Neural correlates of the individual emotional Stroop in borderline personality disorder

Wingenfeld, Katja; Rullkoetter, Nina; Mensebach, Christoph; Beblo, Thomas; Mertens, Markus; Kreisel, Stefan; Toepper, Max; Driessen, Martin; Woermann, Friedrich G.

doi:10.1016/j.psyneuen.2008.10.024

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Volume 34, Issue 4 , Pages 571-586, May 2009

Neural correlates of the individual emotional Stroop in borderline personality disorder

Katja Wingenfeld
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
- Corresponding author at: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany. Tel.: +49 40 42803 4169.
Nina Rullkoetter
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
- University of Bielefeld, Department of Psychology, Bielefeld, Germany
Christoph Mensebach
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
Thomas Beblo
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
Markus Mertens
- Department of Epilepsy, fMRI Unit, Ev. Hospital Bielefeld, Bielefeld, Germany
Stefan Kreisel
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
- Department of Epilepsy, fMRI Unit, Ev. Hospital Bielefeld, Bielefeld, Germany
Max Toepper
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
Martin Driessen
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany
- University of Bielefeld, Department of Psychology, Bielefeld, Germany
- University Schleswig-Holstein, Campus Luebeck, Germany
Friedrich G. Woermann
- Department of Epilepsy, fMRI Unit, Ev. Hospital Bielefeld, Bielefeld, Germany

Received 18 June 2008; received in revised form 22 October 2008; accepted 22 October 2008.

Abstract

Objective

Emotional dysregulation is a key feature of borderline personality disorder (BPD) with altered inhibitory functions having suggested as being crucial. The anterior cingulate cortex and further prefrontal brain regions are crucial for response inhibition. The regulation of emotions is ensured via inhibitory control over the amygdala. The present study aimed to investigate neural correlates of response inhibition in BPD by using an emotional Stroop paradigm extending the task to word stimuli which were related to stressful life events.

Methods

Twenty BPD patients and 20 healthy controls underwent functional magnetic resonance imaging (fMRI) while performing the individual emotional Stroop task. A block design was used with the following word type conditions: neutral words, general negative words, and individual negative words. The individual negative words were recruited from a prior interview conducted with each participant.

Results

While BPD patients had overall slower reaction times in the Stroop task compared to healthy controls, there was no increased slowing with emotional interference. Controls exhibited significant fMRI blood oxygenation level-dependent signal increases in the anterior cingulate cortex as well as in frontal cortex contrasting generally negative vs. neutral and individual negative vs. neutral conditions, respectively. BPD patients did not show equivalent signal changes.

Conclusions

These results provide further evidence for a dysfunctional network of brain areas in BPD, including the ACC and frontal brain regions. These areas are crucial for the regulation of stress and emotions, the core problems of BPD patients.

Keywords: Borderline personality disorder, fMRI, Stroop task, Stress, Emotion, Cingulum