An fMRI Study of Emotional Dysregulation in Borderline Patients

边缘性患者情绪失调的功能磁共振成像研究

• 批准号: 7264285
• 负责人: Harold W Koenigsberg
• 金额: $ 37.82万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7264285
• 关键词: Accounting; Adult; Affect; Affective; Amygdaloid structure; Amyotrophic Lateral Sclerosis; Anger; Anterior; Attention; Avoidant Personality Disorders; Awareness; Behavioral; Body Image; Borderline Personality Disorder; Brain; Brain region; Calculi; Cerebrum; Characteristics; Clinical; Cognitive; Condition; Conscious; Corpus striatum structure; Cues; Data; Depressed mood; Development; Disease; Dorsal; Emotional; Emotions; Exposure to; Face; Failure; Feeling; Female; Functional Magnetic Resonance Imaging; Fusiform gyrus; Future; Gender; Genetic; Genetic Markers; Gestures; Hand; Health Resources; High Prevalence; Hippocampus (Brain); Image; Impairment; Impulsivity; Individual; Inferior; Instruction; Insula of Reil; Judgment; Knowledge; Lateral; Lead; Left; Legal patent; Life; Light; Literature; Love; Maintenance; Measures; Medial; Mediating; Medical center; Memory; Mental disorders; Metals; Methods; Monitor; Moods; Neuroanatomy; Neurons; Outcome; Parietal Lobe; Pathology; Patients; Pattern; Perception; Personal Communication; Personality; Personality Disorders; Persons; Pharmacotherapy; Play; Population; Post-Traumatic Stress Disorders; Posture; Precentral gyrus; Predisposition; Prefrontal Cortex; Prevalence; Principal Investigator; Process; Public Health; RHOA gene; Reaction; Recovery; Recruitment Activity; Reporting; Research; Retrieval; Review Literature; Role; Sampling; Sampling Biases; Sex Characteristics; Site; Slide; Source; Specificity; Stimulus; Stream; Suicide; Superior temporal gyrus; Symptoms; System; Temperament; Temporal Lobe; Thinking; Time; Visual; Woman; Work; angular gyrus; base; behavior measurement; cingulate gyrus; cognitive control; comparison group; cost; design; emotion regulation; emotional reaction; emotional stimulus; endophenotype; experience; frontal lobe; functional disability; gray matter; healthy volunteer; hospital bed; intraparietal sulcus; male; men; neuroimaging; novel; programs; relating to nervous system; response; social; suicide rate; theories; trait

DESCRIPTION (provided by applicant): Borderline Personality Disorder (BPD) is a prevalent and enduring psychiatric disorder found in approximately 2% of the population and 20% of hospitalized psychiatric patients. It is characterized by great volatility, impulsivity, sucidality, and unstable interpersonal relationships, and has proved difficult to treat. Suicide rates of approximately 10% have been reported in borderline patients. A core underlying feature of BPD is extreme emotional instability and this has been shown to be associated with the suicide threats, gestures and acts, inappropriate anger, and identity disturbances which prove so dangerous and disruptive for these patients. Despite its central role in the pathology of BPD, emotional instability is not well understood. This study employs functional magnetic resonance imaging (fMRI) to identify the disturbances in brain emotion processing systems that may explain the impairments in emtional control in BPD. It looks in particular at regional brain activity when BPD patients are consciously trying to control their emotional reactions to disturbing images and as they are systematically re-exposed to these images. Identification of the patterns of brain activity that are associated with efforts at conscious emotional control or with habituation to repeated exposure can lead to the development of new pharmacological approaches to treatment, to the development of new and more appropriately targeted cognitive/behavoral psychotherapeutic strategies, and the identification of brain activity markers for BPD that may guide future genetic studies. To achieve these objectives, we will obtain fMRI images of 30 BPD patients, and of comparison groups of 30 non-borderline personality disorder patients (i.e. patients with Avoidant Personality Disorder) and 30 healthy volunteers 1) as they make efforts to control their emotional reactions to emotion- inducing pictures and 2) as they are exposed to repeated presentions of the same pictures. The findings of this study may help in the development of new treatment strategies for BPD, a disorder which has not only great emotional costs in terms of the suffering experienced by borderline patients and their loved ones, but also social costs since BPD patients typically function at a level substantially below that of individuals with comparable intellect and they consume a disproportionate share of metal health resources. A more effective treatment for this disorder would thus greatly benefit public health.

描述（由申请人提供）：边缘性人格障碍 (BPD) 是一种普遍且持久的精神疾病，约 2% 的人口和 20% 的住院精神病患者患有这种疾病。它的特点是情绪波动大、冲动、有自杀倾向、人际关系不稳定，且已被证明难以治疗。据报道，边缘患者的自杀率约为 10%。 BPD 的一个核心基本特征是极度情绪不稳定，这已被证明与自杀威胁、手势和行为、不恰当的愤怒和身份障碍有关，这些对这些患者来说非常危险和具有破坏性。尽管情绪不稳定在边缘性人格障碍的病理学中发挥着核心作用，但人们对其的了解还不够深入。这项研究采用功能磁共振成像（fMRI）来识别大脑情绪处理系统的紊乱，这可能解释边缘性人格障碍患者情绪控制的障碍。它特别关注当边缘性人格障碍患者有意识地试图控制他们对令人不安的图像的情绪反应以及当他们系统地重新暴露于这些图像时的区域大脑活动。识别与有意识的情绪控制或与重复暴露的习惯相关的大脑活动模式可以导致开发新的药理学治疗方法，开发新的且更有针对性的认知/行为心理治疗策略，以及识别 BPD 的大脑活动标记物可能指导未来的遗传学研究。为了实现这些目标，我们将获得 30 名 BPD 患者以及 30 名非边缘性人格障碍患者（即回避型人格障碍患者）和 30 名健康志愿者 1) 的对照组的 fMRI 图像，因为他们努力控制自己的情绪反应2）当他们反复看到相同的图片时。这项研究的结果可能有助于开发针对 BPD 的新治疗策略，这种疾病不仅会给边缘型患者及其亲人带来巨大的痛苦，而且还会带来社会成本，因为 BPD 患者通常在其水平大大低于具有同等智力的个人，并且他们消耗了不成比例的金属健康资源。因此，对这种疾病的更有效治疗将极大地有益于公众健康。