Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study
Borderline personality disorder (BPD) is a prevalent, devastating, and heterogeneous psychiatric disorder. Treatment success is highly variable within this patient group. A cognitive neuroscientific approach to BPD might contribute to precision psychiatry by identifying neurocognitive factors that p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Behavioral Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnbeh.2022.938403/full |
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| author | Dirk E. M. Geurts Dirk E. M. Geurts Thom J. Van den Heuvel Thom J. Van den Heuvel Quentin J. M. Huys Robbert J. Verkes Robbert J. Verkes Roshan Cools Roshan Cools |
| author_facet | Dirk E. M. Geurts Dirk E. M. Geurts Thom J. Van den Heuvel Thom J. Van den Heuvel Quentin J. M. Huys Robbert J. Verkes Robbert J. Verkes Roshan Cools Roshan Cools |
| author_sort | Dirk E. M. Geurts |
| collection | DOAJ |
| description | Borderline personality disorder (BPD) is a prevalent, devastating, and heterogeneous psychiatric disorder. Treatment success is highly variable within this patient group. A cognitive neuroscientific approach to BPD might contribute to precision psychiatry by identifying neurocognitive factors that predict who will benefit from a specific treatment. Here, we build on observations that BPD is accompanied by the enhanced impact of the aversive effect on behavior and abnormal neural signaling in the amygdala. We assessed whether BPD is accompanied by abnormal aversive regulation of instrumental behavior and associated neural signaling, in a manner that is predictive of symptom reduction after therapy. We tested a clinical sample of 15 female patients with BPD, awaiting dialectical behavior therapy (DBT), and 16 matched healthy controls using fMRI and an aversive Pavlovian-to-instrumental transfer (PIT) task that assesses how instrumental behaviors are influenced by aversive Pavlovian stimuli. Patients were assessed 1 year after the start of DBT to quantify changes in BPD symptom severity. At baseline, behavioral aversive PIT and associated neural signaling did not differ between groups. However, the BOLD signal in the amygdala measured during aversive PIT was associated with symptom reduction at 1-year follow-up: higher PIT-related aversive amygdala signaling before treatment was associated with reduced clinical improvement at follow-up. Thus, within the evaluated group of BPD patients, the BOLD signal in the amygdala before treatment was related to clinical symptom reduction 1 year after the start of treatment. The results suggest that less PIT-related responsiveness of the amygdala increases the chances of treatment success. We note that the relatively small sample size is a limitation of this study and that replication is warranted. |
| first_indexed | 2024-04-11T11:10:40Z |
| format | Article |
| id | doaj.art-63dd0f1274d242b4b53e3cabfef96110 |
| institution | Directory Open Access Journal |
| issn | 1662-5153 |
| language | English |
| last_indexed | 2024-04-11T11:10:40Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Behavioral Neuroscience |
| spelling | doaj.art-63dd0f1274d242b4b53e3cabfef961102022-12-22T04:27:30ZengFrontiers Media S.A.Frontiers in Behavioral Neuroscience1662-51532022-08-011610.3389/fnbeh.2022.938403938403Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI studyDirk E. M. Geurts0Dirk E. M. Geurts1Thom J. Van den Heuvel2Thom J. Van den Heuvel3Quentin J. M. Huys4Robbert J. Verkes5Robbert J. Verkes6Roshan Cools7Roshan Cools8Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Scelta, Expert Centre for Personality Disorders, GGNet, Nijmegen, NetherlandsMental Health Neuroscience Department, Division of Psychiatry and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Institute of Neurology, University College London, London, United KingdomDepartment of Psychiatry, Radboud University Medical Center, Nijmegen, NetherlandsKairos Center for Forensic Psychiatry, Pro Persona Mental Health, Nijmegen, NetherlandsCentre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Nijmegen, NetherlandsBorderline personality disorder (BPD) is a prevalent, devastating, and heterogeneous psychiatric disorder. Treatment success is highly variable within this patient group. A cognitive neuroscientific approach to BPD might contribute to precision psychiatry by identifying neurocognitive factors that predict who will benefit from a specific treatment. Here, we build on observations that BPD is accompanied by the enhanced impact of the aversive effect on behavior and abnormal neural signaling in the amygdala. We assessed whether BPD is accompanied by abnormal aversive regulation of instrumental behavior and associated neural signaling, in a manner that is predictive of symptom reduction after therapy. We tested a clinical sample of 15 female patients with BPD, awaiting dialectical behavior therapy (DBT), and 16 matched healthy controls using fMRI and an aversive Pavlovian-to-instrumental transfer (PIT) task that assesses how instrumental behaviors are influenced by aversive Pavlovian stimuli. Patients were assessed 1 year after the start of DBT to quantify changes in BPD symptom severity. At baseline, behavioral aversive PIT and associated neural signaling did not differ between groups. However, the BOLD signal in the amygdala measured during aversive PIT was associated with symptom reduction at 1-year follow-up: higher PIT-related aversive amygdala signaling before treatment was associated with reduced clinical improvement at follow-up. Thus, within the evaluated group of BPD patients, the BOLD signal in the amygdala before treatment was related to clinical symptom reduction 1 year after the start of treatment. The results suggest that less PIT-related responsiveness of the amygdala increases the chances of treatment success. We note that the relatively small sample size is a limitation of this study and that replication is warranted.https://www.frontiersin.org/articles/10.3389/fnbeh.2022.938403/fullborderline personality disorderdialectical behavior therapy (DBT)fMRIamygdalaPavlovian-to-instrumental transfer |
| spellingShingle | Dirk E. M. Geurts Dirk E. M. Geurts Thom J. Van den Heuvel Thom J. Van den Heuvel Quentin J. M. Huys Robbert J. Verkes Robbert J. Verkes Roshan Cools Roshan Cools Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study Frontiers in Behavioral Neuroscience borderline personality disorder dialectical behavior therapy (DBT) fMRI amygdala Pavlovian-to-instrumental transfer |
| title | Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study |
| title_full | Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study |
| title_fullStr | Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study |
| title_full_unstemmed | Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study |
| title_short | Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study |
| title_sort | amygdala response predicts clinical symptom reduction in patients with borderline personality disorder a pilot fmri study |
| topic | borderline personality disorder dialectical behavior therapy (DBT) fMRI amygdala Pavlovian-to-instrumental transfer |
| url | https://www.frontiersin.org/articles/10.3389/fnbeh.2022.938403/full |
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