First AD

Second AD

A. Hyperactivity of the amygdala and prefontal cortex is characteristic of patients with BPD.

B. Increased acetylcholine activity in the hippocampus and neocortex accounts for impulsive aggression in patients with BPD.

C. Treatment of BPD with oxytocin increases hypermentalization by decreasing activity in the prefrontal cortex. 

D. Use of emotion regulation strategies taught in DBT correlates with decreased activity in the amygdala.

E. fMRI studies show that affective, cognitive, behavioral, and interpersonal difficulties are inherited rather than BPD itself.

 Use of emotion regulation strategies taught in 

 (DBT) correlates with decreased activity in the amygdala.

 of functional MRI (fMRI) findings in persons with borderline personality disorder (BPD) revealed heightened activation during processing of negative emotional stimuli in the left amygdala, left hippocampus, and posterior cingulate cortex as well as diminished activation in prefrontal regions (including the dorsal lateral prefrontal cortex).

 in the insula and less activation in the subgenual anterior cingulate cortex in persons with BPD but did not find amygdala hyperactivity.

Conflicting amygdala results are believed to result from the medication status of research participants because psychoactive drugs attenuate limbic activity. Pharmacologic probes have also shown 

 in the anterior cingulate cortex and orbital frontal cortex in response to serotonergic challenge in impulsive-aggressive and affectively unstable BPD populations, and decreased coupling of resting metabolism between the orbital frontal cortex and the ventral anterior cingulate cortex has been reported.

amygdala hyperactivity at baseline, which correlated with changes in a measure of emotion regulation and increased use of emotion regulation strategies.

 Taken together, these findings highlight that dysfunctional circuits involving hyperactive limbic regions and hypoactive prefrontal modulation-most pronounced in the dorsal lateral prefrontal cortex-represent the anatomical corollaries to BPD.

The Neurobiology of Borderline Personality Disorder

Neural correlates of disturbed emotion processing in borderline personality disorder: a multimodal meta-analysis

2. Ruocco AC, Amirthavasagam S, Choi-Kain LW, McMain SF. 

Neural correlates of negative emotionality in borderline personality disorder: an activation-likelihood-estimation meta-analysis

3. New AS, Hazlett EAB, Buchsbaum AS, et al. 

Amygdala-prefrontal disconnection in borderline personality disorder

4. Goodman M, Carpenter D, Tang CY, et al. 

Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder

This quiz was originally published on February 13, 2017, and has since been updated. -Ed

Borderline Personality

Neuropsychiatry

Personality Disorders

Psychotherapy

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Mini Quiz: Neurobiology of Borderline Personality Disorder

Katherine S. Pier, MD

Lea K. Marin, MD, MPH

Jaime Wilsnack, MA

Marianne Goodman, MD