Interaction of neuroimaging and treatment in borderline personality disorder

In borderline personality disorder, several symptom domains can be characterized whose underlying mechanisms are amenable to neurobiological characterization. These include disturbance of emotion regulation, impulsivity, dissociation, and difficulties in social interaction and these domains have been the focus of experimentally oriented research in recent years. Another focus of recent research is the integration of improved neurobiological knowledge into psychotherapy development. Here, neurobiological investigation methods such as functional imaging can be used to examine therapy results on an additional level. On the one hand, this showed a change of altered activation patterns after successful therapy, e.g. in the amygdala, and on the other hand also a change in the volume of certain brain regions associated with emotion regulation. Modern methods such as real-time fMRI can also be used to train emotion regulation by means of neurofeedback First studies showed not only a decrease of amygdala hyperactivity, but also a transfer into improved emotion regulation in everyday life of the affected persons. Pharmacotherapeutic options for BPD concentrate on amygdala dysfunction as well.