Các mạch xử lý cảm xúc bị thay đổi trong quá trình dự đoán các kích thích cảm xúc ở phụ nữ mắc rối loạn nhân cách biên giới

Springer Science and Business Media LLC - Tập 264 - Trang 45-60 - 2013
Sigrid Scherpiet1,2, Annette B. Brühl1, Sarah Opialla1,2, Lilian Roth1, Lutz Jäncke2, Uwe Herwig1,3
1Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
2Department of Neuropsychology, University of Zurich, Zurich, Switzerland
3Department of Psychiatry, University of Ulm, Ulm, Germany

Tóm tắt

Rối loạn nhân cách biên giới (BPD) liên quan đến sự rối loạn trong quá trình xử lý cảm xúc, thường bao gồm các phản ứng cảm xúc mãnh liệt và nhanh chóng đối với các kích thích cảm xúc. Trong nghiên cứu này, chúng tôi quan tâm đến việc liệu sự rối loạn cảm xúc trong BPD có diễn ra không chỉ trong quá trình cảm nhận các kích thích cảm xúc mà còn trong việc dự đoán các hình ảnh cảm xúc sắp tới khi không có kích thích cụ thể nào. Mười tám bệnh nhân nữ được chẩn đoán BPD và 18 đối tượng kiểm soát khỏe mạnh đã dự đoán các kích thích thị giác được gợi ý với trị số cảm xúc đã biết từ trước hoặc nội dung cảm xúc chưa biết trước trong khi chụp cộng hưởng từ chức năng. Hoạt động não trong quá trình dự đoán kích thích cảm xúc được so sánh giữa hai nhóm. Khi dự đoán các hình ảnh tiêu cực, bệnh nhân BPD thể hiện sự thay đổi tín hiệu ít hơn ở vỏ não cingulate lưng trái (dACC) và vỏ não cingulate giữa trái (MCC), cùng với sự kích hoạt tăng cường ở vỏ não cingulate pregenual trái, vỏ não cingulate sau trái (PCC) cũng như ở các khu vực vỏ não thị giác bên trái bao gồm vòng lưỡi. Trong quá trình dự đoán các kích thích được thông báo không rõ ràng, hoạt động não của BPD cũng giảm ở MCC trái kéo dài vào vùng vỏ não trước trán bên trong và hai bên. Kết quả cho thấy việc tuyển dụng kém các vùng não liên quan đến tương tác nhận thức-cảm xúc ngay cả trong giai đoạn dự đoán có thể làm gia tăng sự rối loạn cảm xúc trong BPD. Sự kích hoạt mạnh mẽ của PCC có thể tương ứng với việc tăng cường tham chiếu tự truyện trong BPD. Hơn nữa, hoạt động hình ảnh chuẩn bị tăng lên trong quá trình dự đoán tiêu cực có thể góp phần vào sự nhạy cảm quá mức đối với các tín hiệu cảm xúc trong rối loạn này.

Từ khóa

#Rối loạn nhân cách biên giới #xử lý cảm xúc #hoạt động não bộ #dự đoán kích thích cảm xúc #nhạy cảm cảm xúc

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