I'm writing a paper on the role of the fronto-limbic network in Borderline Personality Disorder (BPD). In line with my stereotyped notion of BPD behavior, most of the literature seems to correlate BPD with an overactive amygdala-- during various cognitive and emotional tasks, as well as in resting states. The physiology involved is also closely linked with unprocessed trauma.
A compelling 2013 study observed fronto-limbic activity during an emotional processing task in BPD, Bipolar, and healthy control groups. Neuro-images captured the BPD and Bipolar groups diverging from healthy controls as they got more dysregulated: they both used less of the left dl-PFC and more of the right vl-PFC.
In the Bipolar set, this activated the dm-PFC, whose limbic connections soothed the amygdala. Behaviorally, I think this means they became aware of feeling dysregulated; they consciously attended, self-soothed, and gained perspective. In the BPD group, this didn't happen. This makes sense, since structures along the dm-PFC pathway are implicated in the "sense of self" known to be lacking in BPD. What they did find was that somehow, for BPD, activity in the amygdala was already diminished... suggesting a disordered bottom-up process.
I can't seem to understand this; I'm unsure of the timeline, whether there's a causal relationship between the lower left-brain activity and higher right-brain activity; and I don't understand it in the context of the vast majority of BPD/limbic literature, which seems contrasting. However, I am curious whether perhaps even BPD amygdala activity is highly circumstantial. Details such as where in the amygdala, which hemisphere, and what type of activity/connection, are not included here, neither are they usually specified in the literature. I believe there may be a subtype of BPD who shows reduced amygdala function not due to co-morbidity with another PD or psychopathy, but in response to pain, and that this could be linked to developing NSSI as a coping skill. Can anyone tell me more about this, or correct me? Is it related to dissociation? Is it related to this article? :)
I would really appreciate any explanations or information available about this! Most people would probably just leave that article out of the paper, :) but somehow I feel like without it, I'm missing a crucial piece. I've attached it for anyone willing to read-- it's very brief. Thank you SO MUCH!
I think this is an excellent question. Unfortunately, I can only fumble in the dark here as I am not that familiar with the intricacies involved. From what you say, I wonder if the soothing of the amygdala is what triggers the activation of the dmPFC of the BiPolar participant, but failed to do so for the BPD participants. rather than the other way around. I look forward to hearing from the experts!
John,
Thank you so much for your input; that's a fascinating suggestion. And thank you for your validating feedback about the question itself, as well.
-Corrina
Corrina, this is not exactly my field as I am involved with a clinical population that includes both BP and BPD, however I have noted that there is evidence in the literature for differential functioning of the left and right amygdala, for example in the area surrounding the right amydala there is decreased gray matter associated with depression, dissociation and pornography addiction, while in the left amydala projection zone there is decreased gray matter in defiant aggressive females.
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