Sensory-affective Interaction and Body Perception in BPD
Final Report Abstract
In this project we examined dysfunctional sensory processing, including body perception and multisensory integration, in Borderline Personality Disorder (BPD), and the relationship of these dysfunctions to BPD symptomatology. In the first funding period, we characterized these phenomena by comparing current and remitted BPD patients, which offered insights into the question whether these dysfunctions are a consequence of the disorder or rather a vulnerability factor. In the second funding period, we further elucidated the identified mechanisms and focused on implications for treatment. We replicated the finding that current BPD patients are characterized by reduced pain perception compared to healthy controls. However, there is a normalization in pain perception when the disorder is in remission. This is only true under neutral conditions, since emotional arousal is associated with impaired pain perception in both current and remitted patients. We identified supra-spinal mechanisms to be involved in pain insensitivity in BPD, while spinal processes appear to remain unaffected. Interestingly, the impairments were also identified for the perception of affective touch, further highlighting that evaluative rather than sensory processes are disturbed in BPD. Moreover, we quantified body perception disturbances in BPD, finding generalized reductions in habitual body ownership as a function of dissociation. The underlying mechanisms appear to involve disturbed multimodal sensory integration, which might also influence pain perception in BPD, offering a potentially relevant clinical target. We found a close interconnection between body perception, dissociation, and pain perception that was further examined in study using transcranial magnetic stimulation. We found that facilitation of neural activity at the temporoparietal junction, which has abnormal function in BPD, is associated with normalization of pain perception in BPD. These preliminary results might pave the way to novel mechanistic treatments of the disorder.
Publications
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(2014). Mechanisms of disturbed emotion processing and social interaction in borderline personality disorder: State of knowledge and research agenda of the German Clinical Research Unit. Borderline Personality Disorder and Emotion Dysregulation, 1(1), 12
Schmahl, C., Herpertz, S. C., Bertsch, K., Ende, G., Flor, H., Kirsch, P., . . . Bohus, M.
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(2014). The importance of synchrony and temporal order of visual and tactile input for illusory limb ownership experiences – An fMRI study applying virtual reality. PLOS ONE, 9(1), e87013
Bekrater-Bodmann, R., Foell, J., Diers, M., Kamping, S., Rance, M., Kirsch, P., . . . Flor, H.
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(2015). Deficits in pain perception in borderline personality disorder: Results from the thermal grill illusion. Pain, 156(10), 2084-2092
Bekrater-Bodmann, R., Chung, B. Y., Richter, I., Wicking, M., Foell, J., Mancke, F., . . . Flor, H.
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(2016). Body plasticity in borderline personality disorder: A link to dissociation. Comprehensive Psychiatry, 69, 36-44
Bekrater-Bodmann, R., Chung, B. Y., Foell, J., Gescher, D. M., Bohus, M., & Flor, H.
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(2017). Das körperliche Selbst bei der Borderline-Persönlichkeitsstörung. Neuro Aktuell, 31(8), 21-23
Löffler A., Bekrater-Bodmann R.
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(2018). Interoception and its interaction with self, other, and emotion processing: Implications for the understanding of psychosocial deficits in borderline personality disorder. Current Psychiatry Reports, 20(4), 28
Löffler, A., Foell, J., & Bekrater-Bodmann, R.
