Media Releases

New insights into the ‘borderline personality’ brain

January 17, 2013

TORONTO, ON — New work by Uni­ver­si­ty of Toron­to Scar­bor­ough researchers gives the best descrip­tion yet of the neur­al cir­cuits that under­lie a severe men­tal ill­ness called Bor­der­line Per­son­al­i­ty Dis­or­der (BPD), and could lead to bet­ter treat­ments and diag­no­sis.

The work shows that brain regions that process neg­a­tive emo­tions (for exam­ple, anger and sad­ness) are over­ac­tive in peo­ple with BPD, while brain regions that would nor­mal­ly help damp down neg­a­tive emo­tions are under­ac­tive.

Peo­ple with BPD tend to have unsta­ble and tur­bu­lent emo­tions which can lead to chaot­ic rela­tion­ships with oth­ers, and which put them at high­er risk than aver­age for sui­cide. A num­ber of brain imag­ing stud­ies have found dif­fer­ences in the func­tion of brains of peo­ple with BPD, but some of the stud­ies have been con­tra­dic­to­ry.

A team led by Antho­ny C. Ruoc­co, assis­tant pro­fes­sor in the Depart­ment of Psy­chol­o­gy and pro­gram in neu­ro­science, ana­lyzed data from 11 pre­vi­ous­ly pub­lished stud­ies and con­firmed a num­ber of impor­tant dif­fer­ences between peo­ple with BPD and those with­out.

On the one hand, a brain area called the insu­la – which helps deter­mine how intense­ly we expe­ri­ence neg­a­tive emo­tions – is hyper­ac­tive in peo­ple with BPD. On the oth­er hand, regions in the frontal part of the brain – which are thought to help us con­trol our emo­tion­al reac­tions – are under­ac­tive.

“It’s not just that they have too much dri­ve from their emo­tions,” Ruoc­co says. “They seem to have less of the ‘brakes’ to try to curb those emo­tions and to help reg­u­late their inten­si­ty.”

The find­ings fit well with symp­toms seen in peo­ple with BPD, Ruoc­co says. “The hall­mark symp­tom that peo­ple describe is emo­tion dys­reg­u­la­tion — you’re hap­py one moment, and the next moment you’re feel­ing angry or sad or depressed. Peo­ple with BPD can cycle through emo­tions, usu­al­ly neg­a­tive ones, quite rapid­ly.”

More impor­tant is how the find­ings might be use­ful in diag­no­sis and treat­ment. One chal­lenge is that BPD often occurs with oth­er dis­or­ders, such as major depres­sion, which can make it hard­er to iden­ti­fy and treat.

The new results raise the pos­si­bil­i­ty that brain imag­ing could be used to make a more defin­i­tive diag­no­sis of BPD. In the future it might also help deter­mine what treat­ments are most like­ly to be effec­tive for an indi­vid­ual patient, based on what the imag­ing stud­ies show about their brain func­tion before they even begin treat­ment, Ruoc­co says.

The results are pub­lished in the jour­nal Bio­log­i­cal Psy­chi­a­try.


For more infor­ma­tion, con­tact:

Don Camp­bell
Media & Com­mu­ni­ca­tions Assis­tant
Tel: 416–208-2938