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RESEARCH PRODUCT
Neural correlates of antinociception in borderline personality disorder.
Anja JochimsWolfgang GreffrathKlaus LiebMartin BohusErich SeifritzFrancesco Di SalleRolf-detlef TreedeJuergen HennigKlaus SchefflerPetra LudaescherFabrizio EspositoChristian Schmahlsubject
AdultPain Thresholdmedicine.medical_specialtyHot TemperatureDifferential ThresholdPainPrefrontal CortexAudiologybehavioral disciplines and activitiesAmygdalaGyrus CingulimethodsArts and Humanities (miscellaneous)bloodBorderline Personality DisorderPhysical StimulationAdult Amygdala; physiopathology Borderline Personality Disorder; diagnosis/physiopathology/psychology Brain Mapping Brain; physiopathology Case-Control Studies Differential Threshold; physiology Female Gyrus Cinguli; physiopathology Hot Temperature; diagnostic use Humans Magnetic Resonance Imaging Oxygen; blood Pain Measurement; methods Pain Threshold; physiology Pain; diagnosis/physiopathology/psychology Physical Stimulation Prefrontal Cortex; physiopathology Self-Injurious Behavior; diagnosis/physiopathology Thermosensing; physiologymental disordersThreshold of painmedicineHumansThermosensingPrefrontal cortexPsychiatryBorderline personality disorderPain MeasurementBrain MappingBlood-oxygen-level dependentmedicine.diagnostic_testBrainmedicine.diseaseAmygdalaMagnetic Resonance Imagingdiagnosis/physiopathologyFunctional imagingDorsolateral prefrontal cortexOxygenPsychiatry and Mental healthmedicine.anatomical_structureCase-Control StudiesphysiologyFemalediagnosis/physiopathology/psychologyphysiopathologydiagnostic useFunctional magnetic resonance imagingPsychologySelf-Injurious Behaviordescription
Context A characteristic feature of borderline personality disorder (BPD) is self-injurious behavior in conjunction with stress-induced reduction of pain perception. Reduced pain sensitivity has been experimentally confirmed in patients with BPD, but the neural correlates of antinociceptive mechanisms in BPD are unknown. We predicted that heat stimuli in patients with BPD would activate brain areas concerned with cognitive and emotional evaluation of pain. Objective To assess the psychophysical properties and neural correlates of altered pain processing in patients with BPD. Design Case-control study. Setting A university hospital. Participants Twelve women with BPD and self-injurious behavior and 12 age-matched control subjects. Interventions Psychophysical assessment and blood oxygen level–dependent functional magnetic resonance imaging during heat stimulation with fixed-temperature heat stimuli and individual-temperature stimuli adjusted for equal subjective pain in all the participants. Main Outcome Measure Blood oxygen level–dependent functional magnetic resonance imaging signal changes during heat pain stimulation. Results Patients with BPD had higher pain thresholds and smaller overall volumes of activity than controls in response to identical heat stimuli. When the stimulus temperature was individually adjusted for equal subjective pain level, overall volumes of activity were similar, although regional patterns differed significantly. Patient response was greater in the dorsolateral prefrontal cortex and smaller in the posterior parietal cortex. Pain also produced neural deactivation in the perigenual anterior cingulate gyrus and the amygdala in patients with BPD. Conclusion The interaction between increased pain-induced response in the dorsolateral prefrontal cortex and deactivation in the anterior cingulate and the amygdala is associated with an antinociceptive mechanism in patients with BPD.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2006-06-01 | Archives of general psychiatry |