NEUROTRANSMITTER DYSFUNCTION IN PATIENTS WITH BORDERLINE PERSONALITY DISORDER
Section snippets
Serotonin
Dysfunction in the serotonin (5-HT) system has been associated with self-directed and non–self-directed impulsive aggression. Early evidence for this association emerged from studies of violent suicide attempters and of individuals who had committed violent acts. One of the first approaches to assess the activity of the serotonin 5-HT system was to measure the concentration of the 5-HT metabolite, 5-hydroxyindoleacetic acid (5-HIAA), in the cerebrospinal fluid (CSF). In a study of violent
NEUROCHEMISTRY OF AFFECTIVE INSTABILITY
Although the neurochemistry of affective instability is less understood than that of impulsive aggression, preclinical and clinical research suggests that dysregulations in cholinergic, noradrenergic (NE) or gamma-aminobutyric acid (GABA)-minergic systems may play an important role in affective instability. Also, the instability may result from unstable feedback regulatory systems at the level of neural networks, synaptic neurotransmission, or intracellular signal transduction.
DISCUSSION
Impulsive aggression and affective instability are two traits present in patients with BPD for which evidence associates disturbances with neurotransmitter function. Although each of these traits may contribute individually to certain personality disorders (e. g., impulsive aggression to antisocial personality disorder, or affective instability to histrionic personality disorder), their co-occurrence may particularly predispose to BPD. Certain life experiences, such as ongoing abuse or neglect
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2021, Psychiatry ResearchCitation Excerpt :Based on previous studies indicating that CSP is mediated by γ-aminobutyric acid (GABA) type B neurotransmission (Siebner et al., 1998; Werhahn et al., 1999), the authors suggested that an influence of GABA on the phenomenology of BPD seems plausible, given that GABA is the main inhibitory neurotransmitter, and decreased GABA activity could potentially result in impulsive behaviors and affective instability, both core traits of BPD. Notably, previous studies have found higher amygdala activity as a response to negative stimuli in patients with BPD (Donegan et al., 2003; Herpertz et al., 2000), and high levels of GABA receptors in the amygdala, evidence that suggests a potential influence of GABA in that context (Gurvits et al., 2000). Earlier, Irle et al. found significantly smaller right parietal cortex and hippocampal volumes in a group of female patients with BPD compared to healthy individuals (Irle et al., 2005).
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2020, Personality and Individual DifferencesInflammatory and antioxidant pathway dysfunction in borderline personality disorder
2020, Psychiatry ResearchCitation Excerpt :There is still small knowledge on the pathophysiology and biomarkers of BPD to identify possible therapeutic targets in such a heterogeneous disorder (Schwarz et al., 2011, 2012). Dysfunctions in the regulation of neurotransmitters and hormones have been reported (Gurvits et al., 2000) as well as several genetic variations (Vogel et al., 2012). The most studied factors are the dysfunctional serotonergic regulation (Coccaro et al., 2003, 2010) and the hypothalamic-pituitary-adrenal (HPA) axis over-reactivity (Zimmerman and Choi-Kain, 2009).
Genetic modulation of borderline personality disorder: Systematic review and meta-analysis
2013, Journal of Psychiatric ResearchActivation of the cholinergic anti-inflammatory system in peripheral blood mononuclear cells from patients with Borderline Personality Disorder
2012, Journal of Psychiatric Research
Address reprint requests to Harold W. Koenigsberg, MD, Mount Sinai School of Medicine, Bronx Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468