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Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder
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 d...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176869/ https://www.ncbi.nlm.nih.gov/pubmed/37170093 http://dx.doi.org/10.1186/s12991-023-00449-y |
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author | Amiri, Saba Mirfazeli, Fatemeh Sadat Grafman, Jordan Mohammadsadeghi, Homa Eftekhar, Mehrdad Karimzad, Nazila Mohebbi, Maryam Nohesara, Shabnam |
author_facet | Amiri, Saba Mirfazeli, Fatemeh Sadat Grafman, Jordan Mohammadsadeghi, Homa Eftekhar, Mehrdad Karimzad, Nazila Mohebbi, Maryam Nohesara, Shabnam |
author_sort | Amiri, Saba |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10176869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101768692023-05-13 Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder Amiri, Saba Mirfazeli, Fatemeh Sadat Grafman, Jordan Mohammadsadeghi, Homa Eftekhar, Mehrdad Karimzad, Nazila Mohebbi, Maryam Nohesara, Shabnam Ann Gen Psychiatry Research 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. BioMed Central 2023-05-11 /pmc/articles/PMC10176869/ /pubmed/37170093 http://dx.doi.org/10.1186/s12991-023-00449-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Amiri, Saba Mirfazeli, Fatemeh Sadat Grafman, Jordan Mohammadsadeghi, Homa Eftekhar, Mehrdad Karimzad, Nazila Mohebbi, Maryam Nohesara, Shabnam Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title | Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title_full | Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title_fullStr | Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title_full_unstemmed | Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title_short | Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
title_sort | alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10176869/ https://www.ncbi.nlm.nih.gov/pubmed/37170093 http://dx.doi.org/10.1186/s12991-023-00449-y |
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