An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder

BERRUGA-SÁNCHEZ, MERCEDES; GOLDBERG, XIMENA; CARDONER, NARCÍS; MENCHÓN, JOSÉ M; STEWARD, TREVOR; WAINSZTEIN, AGUSTINA; CASTRO, MARIANA N; GUINJOAN, SALVADOR M; DE LA PEÑA-ARTEAGA, VÍCTOR; MARTÍNEZ-ZALACAÍN, IGNACIO; ABULAFIA, CAROLINA; VILLARREAL, MIRTA; SORIANO-MAS, CARLES

EUROPEAN PSYCHIATRY

ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER

Lugar: Paris; Año: 2021 p. 1 - 20

0924-9338

Background. One common denominator to the clinical phenotypes of borderline personalitydisorder (BPD) and major depressive disorder (MDD) is emotion regulation impairment.Although these two conditions have been extensively studied separately, it remains unclearwhether their emotion regulation impairments are underpinned by shared or distinct neurobiologicalalterations.Methods. We contrasted the neural correlates of negative emotion regulation across an adultsample of BPD patients (n = 19), MDD patients (n = 20), and healthy controls (HCs; n = 19).Emotion regulation was assessed using an established functional magnetic resonance imagingcognitive reappraisal paradigm. We assessed both task-related activations and modulations ofinterregional connectivity.Results. When compared to HCs, patients with BPD and MDD displayed homologousdecreased activation in the right ventrolateral prefrontal cortex (vlPFC) during cognitivereappraisal. In addition, the MDD group presented decreased activations in other prefrontalareas (i.e., left dorsolateral and bilateral orbitofrontal cortices), while the BPD group wascharacterized by a more extended pattern of alteration in the connectivity between the vlPFCand cortices of the visual ventral stream during reappraisal.Conclusions. This study identified, for the first time, a shared neurobiological contributor toemotion regulation deficits in MDD and BPD characterized by decreased vlPFC activity,although we also observed disorder-specific alterations. In MDD, results suggest a primarydeficit in the strength of prefrontal activations, while BPD is better defined by connectivitydisruptions between the vlPFC and temporal emotion processing regions. These findingssubstantiate, in neurobiological terms, the different profiles of emotion regulation alterationsobserved in these disorders.