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ORIGINAL RESEARCH

Impulse control under emotion processing: an fMRI investigation in borderline personality disorder compared to non-patients and cluster-C personality disorder patients Linda van Zutphen 1 & Nicolette Siep 1 & Gitta A. Jacob 2 & Gregor Domes 3,4,5 & Andreas Sprenger 6 & Bastian Willenborg 7 & Rainer Goebel 8,9 & Oliver Tüscher 2,10 & Arnoud Arntz 1,11

# The Author(s) 2019

Abstract Impulsivity is a characteristic syndromal and neurobehavioral feature of borderline personality disorder (BPD). Research suggests an important interaction between high negative emotions and low behavioral inhibition in BPD. However, knowledge about the generalizability across stimulus categories and diagnosis specificity is limited. We investigated neural correlates of hypothesized impaired response inhibition of BPD patients to negative, positive and erotic stimuli, by comparing them to non-patients and cluster-C personality disorder patients. During fMRI scanning, 53 BPD patients, 34 non-patients and 20 cluster-C personality disorder patients completed an affective go/no-go task, including social pictures. BPD patients showed more omission errors than non-patients, independent of the stimulus category. Furthermore, BPD patients showed higher activity in the inferior parietal lobule and frontal eye fields when inhibiting negative versus neutral stimuli. Activity of the inferior parietal lobule correlated positively with the BPD checklist subscale impulsivity. When inhibiting emotional stimuli, BPD patients showed an altered brain activity in the inferior parietal lobe and frontal eye fields, whereas previously shown dysfunctional prefrontal activity was not replicated. BPD patients showed a general responsivity across stimulus categories in the frontal eye fields, whereas effects in the inferior parietal lobe were specific for negative stimuli. Results of diagnosis specificity support a dimensional rather than a categorical differentiation between BPD and cluster-C patients during inhibition of social emotional stimuli. Supported by behavioral results, BPD patients showed no deficiencies in emotionally modulated response inhibition per se but the present findings rather hint at attentional difficulties for emotional information. Keywords BPD . Response inhibition . Impulsivity . Emotion . Neuroimaging Oliver Tüscher and Arnoud Arntz contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11682-019-00161-0) contains supplementary material, which is available to authorized users. * Linda van Zutphen [email protected] 1

2

Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200, MD Maastricht, the Netherlands Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany

3

Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany

4

Freiburg Brain Imaging Cent