境界性人格、感情馴化に問題
2014年01月21日 ソース：専門誌ピックアップ　 カテゴリ： 精神科疾患 ・神経内科疾患 ・検査に関わる問題

　境界性人格障害患者、健康な被験者、回避性人格障害患者を対象とし、感情馴化能力の低下が感情の不安定性の一因との仮説に基づいて神経行動的機構を検証。fMRIスキャン中に負の感情的写真を新規または反復して提示したところ、境界性人格患者は健康な被験者と異なり、写真(negative emotional pictures)による刺激に馴化できなかった。また、馴化中の神経活動が健康な被験者および回避性人格患者と異なった。

文献：Koenigsberg HW et al. The neural correlates of anomalous habituation to negative emotional pictures in borderline and avoidant personality disorder patients.　Am J Psychiatry. 2014 Jan 1;171(1):82-90.

【原文】
The neural correlates of anomalous habituation to negative emotional pictures in borderline and avoidant personality disorder patients.

Koenigsberg HW, Denny BT, Fan J, Liu X, Guerreri S, Mayson SJ, Rimsky L, New AS, Goodman M, Siever LJ.

Abstract
OBJECTIVE Extreme emotional reactivity is a defining feature of borderline personality disorder, yet the neural-behavioral mechanisms underlying this affective instability are poorly understood. One possible contributor is diminished ability to engage the mechanism of emotional habituation. The authors tested this hypothesis by examining behavioral and neural correlates of habituation in borderline patients, healthy comparison subjects, and a psychopathological comparison group of patients with avoidant personality disorder. METHOD During fMRI scanning, borderline patients, healthy subjects, and avoidant personality disorder patients viewed novel and repeated pictures, providing valence ratings at each presentation. Statistical parametric maps of the contrasts of activation during repeated versus novel negative picture viewing were compared between groups. Psychophysiological interaction analysis was employed to examine functional connectivity differences between groups. RESULTS Unlike healthy subjects, neither borderline nor avoidant personality disorder patients exhibited increased activity in the dorsal anterior cingulate cortex when viewing repeated versus novel pictures. This lack of an increase in dorsal anterior cingulate activity was associated with greater affective instability in borderline patients. In addition, borderline and avoidant patients exhibited smaller increases in insula-amygdala functional connectivity than healthy subjects and, unlike healthy subjects, did not show habituation in ratings of the emotional intensity of the images. Borderline patients differed from avoidant patients in insula-ventral anterior cingulate functional connectivity during habituation. CONCLUSIONS Unlike healthy subjects, borderline patients fail to habituate to negative pictures, and they differ from both healthy subjects and avoidant patients in neural activity during habituation. A failure to effectively engage emotional habituation processes may contribute to affective instability in borderline patients.
PMID: 24275960 [PubMed - in process]