Evidence of abnormal amygdala functioning in borderline personality disorder: A functional MRI study

Background: Intense and rapidly changing mood states are a major feature of borderline personality disorder (BPD); however, there have only been a few studies investigating affective processing in BPD, and in particular no ne urofunctional correlates of abnormal emotional processing have been identif ied so far. Methods: Six female BPD patients without additional major psychiatric disor der and six age-matched female control subjects underwent functional magnet ic resonance imaging (fMRI) to measure regional cerebral hemodynamic change s following brain activity when viewing 12 standardized emotionally aversiv e slides compared to 12 neutral slides, which were presented in random orde r. Results: Our main finding it-as that BPD subjects but not control subjects were characterized by an elevated blood oxygenation level dependent fMRI si gnal in the amygdala on both sides. In addition, activation of the medial a nd inferolateral prefrontal cortex was seen in BPD patients. Both groups sh owed activation in the temporo-occipital cortex including the fusiform gyru s in BPD subjects but not in control subjects. Conclusions: Enhanced amygdala activation in BPD is suggested to reflect th e intense and slowly subsiding emotions commonly observed in response to ev en low-level stressors. Borderline subjects' perceptual cortex may be modul ated through the amygdala leading to increased attention to emotionally rel evant environmental stimuli. (C) 2001 Society of Biological Psychiatry.