Psychotherapy Alters Frontolimbic Circuitry in Borderline Personality Disorder

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Transference-focused psychotherapy affected the frontolimbic circuitry in patients with BPD.
Transference-focused psychotherapy affected the frontolimbic circuitry in patients with BPD.

HealthDay News — Transference-focused psychotherapy (TFP) is associated with alterations in frontolimbic circuitry in borderline personality disorder (BPD), according to a study published online recently in Psychiatry and Clinical Neurosciences.

David L. Perez, MD, from Harvard Medical School in Boston, and colleagues examined neural activation associated with, and predictive of, clinical improvement in emotional and behavioral regulation in patients with BPD undergoing TFP. The authors assessed 10 patients with BPD before and after TFP treatment using a within-subjects design.

There were significant treatment-related effects, with relative increased dorsal prefrontal activation and relative decreased ventrolateral prefrontal cortex and hippocampal activation observed following treatment. The researchers found a positive correlation for clinical improvement in constraint with relative increased left dorsal anterior cingulate cortex activation. A positive correlation was seen for clinical improvement in affective lability with left posterior-medial orbitofrontal cortex/ventral striatum activation, while there was a negative correlation with right amygdala/parahippocampal activation. Pre-treatment right dorsal anterior cingulate cortex hypoactivation predicted post-treatment improvements in constraint, while improvements in affective lability were predicted by pre-treatment left posterior-medial orbitofrontal cortex/ventral striatum hypoactivation.

"These preliminary findings demonstrate potential TFP-associated alterations in frontolimbic circuitry and begin to identify neural mechanisms associated with a psychodynamically oriented psychotherapy," the authors write.


  1. Perez DL, Vago DR, Pan H, et al. Frontolimbic neural circuit changes in emotional processing and inhibitory control associated with clinical improvement following transference-focused psychotherapy in borderline personality disorder. Psychiat Clin Neuros. 2015; doi:10.1111/pcn.12357.
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