Chia, Kai Xin; (2019) Altered Intrinsic Connectivity in the Default Mode Network and Central Executive Network in Borderline Personality Disorder and Low Resilient Functioning. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Background. Recent synthesis of neuroimaging evidence proposed that aberrant intrinsic functional connectivity in three large-scale neurocognitive networks; the default mode network, salience network, and central executive network, contributes to psychopathology. Current findings from rest-state functional magnetic resonance imaging (fMRI) studies on borderline personality disorder (BPD) were inconsistent and limited to BPD-specific differences. Objective. The study aims to identify resting-state intrinsic functional connectivity differences in BPD. The secondary aim was to explore resting-state intrinsic functional connectivity associated with resilience. Method. Resting-state fMRI scans were obtained from 66 participants (29 healthy controls and 37 individuals with BPD). Group independent component analysis was conducted to examine intrinsic functional connectivity within and between the default mode network, salience network and central executive network associated with group and resilient functioning. Resilience was quantified as the residual resulting from the difference between the participant’s predicted and observed psychopathology symptoms, based on the severity of their self-reported childhood trauma. The participant’s predicted psychopathology symptoms were derived from a linear regression model which examined the relationship between psychopathology and childhood trauma (N = 198; 111 individuals with BPD and 87 healthy controls). Results. Healthy individuals showed increased intrinsic functional connectivity within the bilateral precuneus compared to individuals with BPD, p < .05, false discovery rate (FDR) corrected, and these group differences remained after controlling for childhood trauma and psychopathology symptoms. Higher resilient functioning in the healthy individuals was associated with decreased intrinsic functional connectivity within the left ventral central executive network, p < .05, FDR corrected. Furthermore, the association between decreased intrinsic functional connectivity in the anterior cingulate and high resilient functioning were only replicated in the healthy individuals and not in the BPD group. Conclusion. Preliminary findings suggest different patterns of intrinsic functional connectivity within the default mode network and central executive network between healthy individuals and individuals with BPD. Implicated regions were associated with self-referential processing, autobiographical memory and cognitive control. The findings contribute to future investigations on BPD-specific differences and general resilience mechanisms in intrinsic brain architecture.

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