Williams2006missinglinksBPD20879703

Williams2006missinglinksBPD20879703 - Research Paper...

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J Psychiatry Neurosci 2006;31(3) 181 Objective: Symptoms of borderline personality disorder (BPD) may reflect distinct breakdowns in the integration of posterior and frontal brain networks. We used a high temporal resolution measure (40-Hz gamma phase synchrony) of brain activity to examine the connec- tivity of brain function in BPD. Methods: Unmedicated patients with BPD ( n = 15) and age- and sex-matched healthy control subjects ( n = 15) undertook a task requiring discrimination of salient from background tones. In response to salient stimuli, the magnitude and la- tency of peak gamma phase synchrony for early (0–150 ms post stimulus) and late (250–500 ms post stimulus) phases were calculated for frontal and posterior regions and for left and right hemispheres. We recorded skin conductance responses (SCRs) and reaction time (RT) simultaneously to examine the contribution of arousal and performance. Results: Compared with controls, patients with BPD had a significant delay in early posterior gamma synchrony and a reduction in right hemisphere late gamma synchrony in response to salient stimuli. Both SCR onset and RT were also delayed in BPD, but independently from differences in synchrony. The delay in posterior syn- chrony was associated with cognitive symptoms, and reduced right hemisphere synchrony was associated with impulsivity. Conclu- sions: These findings suggest that distinct impairments in the functional connectivity of neural systems for orienting to salient input un- derlie core dimensions of cognitive disturbance and poor impulse control in BPD. Objectif : Des symptômes de trouble limite de la personnalité (TLP) peuvent refléter des ruptures distinctes de l’intégration des réseaux cérébraux postérieur et frontal. Nous avons utilisé une mesure à haute résolution temporale (synchronisme de phase gamma de 40 Hz) de l’activité cérébrale pour étudier la connectivité des fonctions cérébrales dans des cas de TLP. Méthodes : Des patients non médica- mentés et ayant un TLP ( n = 15), jumelés selon l’âge et le sexe avec des sujets témoins en bonne santé ( n = 15), ont entrepris une tâche exigeant la discrimination des tons de premier plan de ceux de l’arrière-plan. En réponse aux stimuli de premier plan, on a calculé l’ordre de grandeur et la latence du synchronisme de pointe en phase gamma des phases précoce (0–150 ms après le stimulus) et tar- dive (250–500 ms après le stimulus) pour les régions frontale et postérieure et les hémisphères gauche et droit. Nous avons consigné si- multanément des réponses de la conduction cutanée (RCC) et le temps de réaction (TR) pour analyser la contribution de l’éveil et le ren- dement. Résultats : Comparativement aux sujets témoins, les patients qui avaient un TLP présentaient un retard important du synchronisme gamma postérieur précoce et une réduction du synchronisme gamma tardif de l’hémisphère droit en réponse à des stimuli de premier plan. L’apparition des RCC et le TR étaient aussi retardés chez les sujets qui avaient un TLP, mais indépendamment des dif-
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