One-year functional magnetic resonance imaging follow-up study of neural activation during the recall of unresolved negative life events in borderline personality disorder

Background. Recall of adverse life events under brain imaging conditions has been shown to coincide with activation of limbic and prefrontal brain areas in borderline personality disorder (BPD). We investigate changes of functional magnetic resonance imaging (fMRI) activation patterns during the recall Of unresolved adverse life events (ULE) over 1 year. Method. Thirteen female BPD patients participated in the study During fMRI measurement subjects recalled ULE and negative but resolved life events (RLE) after individual cue words to Stimulate autobiographical memory, retrieval. Subjective intensity of emotional and sensoric experiences during recall was assessed as well as standardized measures of psychopathology. Results. A 2 x 2 factorial analysis of fMRI data (Delta t1/t2 x Delta ULE/RLE) revealed major right more than left differences of activation (i.e. t1 > t2) of the posterior more than anterior cingulate, superior temporal lobes, insula, and right middle and superior frontal lobes (second-level analysis, t = 3.0, p(uncorrected) = 0.003). The opposite contrast (Delta t2/t1 x Delta ULE/RLE) did not reveal an), differences. We did not find changes of emotional or sensoric qualities during recall (ULF versus RLE) or of psychopathology measures over the 1-year period. Conclusions. Although subjective and clinical data did not change within 1 year, we observed a substantial decrease of temporo-frontal activation during the recall of ULF from t1 to t2 If future research confirms these findings, the question arises whether the decrease of neural activation precedes clinical improvement in BPD.