Alterations in Default Mode Network Connectivity During Pain Processing in Borderline Personality Disorder

CONTEXT Recent neuroimaging studies have associated activity in the default mode network (DMN) with self-referential and pain processing, both of which are altered in borderline personality disorder (BPD). In patients with BPD, antinociception has been linked to altered activity in brain regions inv...

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Veröffentlicht in:Archives of general psychiatry 2012-10, Vol.69 (10), p.993-1002
Hauptverfasser: Kluetsch, Rosemarie C, Schmahl, Christian, Niedtfeld, Inga, Densmore, Maria, Calhoun, Vince D, Daniels, Judith, Kraus, Anja, Ludaescher, Petra, Bohus, Martin, Lanius, Ruth A
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container_end_page 1002
container_issue 10
container_start_page 993
container_title Archives of general psychiatry
container_volume 69
creator Kluetsch, Rosemarie C
Schmahl, Christian
Niedtfeld, Inga
Densmore, Maria
Calhoun, Vince D
Daniels, Judith
Kraus, Anja
Ludaescher, Petra
Bohus, Martin
Lanius, Ruth A
description CONTEXT Recent neuroimaging studies have associated activity in the default mode network (DMN) with self-referential and pain processing, both of which are altered in borderline personality disorder (BPD). In patients with BPD, antinociception has been linked to altered activity in brain regions involved in the cognitive and affective evaluation of pain. Findings in healthy subjects indicate that painful stimulation leads to blood oxygenation level–dependent signal decreases and changes in the functional architecture of the DMN. OBJECTIVES To connect the previously separate research areas of DMN connectivity and altered pain perception in BPD and to explore DMN connectivity during pain processing in patients with BPD. DESIGN Case-control study. SETTING University hospital. PARTICIPANTS Twenty-five women with BPD, including 23 (92%) with a history of self-harm, and 22 age-matched control subjects. INTERVENTIONS Psychophysical assessment and functional magnetic resonance imaging during painful heat vs neutral temperature stimulation. MAIN OUTCOME MEASURE Connectivity of DMN as assessed via independent component analysis and psychophysiological interaction analysis. RESULTS Compared with control subjects, patients with BPD showed less integration of the left retrosplenial cortex and left superior frontal gyrus into the DMN. Higher BPD symptom severity and trait dissociation were associated with an attenuated signal decrease of the DMN in response to painful stimulation. During pain vs neutral, patients with BPD exhibited less posterior cingulate cortex seed region connectivity with the left dorsolateral prefrontal cortex. CONCLUSIONS Patients with BPD showed significant alterations in DMN connectivity, with differences in spatial integrity and temporal characteristics. These alterations may reflect a different cognitive and affective appraisal of pain as less self-relevant and aversive as well as a deficiency in the switching between baseline and task-related processing. This deficiency may be related to everyday difficulties of patients with BPD in regulating their emotions, focusing mindfully on 1 task at a time, and efficiently shifting their attention from one task to another.
doi_str_mv 10.1001/archgenpsychiatry.2012.476
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In patients with BPD, antinociception has been linked to altered activity in brain regions involved in the cognitive and affective evaluation of pain. Findings in healthy subjects indicate that painful stimulation leads to blood oxygenation level–dependent signal decreases and changes in the functional architecture of the DMN. OBJECTIVES To connect the previously separate research areas of DMN connectivity and altered pain perception in BPD and to explore DMN connectivity during pain processing in patients with BPD. DESIGN Case-control study. SETTING University hospital. PARTICIPANTS Twenty-five women with BPD, including 23 (92%) with a history of self-harm, and 22 age-matched control subjects. INTERVENTIONS Psychophysical assessment and functional magnetic resonance imaging during painful heat vs neutral temperature stimulation. MAIN OUTCOME MEASURE Connectivity of DMN as assessed via independent component analysis and psychophysiological interaction analysis. RESULTS Compared with control subjects, patients with BPD showed less integration of the left retrosplenial cortex and left superior frontal gyrus into the DMN. Higher BPD symptom severity and trait dissociation were associated with an attenuated signal decrease of the DMN in response to painful stimulation. During pain vs neutral, patients with BPD exhibited less posterior cingulate cortex seed region connectivity with the left dorsolateral prefrontal cortex. CONCLUSIONS Patients with BPD showed significant alterations in DMN connectivity, with differences in spatial integrity and temporal characteristics. These alterations may reflect a different cognitive and affective appraisal of pain as less self-relevant and aversive as well as a deficiency in the switching between baseline and task-related processing. This deficiency may be related to everyday difficulties of patients with BPD in regulating their emotions, focusing mindfully on 1 task at a time, and efficiently shifting their attention from one task to another.</description><identifier>ISSN: 0003-990X</identifier><identifier>EISSN: 1538-3636</identifier><identifier>DOI: 10.1001/archgenpsychiatry.2012.476</identifier><identifier>PMID: 22637967</identifier><identifier>CODEN: ARGPAQ</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Adult and adolescent clinical studies ; Biological and medical sciences ; Borderline Personality Disorder - physiopathology ; Case-Control Studies ; Cerebral Cortex - physiology ; Cerebral Cortex - physiopathology ; Female ; Gyrus Cinguli - physiology ; Gyrus Cinguli - physiopathology ; Humans ; Magnetic Resonance Imaging - instrumentation ; Magnetic Resonance Imaging - methods ; Medical sciences ; Nerve Net - physiology ; Nerve Net - physiopathology ; Pain Perception - physiology ; Personality disorders ; Prefrontal Cortex - physiology ; Prefrontal Cortex - physiopathology ; Psychology. 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Psychiatry ; Self-Injurious Behavior - physiopathology</subject><ispartof>Archives of general psychiatry, 2012-10, Vol.69 (10), p.993-1002</ispartof><rights>2015 INIST-CNRS</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a475t-6f48e9ae9e4e06a908a40766bd91d334e4e8be024110399118d4c3a23ac1338a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamapsychiatry/articlepdf/10.1001/archgenpsychiatry.2012.476$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2012.476$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,780,784,885,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=26442119$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22637967$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kluetsch, Rosemarie C</creatorcontrib><creatorcontrib>Schmahl, Christian</creatorcontrib><creatorcontrib>Niedtfeld, Inga</creatorcontrib><creatorcontrib>Densmore, Maria</creatorcontrib><creatorcontrib>Calhoun, Vince D</creatorcontrib><creatorcontrib>Daniels, Judith</creatorcontrib><creatorcontrib>Kraus, Anja</creatorcontrib><creatorcontrib>Ludaescher, Petra</creatorcontrib><creatorcontrib>Bohus, Martin</creatorcontrib><creatorcontrib>Lanius, Ruth A</creatorcontrib><title>Alterations in Default Mode Network Connectivity During Pain Processing in Borderline Personality Disorder</title><title>Archives of general psychiatry</title><addtitle>Arch Gen Psychiatry</addtitle><description>CONTEXT Recent neuroimaging studies have associated activity in the default mode network (DMN) with self-referential and pain processing, both of which are altered in borderline personality disorder (BPD). In patients with BPD, antinociception has been linked to altered activity in brain regions involved in the cognitive and affective evaluation of pain. Findings in healthy subjects indicate that painful stimulation leads to blood oxygenation level–dependent signal decreases and changes in the functional architecture of the DMN. OBJECTIVES To connect the previously separate research areas of DMN connectivity and altered pain perception in BPD and to explore DMN connectivity during pain processing in patients with BPD. DESIGN Case-control study. SETTING University hospital. PARTICIPANTS Twenty-five women with BPD, including 23 (92%) with a history of self-harm, and 22 age-matched control subjects. INTERVENTIONS Psychophysical assessment and functional magnetic resonance imaging during painful heat vs neutral temperature stimulation. MAIN OUTCOME MEASURE Connectivity of DMN as assessed via independent component analysis and psychophysiological interaction analysis. RESULTS Compared with control subjects, patients with BPD showed less integration of the left retrosplenial cortex and left superior frontal gyrus into the DMN. Higher BPD symptom severity and trait dissociation were associated with an attenuated signal decrease of the DMN in response to painful stimulation. During pain vs neutral, patients with BPD exhibited less posterior cingulate cortex seed region connectivity with the left dorsolateral prefrontal cortex. CONCLUSIONS Patients with BPD showed significant alterations in DMN connectivity, with differences in spatial integrity and temporal characteristics. These alterations may reflect a different cognitive and affective appraisal of pain as less self-relevant and aversive as well as a deficiency in the switching between baseline and task-related processing. 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Psychiatry</topic><topic>Self-Injurious Behavior - physiopathology</topic><toplevel>online_resources</toplevel><creatorcontrib>Kluetsch, Rosemarie C</creatorcontrib><creatorcontrib>Schmahl, Christian</creatorcontrib><creatorcontrib>Niedtfeld, Inga</creatorcontrib><creatorcontrib>Densmore, Maria</creatorcontrib><creatorcontrib>Calhoun, Vince D</creatorcontrib><creatorcontrib>Daniels, Judith</creatorcontrib><creatorcontrib>Kraus, Anja</creatorcontrib><creatorcontrib>Ludaescher, Petra</creatorcontrib><creatorcontrib>Bohus, Martin</creatorcontrib><creatorcontrib>Lanius, Ruth A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of general psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kluetsch, Rosemarie C</au><au>Schmahl, Christian</au><au>Niedtfeld, Inga</au><au>Densmore, Maria</au><au>Calhoun, Vince D</au><au>Daniels, Judith</au><au>Kraus, Anja</au><au>Ludaescher, Petra</au><au>Bohus, Martin</au><au>Lanius, Ruth A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alterations in Default Mode Network Connectivity During Pain Processing in Borderline Personality Disorder</atitle><jtitle>Archives of general psychiatry</jtitle><addtitle>Arch Gen Psychiatry</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>69</volume><issue>10</issue><spage>993</spage><epage>1002</epage><pages>993-1002</pages><issn>0003-990X</issn><eissn>1538-3636</eissn><coden>ARGPAQ</coden><abstract>CONTEXT Recent neuroimaging studies have associated activity in the default mode network (DMN) with self-referential and pain processing, both of which are altered in borderline personality disorder (BPD). In patients with BPD, antinociception has been linked to altered activity in brain regions involved in the cognitive and affective evaluation of pain. Findings in healthy subjects indicate that painful stimulation leads to blood oxygenation level–dependent signal decreases and changes in the functional architecture of the DMN. OBJECTIVES To connect the previously separate research areas of DMN connectivity and altered pain perception in BPD and to explore DMN connectivity during pain processing in patients with BPD. DESIGN Case-control study. SETTING University hospital. PARTICIPANTS Twenty-five women with BPD, including 23 (92%) with a history of self-harm, and 22 age-matched control subjects. INTERVENTIONS Psychophysical assessment and functional magnetic resonance imaging during painful heat vs neutral temperature stimulation. MAIN OUTCOME MEASURE Connectivity of DMN as assessed via independent component analysis and psychophysiological interaction analysis. RESULTS Compared with control subjects, patients with BPD showed less integration of the left retrosplenial cortex and left superior frontal gyrus into the DMN. Higher BPD symptom severity and trait dissociation were associated with an attenuated signal decrease of the DMN in response to painful stimulation. During pain vs neutral, patients with BPD exhibited less posterior cingulate cortex seed region connectivity with the left dorsolateral prefrontal cortex. CONCLUSIONS Patients with BPD showed significant alterations in DMN connectivity, with differences in spatial integrity and temporal characteristics. These alterations may reflect a different cognitive and affective appraisal of pain as less self-relevant and aversive as well as a deficiency in the switching between baseline and task-related processing. This deficiency may be related to everyday difficulties of patients with BPD in regulating their emotions, focusing mindfully on 1 task at a time, and efficiently shifting their attention from one task to another.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>22637967</pmid><doi>10.1001/archgenpsychiatry.2012.476</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; American Medical Association Journals
subjects Adult
Adult and adolescent clinical studies
Biological and medical sciences
Borderline Personality Disorder - physiopathology
Case-Control Studies
Cerebral Cortex - physiology
Cerebral Cortex - physiopathology
Female
Gyrus Cinguli - physiology
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging - instrumentation
Magnetic Resonance Imaging - methods
Medical sciences
Nerve Net - physiology
Nerve Net - physiopathology
Pain Perception - physiology
Personality disorders
Prefrontal Cortex - physiology
Prefrontal Cortex - physiopathology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Self-Injurious Behavior - physiopathology
title Alterations in Default Mode Network Connectivity During Pain Processing in Borderline Personality Disorder
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