Changes in brain activities seen on functional magnetic resonance imaging (fMRI) during autobiographical tasks in patients with borderline personality disorder.

The objective of the present study is to investigate with fMRI the differences in brain functioning between BPD patients and healthy controls during a task of autobiographical memory. In particular, we evaluated brain functioning in patients with identity diffusion, a core psychopathological factor of BPD that had not been assessed in previous investigations. Based on recent findings about neural correlates involved in patients with BPD during autobiographical memories we hypothesised that BPD patients with a deficit in identity integration may present a higher brain activation in dorsolateral prefrontal cortex, insula, anterior cingulate cortex, and temporal parietal junction during the recall of significant life events, both resolved and unresolved, in comparison with controls. Patients with a diagnosis of BPD and a group of healthy subjects will be enrolled. Assessment will be performed only on one occasion (baseline). Autobiographical Interview will be performed to all subjects a week before MRI by an expert clinician (psychiatrist). The duration of interview will be about 90 minutes. Autobiographical Interview will allow to obtain 2 unresolved life events and 2 resolved life events. For each event subjects will provide 4 key-words that will be used to trigger active recall during fMRI. All subjects will undergo a training session immediatly before fMRI. fMRI will be performed by a radiologist. During assessment, patients and controls will choose 4 neutral events from a pool of brief reports/events (24-26 words).Each report/event has 4 key-words. This pool of reports was previously administered to 100 subjects, who indicated what reports were neutral. Only reports that > 80% of subjects considered neutral will use in the task as resting condition. Study will be a bloch design characterized by the following conditions: - activation condition: presentation with eye-glasses a brief summary of life event (24-26 words for each event) for 10 seconds, fixation cross for 10 seconds, key-word event-related for 10 seconds, fixation cross for 10 seconds. - Resting condition: presentation of neutral report/event(24-26 words) for 10 seconds, fixation cross for 10 seconds, key-word report/event related for 10 seconds, fixation cross for 10 seconds. This cycle will be repeated for 32 times. Tasks will be projected from the computer to the specific MRI eye-glassess that patient will wear during fMRI. Activation condition will immediately follow resting condition. MRI registration will continue for all 32 cycle repeats. BPD patients and healthy controls will be undergone activation conditions and resting conditions. Each bloch will last 40 seconds. Functional images will be aquired and compared between patients and controls.