Table_1_Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity.DOCX

Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it.Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala.Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation.Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected.

背景：边缘型人格障碍在可卡因依赖病例中占19%，然而，这种双重病理状态的理解尚显不足。本研究旨在对双重病理状态进行特征描述，并探寻其功能连通性的相关性，以期深化对其的理解。
方法：我们招募了69名参与者，分为四组：双重病理组（n = 20）、可卡因依赖但无边缘型人格障碍组（n = 19）、边缘型人格障碍但无可卡因依赖组（n = 10）以及健康对照组（n = 20）。我们采用自我报告的量表来衡量冲动性和情绪调节能力。我们采集了静息态fMRI数据，并执行了基于种子点的双侧杏仁核功能连通性分析。
结果：边缘型人格障碍和可卡因依赖作为影响因素，在冲动性和情绪调节方面产生了相反的作用，以及左侧杏仁核与内侧前额叶皮层之间功能连通性的影响。另一方面，在右侧杏仁核与左侧颞叶皮层之间的功能连通性中，同时具有两种疾病的效应反而表现为累加，降低了功能连通性的强度。显著的功能连通性簇与冲动性和情绪调节能力相关。
结论：在本研究中，我们发现双重病理状态患者的临床评分更接近于无药物依赖的边缘型人格障碍患者，而非无边缘型人格障碍的可卡因依赖患者，而双重病理状态患者的杏仁核-内侧前额叶皮层功能连通性模式与预期相比，更接近健康对照组。