Neurocircuitry associated with symptom dimensions at baseline and with change in borderline personality disorder

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Borderline personality disorder (BPD) is a serious illness associated with chronic suffering and self-injurious behavior. Parsing the relationships between specific symptom domains and their underlying biological mechanisms may help us further understand the neural circuits implicated in these symptoms and how they might be amenable to change with treatment. This study examines the association between symptom dimensions (Affective Disturbance, Cognitive Disturbance, Disturbed Relationships, and Impulsivity) and amygdala resting-state functional connectivity (RSFC) in a sample of adults with BPD (n = 18). We also explored the relationships between change in symptom dimensions and change in amygdala RSFC in a subset of this sample (n = 13) following 8 weeks of quetiapine or placebo. At baseline, higher impulsivity was associated with increased positive RSFC between right amygdala and left hippocampus. There were no significant differences in neural change between treatment groups. Improvement in cognitive disturbance was associated with increased positive RSFC between left amygdala and temporal fusiform and parahippocampal gyri. Improvement in disturbed relationships was associated with increased negative RSFC between right amygdala and frontal pole. These results support that specific dimensions of BPD are associated with specific neural connectivity patterns at baseline and with change, which may represent neural treatment targets.

Original languageEnglish (US)
Pages (from-to)58-65
Number of pages8
JournalPsychiatry Research - Neuroimaging
StatePublished - Aug 30 2019

Bibliographical note

Funding Information:
The authors thank all participants who contributed their time and effort for the present study as well as research staff that assisted with data collection including Alaa Houri, Ann Romine, and Ana Westervelt. Finally, the authors thank the late Dr. S. Charles Schulz for his work in the funding, design, and conceptualization of the present study. This study was supported in part by an investigator-initiated grant awarded to Dr. S. Charles Schulz from AstraZeneca ( D1443C00097 / IRUSQUET0454 ) to conduct the double-blind placebo-controlled trial portion of the study. These funds were also used for recruitment and clinical assessment. Neuroimaging costs for the present study were supported by internal funds through the University of Minnesota. AstraZeneca did not contribute to the study design or data collection, analysis, and interpretation. AstraZeneca also did not contribute to the decision to submit the article for publication.

Publisher Copyright:
© 2019 Elsevier B.V.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Borderline personality disorder
  • Neuroimaging
  • Resting-state functional connectivity
  • Symptom dimension


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