Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder.

IF 3.6 3区 医学 Q1 PSYCHIATRY
Saba Amiri, Fatemeh Sadat Mirfazeli, Jordan Grafman, Homa Mohammadsadeghi, Mehrdad Eftekhar, Nazila Karimzad, Maryam Mohebbi, Shabnam Nohesara
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Abstract

Background: Borderline personality disorder (BPD) is characterized by impairments in emotion regulation, impulse control, and interpersonal and social functioning along with a deficit in emotional awareness and empathy. In this study, we investigated whether functional connectivity (FC) within the default mode network (DMN) is affected by 1-year psychodynamic psychotherapy in patients with BPD.

Methods: Nine BPD patients filled out the demography, Interpersonal Reactive Index (IRI), Toronto Alexithymia Scale 20 (TAS 20), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the Borderline Evaluation Severity over Time (BEST) questionnaire. The BPD group (9F) and the control group (9F) had a mean ± SD age of 28.2 ± 5.3 years and 30.4 ± 6.1 years, respectively. BPD subjects underwent longitudinal resting-state fMRI before psychodynamic psychotherapy and then every 4 months for a year after initiating psychotherapy. FC in DMN was characterized by calculating the nodal degree, a measure of centrality in the graph theory.

Results: The results indicated that patients with BPD present with aberrant DMN connectivity compared to healthy controls. Over a year of psychotherapy, the patients with BPD showed both FC changes (decreasing nodal degree in the dorsal anterior cingulate cortex and increasing in other cingulate cortex regions) and behavioral improvement in their symptoms and substance use. There was also a significant positive association between the decreased nodal degree in regions of the dorsal cingulate cortex and a decrease in the score of the TAS-20 indicating difficulty in identifying feelings after psychotherapy.

Conclusion: In BPD, there is altered FC within the DMN and disruption in self-processing and emotion regulation. Psychotherapy may modify the DMN connectivity and that modification is associated with positive changes in BPD emotional symptoms.

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边缘型人格障碍心理动力治疗后默认模式网络功能连通性的变化。
背景:边缘型人格障碍(BPD)以情绪调节、冲动控制、人际和社会功能障碍为特征,并伴有情绪意识和共情的缺陷。在这项研究中,我们调查了1年心理动力学治疗是否会影响BPD患者默认模式网络(DMN)内的功能连接(FC)。方法:9例BPD患者填写人口学、人际反应指数(IRI)、多伦多述情障碍量表20 (TAS 20)、酒精、吸烟和物质介入筛查测试(ASSIST)和时间边界严重程度评估(BEST)问卷。BPD组(9F)和对照组(9F)的平均±SD年龄分别为28.2±5.3岁和30.4±6.1岁。BPD受试者在心理动力治疗前进行纵向静息状态功能磁共振成像,然后在开始心理治疗后每4个月进行一次。DMN中的FC通过计算节点度(图论中的中心性度量)来表征。结果:与健康对照相比,BPD患者存在DMN连接异常。经过一年的心理治疗,BPD患者在症状和物质使用方面表现出FC改变(前扣带皮层背侧结度降低,其他扣带皮层区域结度增加)和行为改善。扣带回背区结度的降低与心理治疗后识别情感困难的TAS-20分数的降低之间也存在显著的正相关。结论:BPD患者DMN内FC发生改变,自我加工和情绪调节功能受到干扰。心理治疗可能改变DMN连通性,这种改变与BPD情绪症状的积极变化有关。
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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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