PMID- 22637967 OWN - NLM STAT- MEDLINE DCOM- 20121213 LR - 20220316 IS - 1538-3636 (Electronic) IS - 0003-990X (Print) IS - 0003-990X (Linking) VI - 69 IP - 10 DP - 2012 Oct TI - Alterations in default mode network connectivity during pain processing in borderline personality disorder. PG - 993-1002 LID - 10.1001/archgenpsychiatry.2012.476 [doi] AB - 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. FAU - Kluetsch, Rosemarie C AU - Kluetsch RC AD - Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg and Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. FAU - Schmahl, Christian AU - Schmahl C AD - Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. FAU - Niedtfeld, Inga AU - Niedtfeld I AD - Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. FAU - Densmore, Maria AU - Densmore M AD - Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. FAU - Calhoun, Vince D AU - Calhoun VD AD - The Mind Research Network and Departments of Psychiatry, Electrical and Computer Engineering (Primary), Neurosciences, and Computer Science, University of New Mexico, Albuquerque, New Mexico. FAU - Daniels, Judith AU - Daniels J AD - Department of Psychiatry and Psychotherapy, Charite Universitatsmedizin Berlin, Berlin, Germany. FAU - Kraus, Anja AU - Kraus A AD - Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. FAU - Ludaescher, Petra AU - Ludaescher P AD - Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. FAU - Bohus, Martin AU - Bohus M AD - Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. FAU - Lanius, Ruth A AU - Lanius RA AD - Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. LA - eng GR - P20 GM103472/GM/NIGMS NIH HHS/United States GR - R01 EB006841/EB/NIBIB NIH HHS/United States GR - R01 EB000840/EB/NIBIB NIH HHS/United States GR - P20 RR021938/RR/NCRR NIH HHS/United States GR - R01 EB020407/EB/NIBIB NIH HHS/United States PT - Journal Article PL - United States TA - Arch Gen Psychiatry JT - Archives of general psychiatry JID - 0372435 SB - IM MH - Adult MH - Borderline Personality Disorder/*physiopathology MH - Case-Control Studies MH - Cerebral Cortex/physiology/*physiopathology MH - Female MH - Gyrus Cinguli/physiology/physiopathology MH - Humans MH - Magnetic Resonance Imaging/instrumentation/*methods MH - Nerve Net/physiology/*physiopathology MH - Pain Perception/*physiology MH - Prefrontal Cortex/physiology/physiopathology MH - Self-Injurious Behavior/physiopathology PMC - PMC4429518 MID - NIHMS687403 EDAT- 2012/05/29 06:00 MHDA- 2012/12/14 06:00 PMCR- 2015/05/13 CRDT- 2012/05/29 06:00 PHST- 2012/05/29 06:00 [entrez] PHST- 2012/05/29 06:00 [pubmed] PHST- 2012/12/14 06:00 [medline] PHST- 2015/05/13 00:00 [pmc-release] AID - 10.1001/archgenpsychiatry.2012.476 [doi] PST - ppublish SO - Arch Gen Psychiatry. 2012 Oct;69(10):993-1002. doi: 10.1001/archgenpsychiatry.2012.476.