Altered intrinsic functional network connectivity is associated with impulsivity and emotion dysregulation in drug-naïve young patients with borderline personality disorder.

BACKGROUND: Despite impulse control and emotion regulation being altered in borderline personality disorder (BPD), the specific mechanism of these clinical features remains unclear. This study investigated the functional connectivity (FC) abnormalities within- and between- default mode network (DMN), salience network (SN), and central executive network (CEN) in BPD, and examined the association between aberrant FC and clinical features. We aimed to explore whether the abnormal large-scale networks underlie the pathophysiology of impulsivity and emotion dysregulation in BPD. METHODS: Forty-one young, drug-naïve patients with BPD (24.98 ± 3.12 years, 20 males) and 42 healthy controls (HCs; 24.74 ± 1.29 years, 17 males) were included in resting-state functional magnetic resonance imaging analyses. Independent component analysis was performed to extract subnetworks of the DMN, CEN, and SN. Additionally, partial correlation was performed to explore the association between brain imaging variables and clinical features in BPD. RESULTS: Compared with HCs, BPD showed significant decreased intra-network FC of right medial prefrontal cortex in the anterior DMN and of right angular gyrus in the right CEN. Intra-network FC of right angular gyrus in the anterior DMN was significantly negatively correlated with attention impulsivity in BPD. The patients also showed decreased inter-network FC between the posterior DMN and left CEN, which was significantly negatively correlated with emotion dysregulation. CONCLUSION: These findings suggest that impaired intra-network FC may underlie the neurophysiological mechanism of impulsivity, and abnormal inter-network FC may elucidate the neurophysiological mechanism of emotion dysregulation in BPD.

Application of Cognitive Emotion Regulation Questionnaire in Chinese Community Elderly.

Background: The present study investigated the applicability of the Cognitive Emotion Regulation Questionnaire (CERQ) in the Chinese community elderly and explored the influence of cognitive emotion regulation strategies on late-life depression. Methods: A total of 367 community elderly aged 60-94 were deemed eligible and completed CERQ, the Perceived Stress Scale-10, the Geriatric Depression Questionnaire-15, and the State Anxiety Inventory. Confirmatory factor analysis was adopted to verify the 9-factor structure of CERQ. Cronbach's α coefficient, Ω coefficient and split-half reliability were used to test the internal consistency of CERQ. Pearson correlations among scores of CERQ and other scales were calculated to examine its convergent validity. In addition, a structural equation model was used to further examine the effect of cognitive emotion regulation strategies on the association between perceived stress and late-life depression. Results: All the fitting indexes of CERQ's 9-factor model met the criterion (χ 2/df= 2.26, CFI= 0.916, TLI= 0.904, RMSEA= 0.052). For the total score of CERQ, the Cronbach's α coefficient and Ω coefficient were both 0.90, and the split-half reliability was 0.74. For the nine subscales, the α coefficients ranged from 0.66 to 0.88, and the Ω coefficients ranged from 0.69 to 0.88. Significant positive correlations were found between the maladaptive dimension of CERQ and other scales (all p < 0.001). The maladaptive emotion regulation strategies indirectly affected the effect of perceived stress on late-life depression (effect size was 21.57%). Conclusion: With good reliability and factor validity, the CERQ showed good applicability in the Chinese elderly population. The influence of perceived stress on depression in the elderly was mediated by maladaptive emotion regulation strategies.

Right amygdala-right precuneus connectivity is associated with childhood trauma in major depression patients and healthy controls.

The present study investigated the effect of childhood trauma (CT) on amygdala and hippocampus functional connectivity (FC) and the association with clinical presentations of major depressive disorder (MDD). Participants included 73 MDD patients (42 with moderate-to-severe CT and 31 with no or low CT) and 64 healthy controls (HC; 30 with moderate-to-severe CT and 34 with no or low CT). Seed-based whole-brain resting-state FC analyses were performed with seeds located in amygdala and hippocampus. Individuals with moderate-to-severe CT, irrespective of MDD diagnosis, had decreased right amygdala-right precuneus connectivity compared to those with no or low CT. Right amygdala-right precuneus connectivity was significantly correlated with physical and social trait anhedonia in MDD. Mediation effects of this FC on relationship between CT (specifically neglect but not abuse) and trait anhedonia in MDD were significant. MDD patients demonstrated increased right amygdala-left middle frontal gyrus FC, decreased right amygdala-right medial superior frontal gyrus (mSFG) FC and decreased right hippocampus-bilateral mSFG FC relative to HC. Findings highlight the effect of CT on right amygdala-right precuneus FC irrespective of MDD diagnosis. FC of right amygdala-right precuneus may be involved in the mechanism linking CT and depression through its association with trait anhedonia.

Correlates of poor insight: A comparative fMRI and sMRI study in obsessive-compulsive disorder and schizo-obsessive disorder.

BACKGROUND: Despite the several researches on the correlates of insight in psychosis, less is known regarding the specificity of disease diagnosis on the relationship between insight and the correlates. The current study sought to explore the effects of insight and disease diagnosis on those in patients with obsessive-compulsive disorder (OCD) and patients with schizo-obsessive disorder (SOD). METHODS: We evaluated clinical symptoms and neurocognitions among 111 patients (including 41 OCD with good insight, 40 OCD with poor insight, 14 SOD with good insight and 16 SOD with poor insight. Gray matter volume and spontaneous neural activity were also examined by analyzing the voxel-based morphometry and amplitude of low frequency fluctuation (ALFF), respectively. RESULTS: Interactive effects of insight and diagnosis was found on working memory and the gray matter volume in right superior and middle temporal gyrus. Main effect of insight was found on working and visual memory, compulsion and obsession, and ALFF in right middle and superior occipital cortex. Main effect of diagnosis was found on severity of compulsion, relative verbal IQ, executive function, verbal and visual memory, working memory and ALFF in precuneus, medial superior frontal gyrus, anterior cingulate and paracingulate gyri, and inferior parietal, postcentral gyrus, paracentral lobule. CONCLUSIONS: As a common feature in mental disorders, insight has its own special influence on neurocognition and possible structural/functional alterations in brain, and the influence is partly dependent of disease diagnosis.

Modern lifestyle risks associated with alcohol consumption and cigarette smoking in Ukraine.

Background: Substance uses confer huge risks for public health in modern society. This study aimed to evaluate current factors related to alcohol drinking and tobacco smoking in the republic of Ukraine. Methods: We distributed a questionnaire to healthy volunteers in four Ukrainian regions and collected 929 responses regarding demographic information, reasons for starting substance use, substance use family history, environmental factors, use pattern (internet, drinking or smoking), consequences of drinking, and insomnia. Linear regression and logistic regression analyses were performed to identify factors related to alcohol drinking and cigarette smoking. Results: Aging appeared to attenuate either drinking or smoking. To reduce school- or job-related stress, staying awake, peer pressure, friend-related issues, or to increase sexual desire and single parenting all would trigger drinking; male gender, family divorce, unhealthy diet and lack of awareness about harmful consequences were the main factors leading to smoking. Logistic regression suggested that education background, sleep problems, celebration events and lengthy internet work all could contribute to drinking. Conclusions: Various real-world factors related to substance uses were identified for the public of Ukraine. A validated instrument would help to identify risk factors in patients with substance use disorders.

Childhood trauma is associated with social anhedonia and brain gray matter volume differences in healthy subjects.

The present study tested the effects of childhood trauma (CT) on trait social anhedonia (SA) and on gray matter volume (GMV) and explored the possible relationships among CT, SA and brain GMV. Forty-three healthy individuals with experience of moderate-to-severe CT and sixty-eight individuals with no or low CT participated in the present study. Trait SA was evaluated using the Revised Social Anhedonia Scale. GMV was measured using voxel-based morphometry. Participants with moderate-to-severe CT had elevated trait SA, as well as brain volumetric differences in left inferior parietal lobule (IPL), left precuneus, right insula, left superior temporal gyrus, and left middle occipital gyrus extending into middle temporal gyrus relative to participants with no or low level of CT. CT was also found to be positively correlated with GMV in right dorsolateral prefrontal cortex (DLPFC) and bilateral precuneus. Partial mediation effect of GMV in left IPL and right DLPFC on the relationship between CT and trait SA was significant. These findings suggest that CT may have effects on trait SA and on GMV of widespread brain regions. GMV differences in DLPFC and left IPL may mediate the effect of CT on trait SA, although this needs to be verified by future longitudinal studies.

Psychological resilience and daily stress mediate the effect of childhood trauma on depression.

OBJECTIVE: Childhood trauma (CT) is a well-recognized distal risk factor for depression. Previous studies suggested that the psychological mechanism of the impact of childhood trauma on depression may be attributed to some mediators such as daily stress and psychological resilience. This study aimed to assess how daily stress and resilience affect the relationship between childhood trauma and depression in adult clinical context. METHOD: In this cross-section survey, a total of 569 clinical patients with psychological disorders completed a series of psychological scales such as the Childhood Trauma Questionnaire (CTQ), the Center for Epidemiologic Studies Depression Scale (CESD), the Perceived Stress Scale (PSS) and Connor-Davidson Resilience Scale (CD-RISC). To show the relationship among childhood trauma, psychological resilience, daily stress and depression, structural equation modeling (SEM) was performed. RESULTS: The results indicated that psychological resilience and daily stress partially mediated the relationship between childhood trauma and depressive symptoms. Childhood trauma not only exerted direct effect on depressive symptoms, but also had indirect effect through the mediation pathway (resilience â†’ daily stress) on depressive symptoms. The chain mediation pathway through resilience and daily stress was weighted 43.31%. CONCLUSIONS: The study provides novel evidence on the underlying process between childhood trauma and depression. The distal factor childhood trauma can influence the latter depression by the chain effect of psychological resilience and daily stress. Therefore, some clinical interventions to improve psychological resilience to carry off daily stress are the way to reduce the impact of childhood trauma on depression.

Impaired white matter microstructure associated with severe depressive symptoms in patients with PD.

Depression is a common occurrence in patients with Parkinson's disease (PD); however, its pathophysiology is still unclear. This study assessed the association between the integrity of white matter and depressive symptoms in patients with PD. 67 patients with PD were divided into a non-depressed PD group (ndPD, n = 30) and a depressed PD group (dPD, n = 37). The dPD group was further subdivided into a mild-moderately depressed PD (mdPD, n = 22) and a severely depressed PD group (sdPD, n = 15). Tract-Based Spatial Statistics was used to compare fractional anisotropy (FA) between groups. Region-of-interest analysis was used to explore changes in diffusivity indices in the regions showing FA abnormalities. The sdPD patients exhibited significantly reduced FA in the left superior longitudinal fasciculus, uncinate fasciculus, anterior corona radiata, corticospinal tract, and bilateral inferior fronto-occipital fasciculus when compared with the ndPD patients, but the decreased FA was within a smaller area when compared with the mdPD patients. No significant difference in FA was found between the mdPD and ndPD groups. Among the dPD patients, FA values in the left superior longitudinal fasciculus negatively correlated with BDI scores. Impaired white matter integrity in the prefronto-limbic/temporal circuitry, mainly in the left hemisphere, is associated with severe, but not mild-moderate depressive symptoms in patients with PD.

Aggression in borderline personality disorder: A systematic review of neuroimaging studies.

Aggressive behaviors are prevalent among patients with Borderline Personality Disorder (BPD). Neuroimaging studies have linked aggression in BPD patients to neurochemical, structural, functional, and metabolic alterations in various brain regions, especially in frontal-limbic areas. This systematic review summarizes current neuroimaging results on aggression among BPD patients and provides an overview of relevant brain mechanisms. A systematic search of PubMed and Web of Science databases, in addition to manual check of references, identified thirty-two eligible articles, including two magnetic resonance spectrum (MRS), thirteen structural magnetic resonance imaging (sMRI), six functional magnetic resonance imaging (fMRI), and eleven positron emission tomography (PET) studies. The reviewed studies have highlighted the abnormalities in prefrontal cortices and limbic structures including amygdala and hippocampus. Less studies have zoomed in the roles of parietal and temporal regions or taken a network perspective. Connectivity studies have shed light on the importance of the frontal-limbic interactions in regulating aggression. Conflicted findings might be attributed to disparity in controlling gender, anatomical subdivisions, and comorbidities, which shall be considered in future studies.

Factor structure and measurement invariance of the Chinese version of the Center for Epidemiological Studies Depression (CES-D) scale among undergraduates and clinical patients.

BACKGROUND: The Center for Epidemiologic Studies Depression scale (CESD) was widely used for screening of depressive symptoms. The purpose of the current study was to investigate the factor structure and measurement invariance of the CESD across genders and groups in a sample of Chinese undergraduates and clinical patients. METHODS: Participants included 3093 undergraduates from the Hunan province and 336 patients from psychological clinics. The structure of the CESD scale was analyzed by confirmatory factor analysis (CFA). Multiple sets of CFAs were used to test measurement invariance across genders among undergraduates and clinical patients. Internal consistency reliability was also evaluated. RESULTS: The five-factor model achieved satisfactory fit (in the undergraduate sample: WLSMVχ2 = 1662.385, df = 160, CFI = 0.973, TLI = 0.968, RMSEA = 0.055; in the clinical patients: WLSMVχ2 = 502.089, df = 160, CFI = 0.962, TLI = 0.955, RMSEA = 0.072). The measurement invariance of the five-factor model across genders was supported fully assuming different degrees of invariance. The CESD also showed acceptable internal consistency. CONCLUSION: Due to its sound structure and measurement invariance, the five-factor model of the CESD is best suited for testing in Chinese mainland college students and clinical patients.

Impaired impulse inhibition of emotional stimuli in patients with borderline personality disorder.

This study was aimed to investigate whether BPD patients showed impaired impulse inhibition of emotional and non-emotional stimuli and to explore relevant neuroelectrophysiological mechanisms. A total of 32 BPD patients and 32 matched healthy controls were recruited. Self-reported scales were used to measure psychiatric symptoms. The event-related potentials (ERPs) were recorded when subjects were performing neutral and emotional Stop Signal Task (SST). Group differences in self-reported scores, behavioral variables and ERPs were compared. The BPD group scored significantly higher on impulsivity, severity of BPD symptoms, levels of depression and anxiety than the control group. In neutral SST, no significant group differences were detected in the amplitude and latency of ERPs components induced. In emotional SST, the P2 amplitude of negative emotion was significantly larger than that of neutral emotion in Go trials. In Stop trials, the P2 amplitude of BPD group was significantly smaller than that of control group, and the N2 amplitude of BPD group was significantly greater than that of control group. BPD patients showed impaired inhibition of emotional stimuli rather than non-emotional stimuli. The deficits of emotional impulse control mainly exhibit at the early attention, stimulus evaluation and conflict detection stages.

Increased functional interaction within frontoparietal network during working memory task in major depressive disorder.

Abnormal fronto-parietal activation has been suggested as a neural underpinning of the working memory (WM) deficits in major depressive disorder (MDD). However, the potential interaction within the frontoparietal network during WM processing in MDD remains unclear. This study aimed to examine the role of abnormal functional interactions within frontoparietal network in the neuropathological mechanisms of WM deficits in MDD. A total of 40 MDD patients and 47 demographic matched healthy controls (HCs) were included. Functional magnetic resonance imaging and behavioral data were collected during numeric n-back tasks. The psychophysiological interaction and dynamic causal modelling methods were applied to investigate the connectivity within the frontoparietal network in MDD during n-back tasks. The psychophysiological interaction analysis revealed that MDD patients showed increased functional connectivity between the right inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (dlPFC) compared with HCs during the 2-back task. The dynamic causal modelling analysis revealed that MDD patients had significantly increased forward modulation connectivity from the right IPL to the right dlPFC than HCs during the 2-back task. Partial correlation was used to calculate the relationship between connective parameters and psychological variables in the MDD group, which showed that the effective connectivity from right IPL to right dlPFC was correlated negatively with the sensitivity index d' of WM performances and positively with the depressive severity in MDD group. In conclusion, the abnormal functional and effective connectivity between frontal and parietal regions might contribute to explain the neuropathological mechanism of working memory deficits in major depressive disorder.

Changes in Degree Centrality of Network Nodes in Different Frequency Bands in Parkinson's Disease With Depression and Without Depression.

BACKGROUND: Depression induces an early onset of Parkinson's disease (PD), aggravates dyskinesia and cognitive impairment, and accelerates disease progression. However, it is very difficult to identify and diagnose PD with depression (PDD) in the early clinical stage. Few studies have suggested that the changes in neural networks are associated with PDD, while degree centrality (DC) has been documented to be effective in detecting brain network changes. OBJECTIVES: The objectives of this study are to explore DC changes between patients with PDD and without depression (PDND) and to find the key brain hubs involved with depression in PD patients. METHODS: One hundred and four PD patients and 54 healthy controls (HCs) underwent brain resting-state functional magnetic resonance imaging. The Data Processing and Analysis of Brain Imaging and Resting-State Functional Magnetic Resonance Data Analysis Toolkit were used for processing and statistical analysis. The DC value of each frequency band was calculated. One-way analysis of variance and a two-sample t-test for post hoc comparison were used to compare the differences of the DC values in different frequency bands among PDD, PDND, and healthy control group. Gaussian random field was used for multiple comparison correction. Pearson correlation analysis was performed between each individual's DC map and clinical indicators. RESULTS: The DC value of different brain regions changed in PDD and PDND in different frequency bands. The prefrontal lobe, limbic system, and basal ganglia were the main brain regions involved. PDD patients showed a wider range and more abnormal brain areas in the slow-4 frequency band (0.027-0.073 Hz) compared to the HCs. PDD showed a decreased DC value in the medial frontal gyrus, bilateral cuneus gyrus, right lingual gyrus, bilateral supplementary motor area (SMA), bilateral superior frontal gyrus, and left paracentral lobule, but an increased DC value in the bilateral brainstem, midbrain, bilateral parahippocampal gyrus, cerebellum, left superior temporal gyrus, bilateral insula, left fusiform gyrus, and left caudate nucleus in the traditional frequency band (0.01-0.08 Hz) compared to PDND patients. PDND patients displayed more abnormal functions in the basal ganglia in the slow-4 frequency band. CONCLUSION: The DC changes in PDD and PDND are frequency dependent and frequency specific. The medial frontal gyrus, SMA, and limbic system may be the key hubs for depression in PD.

Insecure attachment and maladaptive emotion regulation mediating the relationship between childhood trauma and borderline personality features.

BACKGROUND: Previous studies suggested that childhood trauma is an important etiologic factor for the development of borderline personality disorder (BPD). Moreover, insecure attachment and maladaptive emotion regulation (ER) might be related to childhood trauma and BPD. This study was aimed to explore the relationships among childhood trauma, insecure attachment, maladaptive ER, and BPD features. METHODS: A cohort of 637 patients with psychological disorders completed a series of psychometric instruments such as the Personality Diagnostic Questionnaire-4+ (PDQ-4+), the 23-Item Borderline Symptom List, the Childhood Trauma Questionnaire, the Attachment Style Questionnaire, and the Cognitive Emotion Regulation Questionnaire. The path analyses were conducted to investigate the experience-driven model that whether insecure attachment and maladaptive ER could mediate the relationship between childhood trauma and BPD features. The random forest regression was performed to select variables that contribute significantly to BPD features, which variables would be incorporated into the data-driven model to further confirm the experience-driven model. RESULTS: Both the experience-driven model and the data-driven model verified that there were three significant mediation pathways (childhood trauma → insecure attachment/maladaptive ER → BPD features, childhood trauma → insecure attachment → maladaptive ER → BPD features; all p < .05), and the most weighted mediation pathway by which childhood trauma influencing the BPD features was through insecure attachment and then through maladaptive ER (weighted 53.16%). CONCLUSION: The influence of childhood trauma on BPD features was mainly mediated by the combination of insecure attachment and maladaptive emotion regulation.

Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls.

Childhood trauma (CT) is a well-established risk factor for major depressive disorder (MDD). However, the underlying mechanism linking CT and MDD remains not fully understood. The present study tested the hypothesis that CT have effects on specific types of anhedonia in depression via reward system. To do so, we evaluated different aspects of anhedonia and resting-state functional connectivity (FC) in reward system among 66 patients with MDD (44 with moderate-to-severe and 22 with no or low CT), and 57 healthy controls (HC; 23 with moderate-to-severe and 34 with no or low CT). Results showed that MDD patients with moderate-to-severe CT suffered more severe state anhedonic depression than patients with no or low level of CT. Individuals with moderate-to-severe CT, irrespective of MDD diagnosis, had elevated physical, social and anticipatory but not consummatory trait anhedonia, and demonstrated decreased left nucleus accumbens (NAcc)-right orbital frontal cortex (OFC) and left ventral caudate-left OFC connectivity compared to those with no or low exposure. Left NAcc-right OFC connectivity mediated relationship between CT and state anhedonia in MDD. The total altered ventral striatum (VS)-OFC connectivity mediated links between CT and physical trait anhedonia in HC. These findings highlight specific types of anhedonia and the core reward system as targets of CT. Blunted hedonic responses via decreased coupling within core reward system may be involved in the mechanism of depression following CT. Implications for clinical interventions are also discussed.

Impaired set-shifting in drug-naïve patients with borderline personality disorder: an event-related potentials study.

BACKGROUND: Neurocognitive impairments might play a key role in the development of Borderline Personality Disorder (BPD), however, the pathophysiological mechanism underlying cognitive impairment of BPD is largely unknown. This study was aimed to examine the electrophysiological mechanism of deficits in set-shifting processing in patients with BPD. METHODS: Twenty-seven drug-naïve patients with BPD and twenty-four healthy controls were recruited. Demographic variables and clinical characteristics of all subjects were collected. Behavioral data and event-related potentials (ERPs) were recorded when subjects were performing the task-switching paradigm, which was applied to investigate the set-shifting function. The P2, N2 and P3 components in the task-switching paradigm would be analyzed. RESULTS: Patients with BPD had significantly higher level of impulsivity, depression and anxiety than healthy controls. When performing the switching task, the BPD group had lower P2 amplitude and higher N2 amplitude than the control group. In the BPD group, the P2 latency at Fz electrode in repeat task was correlated positively with the level of depression, and P2 latency at Pz electrode in repeat task and switch task both had significantly negative relationships with the the level of anxiety. LIMITATIONS: This cross-sectional designed study did not clarify the causal relationship of the electrophysiological characteristics and the development of BPD. CONCLUSIONS: Patients with BPD might have abnormal brain activities when overcoming the inhibition of current task and inhibiting the effects of prior task, and their top-down control function might be impaired. These findings provide some useful clues for the underlying pathophysiological mechanism of BPD.

The MAOA Gene Influences the Neural Response to Psychosocial Stress in the Human Brain.

The stress response is regulated by many mechanisms. Monoamine oxidase A (MAOA) has been related to many mental illnesses. However, few studies have explored the relationship between MAOA and acute laboratory-induced psychosocial stress with functional magnetic resonance imaging (fMRI). In the current study, the Montreal Imaging Stress Task (MIST) and fMRI were used to investigate how MAOA influences the stress response. Increased cortisol concentrations were observed after the task; functional connectivity between the bilateral anterior hippocampus and other brain regions was reduced during stress. MAOA-H allele carriers showed greater deactivation of the right anterior hippocampus and greater cortisol response after stress than did MAOH-L allele carriers. Hippocampal deactivation may lead to disinhibition of the hypothalamic-pituitary-adrenal (HPA) axis and the initiation of stress hormone release under stress. Our results suggest that the MAOA gene regulates the stress response by influencing the right anterior hippocampus.

Networks Are Associated With Depression in Patients With Parkinson's Disease: A Resting-State Imaging Study.

BACKGROUND: Disturbance of networks was recently proposed to be associated with the occurrence of depression in Parkinson's disease (PD). However, the neurobiological mechanism of depression underlying PD remains unclear. OBJECTIVE: This study was conducted to investigate whether intra-network and inter-network brain connectivity is differently changed in PD patients with and without depression (PDD and PDND patients, respectively). METHODS: Forty-one PDD patients, 64 PDND patients, and 55 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (fMRI). The default mode network (DMN), executive control network (ECN), salience network (SN), precuneus network (PCUN), and sensorimotor network (SMN) were extracted using independent component analysis (ICA), and then the functional connectivity (FC) values within and between these networks were measured. RESULTS: PDD patients exhibited abnormal FC values within the DMN, ECN, SN, PCUN, and SMN. In addition, PDD patients demonstrated decreased connectivity between anterior SN (aSN) and bilateral ECN, between posterior SN (pSN) and dorsal DMN (dDMN), and between PCUN and dDMN/SMN/bilateral ECN. Connectivity within the left hippocampus of dDMN and the right medial superior frontal gyrus of aSN was a significant predictor of depression level in PD patients. CONCLUSIONS: Aberrant intra- and inter-network FC is involved in several important hubs in the large-scale networks, which can be a biomarker for distinguishing PDD from PDND.

Functional connectivity within the salience network differentiates autogenous- from reactive-type obsessive-compulsive disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. To better understand and treat patients, symptomatology of OCD has been categorized into more homogenous symptom dimensions. The autogenous-reactive classification model has proven helpful in the elucidation of the neurobiological substrates for clinical heterogeneity in OCD. The purpose of the current study was to systematically compare regional and network functional alterations between OCD subtypes based on the autogenous-reactive model. METHODS: Autogenous-type OCD patients (OCD-AO, n = 40), reactive-type patients (OCD-RO, n = 42), and healthy controls (HC, n = 70) underwent functional magnetic resonance imaging (fMRI) scans. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) were compared among subjects. Areas of abnormal local spontaneous brain activity that differentiated OCD-AO and OCD-RO patients were identified and entered as seeds in functional connectivity (FC) analysis. RESULTS: Compared to OCD-RO patients and HC participants, OCD-AO patients showed increased ALFF in the left anterior insula (AI), increased ReHo in the right AI, and hyperconnectivity between bilateral AI and anterior cingulate cortex (ACC). Both OCD-AO and OCD-RO patients shared regional function deficits in several areas within the prefrontal cortex, and stronger FC between bilateral AI and major nodes of the default mode network (DMN) compared to healthy controls. CONCLUSION: The current results suggest that aberrant functional interaction between the salience network (SN) and the DMN may represent a common substrate in the pathophysiology of OCD, while impaired functional coupling within the SN is distinct to autogenous-type OCD patients. These findings provide further neurobiological evidence to support the autogenous-reactive classification model and contribute to the understanding of the neurobiological basis for clinical heterogeneity in OCD.

Structural and Functional Connectivity of the Anterior Cingulate Cortex in Patients With Borderline Personality Disorder.

BACKGROUND: Emerging evidences supported the hypothesis that emotional dysregulation results from aberrant connectivity within the fronto-limbic neural networks in patients with borderline personality disorder (BPD). Considering its important role in emotional regulation, the anterior cingulate cortex (ACC) has not yet been fully explored in BPD patients. Therefore, using the seed-based resting state functional connectivity (rsFC) and probabilistic fiber tracking, we aimed to explore the alterations of functional and structural connectivity (SC) of the ACC in patients with BPD. METHODS: A cohort of 50 unmedicated, young BPD patients and 54 sex-, age-, and education-matched healthy controls (HCs) completed psychological tests and underwent rs-fMRI and diffuse tensor imaging (DTI) scanning. Rs-FC analysis and probabilistic fiber tracking were used to plot SC and FC of the ACC. RESULTS: With the left ACC selected as a seed, BPD patients exhibited increased rsFC and abnormal SC with the right middle frontal gyrus (MFG), and decreased rsFC with the left middle temporal gyrus (MTG), compared with HCs. Additionally, negative cognitive emotion regulation and depressive symptoms both correlated negatively with the rsFC of the left ACC in BPD patients. CONCLUSION: Abnormal SC and FC of the ACC underlie the deficient emotional regulation circuitry in BPD patients. Such alterations may be important biomarkers of BPD and thus could point to potential BPD treatment targets.