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D'Iorio A, Benedetto GLD, Santangelo G. A meta-analysis on the neuropsychological correlates of Borderline Personality Disorder: An update. Neurosci Biobehav Rev 2024; 165:105860. [PMID: 39173987 DOI: 10.1016/j.neubiorev.2024.105860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/28/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024]
Abstract
Previous research on Borderline Personality Disorder (BPD) demonstrated dysfunction across a broad range of cognitive domains. However, the limited number of neuropsychological studies on BPD and their occasionally conflicting results have precluded a clear characterization of the neuropsychological features associated with this personality disorder. Therefore, the main aim of the present study is to provide an updated overview of neuropsychological functions related to BPD. A meta-analysis of 36 studies was performed, comparing the performance of BPD patients and healthy controls (HCs) across several cognitive domains. Significant differences between BPD patients and HCs in multiple cognitive domains were found. The smallest effect size was observed for general executive function, while the largest effect sizes were found in the long-term spatial memory and inhibition domains. In conclusion, the neuropsychological profile of BPD, characterized by deficits in inhibition as well as attention, memory, and executive functions, can result in difficulties in performing everyday activities. Accordingly, assessing neuropsychological functions could assist clinicians in developing more targeted non-pharmacological treatments.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
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Calancie OG, Parr AC, Brien DC, Coe BC, Booij L, Khalid-Khan S, Munoz DP. Impairment of Visual Fixation and Preparatory Saccade Control in Borderline Personality Disorder With and Without Comorbid Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00191-5. [PMID: 39032694 DOI: 10.1016/j.bpsc.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/31/2024] [Accepted: 07/04/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Borderline personality disorder (BPD) is associated with heightened impulsivity, evidenced by increased substance abuse, self-harm, and suicide attempts. Addressing impulsivity in individuals with BPD is a therapeutic objective, but its underlying neural basis in this clinical population remains unclear, partly due to its frequent comorbidity with attention-deficit/hyperactivity disorder (ADHD). METHODS We used a response inhibition paradigm-the interleaved pro-/antisaccade task-among adolescents diagnosed with BPD with and without comorbid ADHD (n = 25 and n = 24, respectively) during concomitant video-based eye tracking. We quantified various eye movement response parameters reflective of impulsive action during the task, including delay to fixation acquisition, fixation breaks, anticipatory saccades, and direction errors with express saccade (saccade reaction time: 90-140 ms) and regular saccade latencies (saccade reaction time > 140 ms). RESULTS Individuals with BPD exhibited deficient response preparation, as evidenced by reduced visual fixation on task cues and greater variability of saccade responses (i.e., saccade reaction time and peak velocity). The ADHD/BPD group shared these traits and made more anticipatory responses and direction errors with express saccade latencies and reduced error correction. CONCLUSIONS Saccadic deficits in BPD and ADHD/BPD stemmed not from an inability to execute antisaccades but rather from inadequate preparation for the upcoming task set. These distinctions may arise due to abnormal signaling in cortical areas like the frontal eye fields, posterior parietal cortex, and anterior cingulate cortex. Understanding these mechanisms could provide insights into targeted interventions focusing on task set preparation to manage response inhibition deficits in BPD and ADHD/BPD.
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Affiliation(s)
- Olivia G Calancie
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada; School of Medicine, Queen's University, Kingston, Ontario, Canada.
| | - Ashley C Parr
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Don C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Linda Booij
- Department of Psychiatry, McGill University, Montreal, Québec, Canada; Research Centre and Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Sarosh Khalid-Khan
- School of Medicine, Queen's University, Kingston, Ontario, Canada; Division of Child and Youth Psychiatry, Department of Psychiatry, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Doug P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
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Cao W, Liu Y, Zhong M, Liao H, Cai S, Chu J, Zheng S, Tan C, Yi J. Altered intrinsic functional network connectivity is associated with impulsivity and emotion dysregulation in drug-naïve young patients with borderline personality disorder. Borderline Personal Disord Emot Dysregul 2023; 10:21. [PMID: 37331972 DOI: 10.1186/s40479-023-00227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/31/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Despite impulse control and emotion regulation being altered in borderline personality disorder (BPD), the specific mechanism of these clinical features remains unclear. This study investigated the functional connectivity (FC) abnormalities within- and between- default mode network (DMN), salience network (SN), and central executive network (CEN) in BPD, and examined the association between aberrant FC and clinical features. We aimed to explore whether the abnormal large-scale networks underlie the pathophysiology of impulsivity and emotion dysregulation in BPD. METHODS Forty-one young, drug-naïve patients with BPD (24.98 ± 3.12 years, 20 males) and 42 healthy controls (HCs; 24.74 ± 1.29 years, 17 males) were included in resting-state functional magnetic resonance imaging analyses. Independent component analysis was performed to extract subnetworks of the DMN, CEN, and SN. Additionally, partial correlation was performed to explore the association between brain imaging variables and clinical features in BPD. RESULTS Compared with HCs, BPD showed significant decreased intra-network FC of right medial prefrontal cortex in the anterior DMN and of right angular gyrus in the right CEN. Intra-network FC of right angular gyrus in the anterior DMN was significantly negatively correlated with attention impulsivity in BPD. The patients also showed decreased inter-network FC between the posterior DMN and left CEN, which was significantly negatively correlated with emotion dysregulation. CONCLUSION These findings suggest that impaired intra-network FC may underlie the neurophysiological mechanism of impulsivity, and abnormal inter-network FC may elucidate the neurophysiological mechanism of emotion dysregulation in BPD.
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Affiliation(s)
- Wanyi Cao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Medical Psychological Institute, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Ying Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Medical Psychological Institute, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Mingtian Zhong
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Haiyan Liao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sainan Cai
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jun Chu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Medical Psychological Institute, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Shuxin Zheng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
- Medical Psychological Institute, Central South University, Changsha, China.
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China.
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Beblo T, Saavedra AS, Mensebach C, Lange W, Markowitsch HJ, Rau H, Woermann FG, Driessen M. Deficits in visual functions and neuropsychological inconsistency in Borderline Personality Disorder. Psychiatry Res 2006; 145:127-35. [PMID: 17070927 DOI: 10.1016/j.psychres.2006.01.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Revised: 01/05/2006] [Accepted: 01/08/2006] [Indexed: 11/30/2022]
Abstract
For Borderline Personality Disorder (BPD) cognitive and perceptual impairments were reported in some but not all studies. The aim of the present study was to analyze the neuropsychological performance of BPD patients in different domains. Predominant impairments of visual functions and an increased intra-individual variation of test performances within neuropsychological domains were expected. We investigated 22 patients with BPD and a matched sample of 22 healthy control subjects. A comprehensive clinical and neuropsychological test battery was administered. Effect sizes indicate primarily deficits of visual functions such as visual memory (Wechsler Memory Scale-Revised, WMS-R: Visual pair associates and visual reproduction, Complex Figure Test: Recall) and visuo-spatial abilities (Leistungspruefsystem, LPS 9 and 10: Spatial imagination and embedded figures), but also of executive functions (Tower of Hanoi, Trail Making Test-B, semantic and figural fluency, LPS 4: Reasoning). In addition, the intra-individual ranges of neuropsychological test results in BPD patients were increased compared to those of healthy subjects. This finding might be due to a high degree of temporary stress that interferes with effective cognitive processing. Further research is needed to confirm the present results and to control for stress during the test procedure.
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Affiliation(s)
- Thomas Beblo
- Division of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany.
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