Brain Scans on Borderlines Show Emotional Oversensitivity

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February 11th, 2009 Leave a comment Go to comments

(Click here for more coverage of Borderline Personality Disorder.)

Recent estimates are that about 6% of the US population suffers from Borderline Personality Disorder. The condition typically results in a range of symptoms involving emotional instability, lack of empathy for others, and increased suicidality with about 10% of Borderlines suffering death by suicide.

On January 17, 2009, Dr. Harold Koenigsberg of Mount Sinai School of Medicine announced his team’s findings that functional MRI scans of adults diagnosed with BPD show they have significant and detectable differences in brain operation versus adults without BPD.

One experiment compared 19 adults with BPD and 17 adults (the control subjects) without serious psychiatric conditions. The participants were monitored by a functional MRI scanner as they were shown a series of 10 images for 6 seconds each. Half the images were pleasant, the other half disturbing.

The scans showed that BPD victims have heightened blood flow in the brain’s visual and amygdala areas versus the controls. The amygdala is responsible for emotional regulation. The higher blood flow in the amygdala indicates increased emotional triggering which is consistent with findings that Borderlines are emotionally oversensitive and poorly regulated compared to those without BPD.

A second experiment compared 18 BPD patients with 16 healthy controls viewing neutral and disturbing images after being asked to attempt to view them with a detached perspective. Compared to the controls, the BPD patients showed almost no brain activity in areas believed responsible for regulating attention and resolving conflicting information. This is believed to show that the BPD patients have trouble integrating conflicting information.

The findings from these experiments indicate that functional brain differences exist between those with BPD and those without. They also suggest that functional MRI testing might eventually be developed into a diagnostic testing tool to help accurately diagnose mental illnesses such as BPD.

There is uncertainty as to how much of BPD is inherited genetically versus acquired environmentally. Many BPD patients were subjected to extreme chronic trauma during childhood such as extensive child abuse. But not all abused children develop BPD, and not all who have BPD were abused. Therefore it is believed that both genetic and environmental factors contribute to the development of BPD. Possibly some people are more genetically susceptible to development of BPD due to childhood trauma. Experiments such as those being done by Mount Sinai School of Medicine may someday help better determine the genetic component of BPD.

These experiments also raise the potential for a means to monitor brain function changes caused by medications. To date, there has been relatively little success treating BPD with psychiatric medications.

Perhaps more importantly, development of functional MRI scans to diagnose mental illness could be tremendously valuable. Improved diagnostic tools for BPD could accelerate diagnosis, help overcome the denial that many Borderline patients exhibit, and thereby enable effective therapy to begin sooner. The National Alliance for Mental Illness has reported that the average time in therapy to reach the BPD diagnosis is about five years. With BPD patients often causing significant harm to themselves and their families, getting them into effective treatment earlier would be highly beneficial.

Further Reading

Science News: People prone to stormy social lives display brain activity that may prompt oversensitivity to emotion and an inability to resolve conflicting information

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