Emotionally painful:insights in pain-related conditions with anomalies in emotion processing and regulation

Emotions and pain are inherent to human experience, and both are related. For example, it is known that the intensity of pain can be modified by the emotions experienced. Nevertheless, the relationship between emotions and pain is not fully understood. The aim of this thesis was to add knowledge on emotions and pain in the context of pain-related conditions with anomalies in emotion processing and regulation. First, the prevalence rates of depression, anxiety and alexithymia in disorders with central sensitization and chronic pain were summarised. We found high prevalence rates for the three psychological conditions in such disorders. Next, we studied the neural correlates of emotion processing and regulation in fibromyalgia, a chronic widespread pain condition. We found that brain connectivity of regions previously related to pain modulation is affected during the processing and regulation of positive and negative emotional stimuli in fibromyalgia. Furthermore, alterations during resting state related to alexithymia were found. Finally, we studied the intrinsic brain connectivity of areas related to emotion regulation in borderline personality disorder, which is characterised by emotion dysregulation and alterations in pain processing. Our study focused on the interaction with cocaine dependence, a frequent comorbidity. Overall, this thesis contributes to a better understanding of disorders characterised by pain and emotion processing and regulation difficulties, and points at future directions to improve the treatment of patients with such conditions. Additionally, it highlights the importance of acknowledging emotions when treating patients with pain conditions

Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity

Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it.Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala.Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation.Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected

A behavioral and brain imaging dataset with focus on emotion regulation of women with fibromyalgia

Fibromyalgia is a chronic condition characterized by widespread pain, as well as numerous symptoms related to central sensitization such as: fatigue, cognitive disturbances, constipation/diarrhea and sensory hypersensitivity. Furthermore, depression and anxiety are prevalent comorbidities, accompanied by emotion processing and regulation difficulties. Although fibromyalgia physiopathology is still not fully understood, neuroimaging research methods have shown brain structural and functional alterations as well as neuroinflammation abnormalities. We believe that open access to data may help fibromyalgia research advance more. Here, we present an open dataset of 33 fibromyalgia female patients and 33 paired healthy controls recruited from a Mexican population. Dataset includes demographic, clinical, behavioural and magnetic resonance imaging (MRI) data. The MRI data consists of: structural (T1- and T2- weighted) and functional (task-based and resting state) sequences. The task was an emotion processing and regulation task based on visual stimuli. The MRI data contained in the repository are unprocessed, presented in Brain Imaging Data Structure (BIDS) format and available on the OpenNeuro platform for future analysis

Emo-Fibro: dataset of woman with fibromyalgia

Demographic, clinical and behavioral data from 33 women with fibromyalgia and 33 healthy controls

Emo-Fibro: dataset of woman with fibromyalgia

Demographic, clinical and behavioral data from 33 women with fibromyalgia and 33 healthy controls

Comorbid personality disorders and their impact on the presentation of severe dissociative experiences in patients with borderline personality disorder in Mexican patients

The objective of this study was to identify personality disorders comorbid to BPD that confer greater risk for the presence of severe dissociative experiences. Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders (SCID-II), the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES). Our results show that the most frequent personality disorders comorbid to BPD were paranoid (83.2%, n = 263) and depressive (81.3%, n = 257). On average, the patients scored with 43.3 points and 28.6 points in the BEST and DES scales respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences. The results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD

Comorbid personality disorders and their impact on the presentation of severe dissociative experiences in patients with borderline personality disorder in Mexican patients

The objective of this study was to identify personality disorders comorbid to BPD that confer greater risk for the presence of severe dissociative experiences. Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders (SCID-II), the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES). Our results show that the most frequent personality disorders comorbid to BPD were paranoid (83.2%, n = 263) and depressive (81.3%, n = 257). On average, the patients scored with 43.3 points and 28.6 points in the BEST and DES scales respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences. The results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD

Table_2_Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity.DOCX

<p>Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it.</p><p>Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala.</p><p>Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation.</p><p>Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected.</p

Table_1_Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity.DOCX

<p>Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it.</p><p>Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala.</p><p>Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation.</p><p>Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected.</p