berlin Berlin, Germany.

ABSTRACT
Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results. Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance. Here we used functional magnetic resonance imaging (fMRI) to investigate how task-irrelevant emotional stimuli (fearful faces) affect performance and fronto-limbic neural activity patterns during attention-demanding cognitive processing in 16 female, unmedicated BPD patients relative to 24 age-matched healthy controls. In a modified flanker task, emotionally negative, socially salient pictures (fearful vs. neutral faces) were presented as distracters in the background. Patients, but not controls, showed an atypical response pattern of the right amygdala with increased activation during emotional interference in the (difficult) incongruent flanker condition, but emotion-related amygdala deactivation in the congruent condition. A direct comparison of the emotional conditions between the two groups revealed that the strongest diagnosis-related differences could be observed in the dorsal and, to a lesser extent, also in the rostral anterior cingulate cortex (dACC, rACC) where patients exhibited an increased neural response to emotional relative to neutral distracters. Moreover, in the incongruent condition, both the dACC and rACC fMRI responses during emotional interference were negatively correlated with trait anxiety in the patients, but not in the healthy controls. As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.

No MeSH data available.


Related in: MedlinePlus

Brain-behavior correlations: STAI (trait). (A) Left panel: Non-overlapping ROIs for the dACC (yellow) and rACC (green). Middle and right panel: rendered dACC and rACC ROI. (B) Correlation of the STAI trait score with activation in the rACC and (C) activation in the dACC in the fearful condition for the contrast inc > cong (solid lines represent regression lines, dashed lines 95% prediction bounds). Left panel: BPD group. Middle panel: HC group. Right panel: Boxplot for the bootstrap-sample correlations (BPD group: red, HC group: blue).
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Figure 5: Brain-behavior correlations: STAI (trait). (A) Left panel: Non-overlapping ROIs for the dACC (yellow) and rACC (green). Middle and right panel: rendered dACC and rACC ROI. (B) Correlation of the STAI trait score with activation in the rACC and (C) activation in the dACC in the fearful condition for the contrast inc > cong (solid lines represent regression lines, dashed lines 95% prediction bounds). Left panel: BPD group. Middle panel: HC group. Right panel: Boxplot for the bootstrap-sample correlations (BPD group: red, HC group: blue).

Mentions: Based on their well-characterized roles in emotion regulation and cognitive control, respectively, we focused our brain-behavior correlations on the rACC and dACC. Pearson correlations of the STAI-trait scores and BOLD responses in the emotional conditions of the congruency effect (incongruent > congruent) yielded significant negative relationships between the two variables in both rACC and dACC ROIs in the BPD group (see Figure 5). Thus, trait anxiety was inversely associated with activation differences between the incongruent and congruent flanker condition when fearful faces were presented as distracters. Notably, these negative correlations were restricted to the patient group, with healthy controls showing no significant relationship between BOLD signal and STAI-trait scores in any of these contrasts or regions. The effect sizes reflecting the group difference in these correlation coefficients were high in both cases (d = 1.51 and d = 3.71 for the rACC and dACC, respectively) and did differ significantly (p < 0.001 for dACC and rACC). Correlation coefficients, bootstrap results and test statistics are given in Table 9 and Figure 5.


Trait anxiety modulates fronto-limbic processing of emotional interference in borderline personality disorder.

Holtmann J, Herbort MC, Wüstenberg T, Soch J, Richter S, Walter H, Roepke S, Schott BH - Front Hum Neurosci (2013)

Brain-behavior correlations: STAI (trait). (A) Left panel: Non-overlapping ROIs for the dACC (yellow) and rACC (green). Middle and right panel: rendered dACC and rACC ROI. (B) Correlation of the STAI trait score with activation in the rACC and (C) activation in the dACC in the fearful condition for the contrast inc > cong (solid lines represent regression lines, dashed lines 95% prediction bounds). Left panel: BPD group. Middle panel: HC group. Right panel: Boxplot for the bootstrap-sample correlations (BPD group: red, HC group: blue).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3585713&req=5

Figure 5: Brain-behavior correlations: STAI (trait). (A) Left panel: Non-overlapping ROIs for the dACC (yellow) and rACC (green). Middle and right panel: rendered dACC and rACC ROI. (B) Correlation of the STAI trait score with activation in the rACC and (C) activation in the dACC in the fearful condition for the contrast inc > cong (solid lines represent regression lines, dashed lines 95% prediction bounds). Left panel: BPD group. Middle panel: HC group. Right panel: Boxplot for the bootstrap-sample correlations (BPD group: red, HC group: blue).
Mentions: Based on their well-characterized roles in emotion regulation and cognitive control, respectively, we focused our brain-behavior correlations on the rACC and dACC. Pearson correlations of the STAI-trait scores and BOLD responses in the emotional conditions of the congruency effect (incongruent > congruent) yielded significant negative relationships between the two variables in both rACC and dACC ROIs in the BPD group (see Figure 5). Thus, trait anxiety was inversely associated with activation differences between the incongruent and congruent flanker condition when fearful faces were presented as distracters. Notably, these negative correlations were restricted to the patient group, with healthy controls showing no significant relationship between BOLD signal and STAI-trait scores in any of these contrasts or regions. The effect sizes reflecting the group difference in these correlation coefficients were high in both cases (d = 1.51 and d = 3.71 for the rACC and dACC, respectively) and did differ significantly (p < 0.001 for dACC and rACC). Correlation coefficients, bootstrap results and test statistics are given in Table 9 and Figure 5.

Bottom Line: Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results.Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance.As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin Berlin Berlin, Germany ; Campus Benjamin Franklin, Charité Universitätsmedizin Berlin Berlin, Germany ; Department of Education and Psychology, Freie Universität Berlin Berlin, Germany.

ABSTRACT
Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results. Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance. Here we used functional magnetic resonance imaging (fMRI) to investigate how task-irrelevant emotional stimuli (fearful faces) affect performance and fronto-limbic neural activity patterns during attention-demanding cognitive processing in 16 female, unmedicated BPD patients relative to 24 age-matched healthy controls. In a modified flanker task, emotionally negative, socially salient pictures (fearful vs. neutral faces) were presented as distracters in the background. Patients, but not controls, showed an atypical response pattern of the right amygdala with increased activation during emotional interference in the (difficult) incongruent flanker condition, but emotion-related amygdala deactivation in the congruent condition. A direct comparison of the emotional conditions between the two groups revealed that the strongest diagnosis-related differences could be observed in the dorsal and, to a lesser extent, also in the rostral anterior cingulate cortex (dACC, rACC) where patients exhibited an increased neural response to emotional relative to neutral distracters. Moreover, in the incongruent condition, both the dACC and rACC fMRI responses during emotional interference were negatively correlated with trait anxiety in the patients, but not in the healthy controls. As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.

No MeSH data available.


Related in: MedlinePlus